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 Dysmenorrhea constitutes one of the most frequent disorders in women of a fertile age . The objective of this research was to determine the effects of acupressure at Sanyinjiao ( SP6 ) point and DiJi ( SP8 ) point on pain severity of primary dysmenorrhea and the associated systemic symptoms . Material s and methods In this crossover clinical trial , 50 females aged 18–30 years old who met the study criteria and were under the care of Sarpolezahab Health Center were selected . Subjects were r and omly assigned to one of two groups and evaluated during three menstrual cycles . We evaluated pain severity using the McGill pain scale and associated systemic symptoms using a verbal multidimensional scoring system . Data acquired from 42 cases were analyzed using SPSS software , with a P value of < 0.05 considered significant . Results The findings of our study indicate that the severity of dysmenorrhea pain diminishes significantly for up to 2 hours following treatment with acupressure at the SP6 and SP8 points ( P < 0.001 ) . Furthermore , the severity of associated systemic symptoms reduced significantly after acupressure at the SP6 and SP8 points , except for nausea and vomiting . Comparison of the severity of systemic symptoms with acupressure at the SP6 and SP8 points revealed no significant difference except for severity of fatigue , which was reduced significantly further with SP6 point compared to SP8 point ( P = 0.004 ) . Conclusion Acupressure at the SP6 and SP8 points can reduce pain severity of dysmenorrhea for up to 2 hours after application , and these points may be used to alleviate the severity of systemic symptoms accompanying dysmenorrhea OBJECTIVES The aim of this study was to evaluate the effects of auricular acupressure on relieving menstrual symptoms and decreasing nitric oxide ( NO ) for women with primary dysmenorrhea . DESIGN This was a r and omized clinical trial comparing the effects of auricular acupressure by seed-pressure method and placebo adhesive patch . SETTING Setting s included colleges in northern and central Taiwan . SUBJECTS Serum CA-125 testing was used as a screening test for primary dysmenorrhea ( < 35 mg/dL ) . The study included 36 college females r and omized to acupressure group , 35 to control group . INTERVENTIONS The acupressure group received auricular acupressure by seed-pressure method on liver ( CO12 ) , kidney ( CO10 ) , and endocrine ( CO18 ) acupoints . The control group had a plain adhesive patch placed on the same acupoints with no seed attached . Acupressure protocol included massaging 15 times on each acupoint , 3 times a day , for a total of 20 days . OUTCOME MEASURES Primary : Short-form Menstrual Distress Question naire ( MDQs ) . Secondary : blood sample of NO . Assessment s of MDQs and NO were performed at baseline and within the first 2 days of their next menses ( after completion of 20 days of acupressure ) . RESULTS In the acupressure group , the overall menstrual symptoms ( 95 % confidence interval [ CI ] = -49.8 to -6.5 , effect size [ ES ] = 0.43 , p = 0.01 ) and two subscales , menstrual pain ( 95 % CI = -16.4 -to -2.2 , ES = 0.45 , p = 0.01 ) and negative affects ( 95 % CI = -11.9 - 2.0 , ES = 0.38 , p = 0.04 ) , revealed that menstrual symptoms decreased significantly after auricular acupressure by the seed-pressure method . The ES for the MDQs were in favor of the auricular acupressure by seed-pressure method . NO level increased in the acupressure group , although this difference did not achieve statistical significance ( p > 0.05 ) . CONCLUSIONS This study supports the effects of auricular acupressure by seed-pressure method in improving menstrual symptoms , and offers a noninvasive complementary therapy for women with primary dysmenorrhea The present study aims at comparing the effects of acupressure using new combination of acupoints , and Ibuprofen on the severity of  primary dysmenorrhea ( PD ) . 