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: Adipose tissue ( AT ) fatty acid ( FA ) composition partly reflects habitual dietary intake . Circulating NEFA are mobilised from AT and might act as a minimally invasive surrogate marker of AT FA profile . Agreement between twenty-eight FA in AT and plasma NEFA was assessed using concordance coefficients in 204 male and female participants in a 12-month intervention using supplements to increase the intake of EPA and DHA . Concordance coefficients generally showed very poor agreement between AT FA and plasma NEFA at baseline SFA : 0·07 ; MUFA : 0·03 ; n-6 PUFA : 0·28 ; n-3 PUFA : 0·01 ) . Participants were r and omly divided into training ( 70 % ) and validation ( 30 % ) data sets , and models to predict AT and dietary FA were fitted using data from the training set , and their predictive ability was assessed using data from the validation set . AT n-6 PUFA and SFA were predicted from plasma NEFA with moderate accuracy ( mean absolute percentage error n-6 PUFA : 11 % and SFA : 8 % ) , but predicted values were unable to distinguish between low , medium and high FA values , with only 25 % of n-6 PUFA and 33 % of SFA predicted values correctly assigned to the appropriate tertile group . Despite an association between AT and plasma NEFA EPA ( P=0·001 ) and DHA ( P=0·01 ) at baseline , there was no association after the intervention . To conclude , plasma NEFA are not a suitable surrogate for AT FA Background : To test whether supplementary antioxidants and n–3 fatty acids , alone or in combination , could improve functional status in stroke survivors . Methods : We performed a r and omized , double-blind , placebo-controlled clinical trial in 72 stroke patients ( 47 males ; age 65.3 ± 12.9 years ) admitted to a rehabilitation hospital for sequelae of first-ever ischemic stroke , and divided them into 4 subgroups . Group 1 patients received daily oral antioxidants , group 2 received n–3 polyunsaturated fatty acids , group 3 both supplements , and group 4 placebo , all for 12 months . No difference at baseline was observed among groups in neurological severity or in disability . All measures were repeated after 6 and 12 months of treatment . All major clinical events were recorded . Results : At baseline , 25 % of the patients had a low plasma vitamin status , and 48.5 % was at risk of undernutrition . At the 1-year follow-up , we observed a trend for lower mortality ( p = 0.060 ) in subgroups treated with n–3 fatty acids , but without significant differences in rehabilitation result status among groups . Conclusions : Malnutrition is widely observed in patients admitted to a rehabilitative hospital for stroke rehabilitation , and dietary supplementation , even if not able to improve rehabilitation results , is likely to reduce mortality at the 1-year follow-up Background Some studies have suggested an association between omega-3 long-chain polyunsaturated fatty acids ( n-3 LC PUFAs ) and better cognitive outcomes in older adults . To date , only two r and omised , controlled trials have assessed the effect of n-3 LC PUFA supplementation on cognitive function in older cognitively healthy population s. Of these trials only one found a benefit , in the subgroup carrying the ApoE-ε4 allele . The benefits of n-3 LC PUFA supplementation on cognitive function in older normal population s thus still remain unclear . The main objective of the current study was to provide a comprehensive assessment of the potential of n-3 LC PUFAs to slow cognitive decline in normal elderly people , and included ApoE-ε4 allele carriage as a potential moderating factor . The detailed methodology of the trial is reported herein . Methods The study was a parallel , 18-month , r and omised , double-blind , placebo-controlled intervention with assessment at baseline and repeated 6-monthly . Participants ( N = 391 , 53.7 % female ) aged 65 - 90 years , English-speaking and with normal cognitive function , were recruited from metropolitan Adelaide , South Australia . Participants in the intervention arm received capsules containing fish-oil at a daily dosage of 1720 mg of docosahexaenoic acid and 600 mg of eicosapentaenoic acid while the placebo arm received the equivalent amount of olive oil in their capsules . The primary outcome is rate of change in cognitive performance , as measured by latent variables for the cognitive constructs ( encompassing Reasoning , Working Memory , Short-term Memory , Retrieval Fluency , Inhibition , Simple and Choice-Reaction Time , Perceptual Speed , Odd-man-out Reaction Time , Speed of Memory Scanning , and Psychomotor Speed ) and assessed by latent growth curve modeling . Secondary outcomes are change in the Mini-mental State Examination , functional capacity and well-being ( including health status , depression , mood , and self-report cognitive functioning ) , blood pressure , and biomarkers of n-3 LC PUFA status , glucose , lipid metabolism , inflammation , oxidative stress , and DNA damage . Trial registration Australia and New Zeal and Clinical Trials Register ( ANZCTR ) : OBJECTIVES To study the effects of omega (Omega)-3 fatty acid ( FA ) supplements on weight and appetite in patients with mild to moderate Alzheimer 's disease ( AD ) in relation to inflammatory biomarkers and apolipoprotein E epsilon4 ( APOEepsilon4 ) . DESIGN R and omized , double-blind , placebo-controlled trial . SETTING Specialist memory clinics in the Stockholm catchment area . PARTICIPANTS Two hundred four patients ( aged 73+/-9 , 52 % women ) with mild to moderate AD . INTERVENTION Patients with AD received 1.7 g of docosahexaenoic acid ( DHA ) and 0.6 g of eicosapentaenoic acid ( EPA ) ( Omega-3/Omega-3 group ; n=89 , aged 73+/-9 , 57 % women ) or placebo 0.6 g of linoleic acid per day ( placebo/Omega-3 group ; n=85 , aged 73+/-9 , 46 % women ) for 6 months . After 6 months , all patients received DHA and EPA for another 6 months . MEASUREMENTS Anthropometry , biochemical nutritional and inflammatory markers , and appetite assessed by caregiver . RESULTS Mean weight and body mass index ( kg/m(2 ) ) at baseline were 70.0+/-11.8 kg and 24.3+/-3.0 kg/m(2 ) , respectively . At 6- and 12-month follow-up , weight had increased 0.7+/-2.5 kg ( P=.02 ) and 1.4+/-2.9 kg ( P<.001 ) in the Omega-3/Omega-3 group . In the placebo group , weight was unchanged at 6 months but had increased ( P=.01 ) at 12 months follow-up after Omega-3 supplementation was initiated . Appetite improved in the Omega-3/Omega-3 group over the treatment period ( P=.01 ) . In logistic regression analyses , not carrying the APOEepsilon4 allele and high plasma DHA concentrations were independently related to weight gain in the combined group of patients at 6 months follow-up . CONCLUSION A DHA-enriched Omega-3 FA supplement may positively affect weight and appetite in patients with mild to moderate AD . Not carrying the APOEepsilon4 allele and high DHA were independently associated with weight gain Depressive symptoms may increase the risk of progressing from mild cognitive impairment ( MCI ) to dementia . Consumption of n-3 PUFA may alleviate both cognitive decline and depression . The aim of the present study was to investigate the benefits of supplementing a diet with n-3 PUFA , DHA and EPA , for depressive symptoms , quality of life ( QOL ) and cognition in elderly people with MCI . We conducted a 6-month double-blind , r and omised controlled trial . A total of fifty people aged > 65 years with MCI were allocated to receive a supplement rich in EPA ( 1·67 g EPA + 0·16 g DHA/d ; n 17 ) , DHA ( 1·55 g DHA + 0·40 g EPA/d ; n 18 ) or the n-6 PUFA linoleic acid ( LA ; 2·2 g/d ; n 15 ) . Treatment allocation was by minimisation based on age , sex and depressive symptoms ( Geriatric Depression Scale , GDS ) . Physiological and cognitive assessment s , question naires and fatty acid composition of erythrocytes were obtained at baseline and 6 months ( completers : n 40 ; EPA n 13 , DHA n 16 , LA n 11 ) . Compared with the LA group , GDS scores improved in the EPA ( P=0·04 ) and DHA ( P=0·01 ) groups and verbal fluency ( Initial Letter Fluency ) in the DHA group ( P=0·04 ) . Improved GDS scores were correlated with increased DHA plus EPA ( r 0·39 , P=0·02 ) . Improved self-reported physical health was associated with increased DHA . There were no treatment effects on other cognitive or QOL parameters . Increased intakes of DHA and EPA benefited mental health in older people with MCI . Increasing n-3 PUFA intakes may reduce depressive symptoms and the risk of progressing to dementia . This needs to be investigated in larger , depressed sample s with MCI Background / Objectives : This study aims to increase knowledge regarding the association of sarcopenia with hospitalization costs among a wide-ranging sample of adult hospitalized patients .Subjects/ Methods : A prospect i ve study was conducted among hospitalized adult patients . Sarcopenia was identified according to the European Working Group on Sarcopenia in Older People , as low muscle mass , assessed by bioelectrical impedance analysis and low muscle function evaluated by h and grip strength .  Hospitalization cost was calculated for each patient based on discharge diagnosis-related group codes and determined on the basis of a relative weight value . Costs were defined as the percentage of deviation from the cost of a patient with a relative weight equal to one . Multivariable linear regression models were performed to identify the factors independently associated with hospitalization costs . Results : A total of 656 hospitalized patients aged ⩾18 years ( 24.2 % sarcopenic ) composed the study sample . Sarcopenia increased hospitalization costs by [ euro ] 1240 ( 95 % confidence interval ( CI ) : [ euro ] 596–1887 ) for patients aged < 65 years and [ euro ] 721 ( 95 % CI : [ euro ] 13–1429 ) for patients aged ⩾65 years . Sarcopenic overweight was related to an increase in hospitalization costs of [ euro ] 884 ( 95 