216 female high school students , aged between 14 to 18 years , were r and omly selected and divided into three groups . Each group underwent different treatment techniques : acupressure , Ibuprofen and sham acupressure as a placebo . The results indicated that the three therapeutic techniques were significantly effective in reducing the pain . However the therapeutic efficacies of acupressure and Ibuprofen were similar with no significant difference , and were significantly better than the placebo . Thus acupressure , with no complications , is recommended as an alternative and also a better choice in the decrease of the severity of PD AIM This paper presents the findings of a study that assessed the effects of acupressure at the Sanyinjiao point on symptoms of primary dysmenorrhoea among adolescent girls . BACKGROUND Dysmenorrhoea is the most common gynaecological disorder among adolescents . Traditional Chinese acupressure derived from acupuncture is a non-invasive technique . Despite renewed interest in the use of acupressure , relatively few studies have been undertaken to examine its effects on primary dysmenorrhoea . METHODS An experimental study was conducted between December 2000 and August 2001 . Participants were female students attending a technical college in Taiwan . None of the 69 participants had a prior history of gynaecological disease or secondary dysmenorrhoea , and all were rated higher than five for pain on a visual analogue scale from 0 to 10 . The experimental group ( n = 35 ) received acupressure at Sanyinjiao ( above the ankle ) while the control group ( n = 34 ) rested for 20 min , while the control group underwent rest in the school health centre for 20 min without receiving acupressure .  Fifty participants ( 30 experimental , 20 control ) completed the 4 - 6-week follow-up session . Five instruments were used to collect pretest and post-test data at each session : ( 1 ) Visual Analogue Scale for pain ; ( 2 ) the Short-Form McGill Pain Question naire ; ( 3 ) the Menstrual Distress Question naire ; ( 4 ) the Visual Analogue Scale for anxiety ; and , for the experimental group only , ( 5 ) the Acupressure Self- Assessment Form . Data were analysed using the chi-square test , two- sample t-test and repeated measures two-way anova . RESULTS Acupressure at Sanyinjiao during the initial session reduced the pain and anxiety typical of dysmenorrhoea . In the self-treatment follow-up session , acupressure at Sanyinjiao significantly reduced menstrual pain but not anxiety . Thirty-one ( 87 % ) of the 35 experimental participants reported that acupressure was helpful , and 33 ( 94 % ) were satisfied with acupressure in terms of its providing pain relief and psychological support during dysmenorrhoea . CONCLUSION The findings suggest that acupressure at Sanyinjiao can be an effective , cost-free intervention for reducing pain and anxiety during dysmenorrhoea , and we recommend its use for self-care of primary dysmenorrhoea Background Deqi is a central concept in traditional Chinese acupuncture . We performed a secondary analysis on data from a larger r and omized controlled trial ( RCT ) in order to assess the effect of acupuncture on deqi traits and pain intensity in primary dysmenorrhea . Methods A total of 60 primary dysmenorrhea patients were enrolled and r and omly assigned to one of three treatment groups . Acupuncture was given at SP6 , GB39 or nonacupoint .  Subjective pain was measured by a 100-mm visual analogue scale ( VAS ) before and after acupuncture . The Massachusetts General Hospital acupuncture sensation scales ( MASS ) with minor modification was used to rate deqi sensations during acupuncture . Results The results showed that VAS scores of pain after acupuncture were significantly decreased comparing to before acupuncture treatment in all three groups ( P = 0.000 ) . However , no significant differences were found among three groups at the beginning or end of acupuncture treatment ( P = 0.928 , P = 0.419 ) . Conclusions There was no statistical difference among three groups in terms of intensity of deqi feeling . The types of sensation were similar across the groups with only minor differences among them . Trial registration Trial registration number : Controlled-Trials.com IS RCT N24863192 BACKGROUND AND OBJECTIVE To conduct a pilot study to compare the frequency of errors that accompany single vs. double data extraction , compare the estimate of treatment effect derived from these methods , and compare the time requirements for these methods . METHODS Review ers were r and omized to the role of data extractor or data verifier , and were blind to the study hypothesis . The frequency of errors associated with each method of data extraction was compared using the McNemar test . The data set for each method was used to calculate an efficacy estimate by each method , using st and ard meta-analytic techniques . The time requirement for each method was compared using a paired t-test . RESULTS Single data extraction result ed in more errors than double data extraction ( relative difference : 21.7 % , P = .019 ) . There was no substantial difference between methods in effect estimates for most outcomes . The average time spent for single data extraction  was less than the average time for double data extraction ( relative difference : 36.1 % , P = .003 ) . CONCLUSION In the case that single data extraction is used in systematic review s , review ers and readers need to be mindful of the possibility for more errors and the potential impact these errors may have on effect estimates BACKGROUND Complementary and alternative therapies may be adopted as nursing interventions to alleviate dysmenorrhea and improve productivity , creativity , work performance , and quality of life . OBJECTIVES This study aim ed to evaluate the efficacy of San Yin Jiao ( SP6 ) acupressure as a non-pharmacologic nursing intervention for dysmenorrhea and identify its effects on temperature changes in two related acupoints as an explanatory mechanism of chi circulation . DESIGN A non-equivalent control group pre and post-test design was employed to verify the effects of SP6 acupressure on skin temperature and dysmenorrhea . SETTING AND PARTICIPANTS Young college women with primary dysmenorrhea were recruited from classrooms at two universities in Korea and 58 eligible participants were allotted to either a SP6 acupressure group or placebo group that received light touch on the SP6 acupoint . METHODS The experimental group received acupressure treatment within the first 8h of menstruation , and severity of dysmenorrhea and skin temperature changes in the Zhongwan ( CV2 ) and Qugu ( CV12 ) acupoints were assessed prior to and 30 min , 1 , 2 , and 3h following treatment . RESULTS There was a significant difference in severity of dysmenorrhea between the two groups immediately after ( F=18.50 , p=0.000 ) and for up to 2h ( F=8.04 , p=0.032 ) post treatment . Skin temperature was significantly elevated at 30 min after acupressure at the suprapubic CV2 acupoint in the experimental group compared to the control group . Temperature elevation was also noted at the epigastric CV12 acupoint post treatment but group differences were not significant , indicating that SP6 acupressure relieves dysmenorrhea primarily by temperature elevation in the CV2 pathway . CONCLUSIONS Acupressure to the SP6 meridian can be an effective non-invasive nursing intervention for alleviation of primary dysmenorrhea , with effects lasting 2h post treatment OBJECTIVE To investigate the clinical effectiveness and cost-effectiveness of acupuncture in patients with dysmenorrhea . STUDY DESIGN In a r and omized controlled trial plus non-r and omized cohort , patients with dysmenorrhea were r and omized to acupuncture ( 15 sessions over three months ) or to a control group ( no acupuncture ) . Patients who declined r and omization received acupuncture treatment . All subjects were allowed to receive usual medical care . RESULTS Of 649 women ( mean age 36.1 + /- 7.1 years ) , 201 were r and omized . After three months , the average pain intensity ( NRS 0 - 10 ) was lower in the acupuncture compared to the control group : 3.1 ( 95 % CI 2.7 ; 3.6 ) vs. 5.4 ( 4.9 ; 5.9 ) , difference -2.3 ( -2.9 ; -1.6 ) ; P<.001 . The acupuncture group had better quality of life and higher costs . ( overall ICER 3,011 euros per QALY ) . CONCLUSION Additional acupuncture in patients with dysmenorrhea was associated with improvements in pain and quality of life as compared to treatment with usual care alone and was cost-effective within usual thresholds OBJECTIVES To develop and test the safety and effectiveness of an acupressure garment ( the Relief Brief ) in decreasing the pain and symptom distress associated with dysmenorrhea . DESIGN A r and omized clinical trial applied a 2 ( Relief Brief use or control group ) x 3 ( baseline and two treatment measurement occasions ) mixed factorial design . PARTICIPANTS Sixty-one ( 61 ) women with moderately severe primary dysmenorrhea were r and omly assigned to the st and ard treatment control group  or the  Relief Brief acupressure device group after one pretreat 
    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: Background Dysmenorrhea constitutes one of the most frequent disorders in women of a fertile age . The objective of this research was to determine the effects of acupressure at Sanyinjiao ( SP6 ) point and DiJi ( SP8 ) point on pain severity of primary dysmenorrhea and the associated systemic symptoms . Material s and methods In this crossover clinical trial , 50 females aged 18–30 years old who met the study criteria and were under the care of Sarpolezahab Health Center were selected . Subjects were r and omly assigned to one of two groups and evaluated during three menstrual cycles . We evaluated pain severity using the McGill pain scale and associated systemic symptoms using a verbal multidimensional scoring system . Data acquired from 42 cases were analyzed using SPSS software , with a P value of < 0.05 considered significant . Results The findings of our study indicate that the severity of dysmenorrhea pain diminishes significantly for up to 2 hours following treatment with acupressure at the SP6 and SP8 points ( P < 0.001 ) . Furthermore , the severity of associated systemic symptoms reduced significantly after acupressure at the SP6 and SP8 points , except for nausea and vomiting . Comparison of the severity of systemic symptoms with acupressure at the SP6 and SP8 points revealed no significant difference except for severity of fatigue , which was reduced significantly further with SP6 point compared to SP8 point ( P = 0.004 ) . Conclusion Acupressure at the SP6 and SP8 points can reduce pain severity of dysmenorrhea for up to 2 hours after application , and these points may be used to alleviate the severity of systemic symptoms accompanying dysmenorrhea OBJECTIVES The aim of this study was to evaluate the effects of auricular acupressure on relieving menstrual symptoms and decreasing nitric oxide ( NO ) for women with primary dysmenorrhea . DESIGN This was a r and omized clinical trial comparing the effects of auricular acupressure by seed-pressure method and placebo adhesive patch . SETTING Setting s included colleges in northern and central Taiwan . SUBJECTS Serum CA-125 testing was used as a screening test for primary dysmenorrhea ( < 35 mg/dL ) . The study included 36 college females r and omized to acupressure group , 35 to control group . INTERVENTIONS The acupressure group received auricular acupressure by seed-pressure method on liver ( CO12 ) , kidney ( CO10 ) , and endocrine ( CO18 ) acupoints . The control group had a plain adhesive patch placed on the same acupoints with no seed attached . Acupressure protocol included massaging 15 times on each acupoint , 3 times a day , for a total of 20 days . OUTCOME MEASURES Primary : Short-form Menstrual Distress Question naire ( MDQs ) . Secondary : blood sample of NO . Assessment s of MDQs and NO were performed at baseline and within the first 2 days of their next menses ( after completion of 20 days of acupressure ) . RESULTS In the acupressure group , the overall menstrual symptoms ( 95 % confidence interval [ CI ] = -49.8 to -6.5 , effect size [ ES ] = 0.43 , p = 0.01 ) and two subscales , menstrual pain ( 95 % CI = -16.4 -to -2.2 , ES = 0.45 , p = 0.01 ) and negative affects ( 95 % CI = -11.9 - 2.0 , ES = 0.38 , p = 0.04 ) , revealed that menstrual symptoms decreased significantly after auricular acupressure by the seed-pressure method . The ES for the MDQs were in favor of the auricular acupressure by seed-pressure method . NO level increased in the acupressure group , although this difference did not achieve statistical significance ( p > 0.05 ) . CONCLUSIONS This study supports the effects of auricular acupressure by seed-pressure method in improving menstrual symptoms , and offers a noninvasive complementary therapy for women with primary dysmenorrhea The present study aims at comparing the effects of acupressure using new combination of acupoints , and Ibuprofen on the severity of  primary dysmenorrhea ( PD ) . 216 female high school students , aged between 14 to 18 years , were r and omly selected and divided into three groups . Each group underwent different treatment techniques : acupressure , Ibuprofen and sham acupressure as a placebo . The results indicated that the three therapeutic techniques were significantly effective in reducing the pain . However the therapeutic efficacies of acupressure and Ibuprofen were similar with no significant difference , and were significantly better than the placebo . Thus acupressure , with no complications , is recommended as an alternative and also a better choice in the decrease of the severity of PD AIM This paper presents the findings of a study that assessed the effects of acupressure at the Sanyinjiao point on symptoms of primary dysmenorrhoea among adolescent girls . BACKGROUND Dysmenorrhoea is the most common gynaecological disorder among adolescents . Traditional Chinese acupressure derived from acupuncture is a non-invasive technique . Despite renewed interest in the use of acupressure , relatively few studies have been undertaken to examine its effects on primary dysmenorrhoea . METHODS An experimental study was conducted between December 2000 and August 2001 . Participants were female students attending a technical college in Taiwan . None of the 69 participants had a prior history of gynaecological disease or secondary dysmenorrhoea , and all were rated higher than five for pain on a visual analogue scale from 0 to 10 . The experimental group ( n = 35 ) received acupressure at Sanyinjiao ( above the ankle ) while the control group ( n = 34 ) rested for 20 min , while the control group underwent rest in the school health centre for 20 min without receiving acupressure .  Fifty participants ( 30 experimental , 20 control ) completed the 4 - 6-week follow-up session . Five instruments were used to collect pretest and post-test data at each session : ( 1 ) Visual Analogue Scale for pain ; ( 2 ) the Short-Form McGill Pain Question naire ; ( 3 ) the Menstrual Distress Question naire ; ( 4 ) the Visual Analogue Scale for anxiety ; and , for the experimental group only , ( 5 ) the Acupressure Self- Assessment Form . Data were analysed using the chi-square test , two- sample t-test and repeated measures two-way anova . RESULTS Acupressure at Sanyinjiao during the initial session reduced the pain and anxiety typical of dysmenorrhoea . In the self-treatment follow-up session , acupressure at Sanyinjiao significantly reduced menstrual pain but not anxiety . Thirty-one ( 87 % ) of the 35 experimental participants reported that acupressure was helpful , and 33 ( 94 % ) were satisfied with acupressure in terms of its providing pain relief and psychological support during dysmenorrhoea . CONCLUSION The findings suggest that acupressure at Sanyinjiao can be an effective , cost-free intervention for reducing pain and anxiety during dysmenorrhoea , and we recommend its use for self-care of primary dysmenorrhoea Background Deqi is a central concept in traditional Chinese acupuncture . We performed a secondary analysis on data from a larger r and omized controlled trial ( RCT ) in order to assess the effect of acupuncture on deqi traits and pain intensity in primary dysmenorrhea . Methods A total of 60 primary dysmenorrhea patients were enrolled and r and omly assigned to one of three treatment groups . Acupuncture was given at SP6 , GB39 or nonacupoint .  Subjective pain was measured by a 100-mm visual analogue scale ( VAS ) before and after acupuncture . The Massachusetts General Hospital acupuncture sensation scales ( MASS ) with minor modification was used to rate deqi sensations during acupuncture . Results The results showed that VAS scores of pain after acupuncture were significantly decreased comparing to before acupuncture treatment in all three groups ( P = 0.000 ) . However , no significant differences were found among three groups at the beginning or end of acupuncture treatment ( P = 0.928 , P = 0.419 ) . Conclusions There was no statistical difference among three groups in terms of intensity of deqi feeling . The types of sensation were similar across the groups with only minor differences among them . Trial registration Trial registration number : Controlled-Trials.com IS RCT N24863192 BACKGROUND AND OBJECTIVE To conduct a pilot study to compare the frequency of errors that accompany single vs. double data extraction , compare the estimate of treatment effect derived from these methods , and compare the time requirements for these methods . METHODS Review ers were r and omized to the role of data extractor or data verifier , and were blind to the study hypothesis . The frequency of errors associated with each method of data extraction was compared using the McNemar test . The data set for each method was used to calculate an efficacy estimate by each method , using st and ard meta-analytic techniques . The time requirement for each method was compared using a paired t-test . RESULTS Single data extraction result ed in more errors than double data extraction ( relative difference : 21.7 % , P = .019 ) . There was no substantial difference between methods in effect estimates for most outcomes . The average time spent for single data extraction  was less than the average time for double data extraction ( relative difference : 36.1 % , P = .003 ) . CONCLUSION In the case that single data extraction is used in systematic review s , review ers and readers need to be mindful of the possibility for more errors and the potential impact these errors may have on effect estimates BACKGROUND Complementary and alternative therapies may be adopted as nursing interventions to alleviate dysmenorrhea and improve productivity , creativity , work performance , and quality of life . OBJECTIVES This study aim ed to evaluate the efficacy of San Yin Jiao ( SP6 ) acupressure as a non-pharmacologic nursing intervention for dysmenorrhea and identify its effects on temperature changes in two related acupoints as an explanatory mechanism of chi circulation . DESIGN A non-equivalent control group pre and post-test design was employed to verify the effects of SP6 acupressure on skin temperature and dysmenorrhea . SETTING AND PARTICIPANTS Young college women with primary dysmenorrhea were recruited from classrooms at two universities in Korea and 58 eligible participants were allotted to either a SP6 acupressure group or placebo group that received light touch on the SP6 acupoint . METHODS The experimental group received acupressure treatment within the first 8h of menstruation , and severity of dysmenorrhea and skin temperature changes in the Zhongwan ( CV2 ) and Qugu ( CV12 ) acupoints were assessed prior to and 30 min , 1 , 2 , and 3h following treatment . RESULTS There was a significant difference in severity of dysmenorrhea between the two groups immediately after ( F=18.50 , p=0.000 ) and for up to 2h ( F=8.04 , p=0.032 ) post treatment . Skin temperature was significantly elevated at 30 min after acupressure at the suprapubic CV2 acupoint in the experimental group compared to the control group . Temperature elevation was also noted at the epigastric CV12 acupoint post treatment but group differences were not significant , indicating that SP6 acupressure relieves dysmenorrhea primarily by temperature elevation in the CV2 pathway . CONCLUSIONS Acupressure to the SP6 meridian can be an effective non-invasive nursing intervention for alleviation of primary dysmenorrhea , with effects lasting 2h post treatment OBJECTIVE To investigate the clinical effectiveness and cost-effectiveness of acupuncture in patients with dysmenorrhea . STUDY DESIGN In a r and omized controlled trial plus non-r and omized cohort , patients with dysmenorrhea were r and omized to acupuncture ( 15 sessions over three months ) or to a control group ( no acupuncture ) . Patients who declined r and omization received acupuncture treatment . All subjects were allowed to receive usual medical care . RESULTS Of 649 women ( mean age 36.1 + /- 7.1 years ) , 201 were r and omized . After three months , the average pain intensity ( NRS 0 - 10 ) was lower in the acupuncture compared to the control group : 3.1 ( 95 % CI 2.7 ; 3.6 ) vs. 5.4 ( 4.9 ; 5.9 ) , difference -2.3 ( -2.9 ; -1.6 ) ; P<.001 . The acupuncture group had better quality of life and higher costs . ( overall ICER 3,011 euros per QALY ) . CONCLUSION Additional acupuncture in patients with dysmenorrhea was associated with improvements in pain and quality of life as compared to treatment with usual care alone and was cost-effective within usual thresholds OBJECTIVES To develop and test the safety and effectiveness of an acupressure garment ( the Relief Brief ) in decreasing the pain and symptom distress associated with dysmenorrhea . DESIGN A r and omized clinical trial applied a 2 ( Relief Brief use or control group ) x 3 ( baseline and two treatment measurement occasions ) mixed factorial design . PARTICIPANTS Sixty-one ( 61 ) women with moderately severe primary dysmenorrhea were r and omly assigned to the st and ard treatment control group  or the  Relief Brief acupressure device group after one pretreat 
    Output:
    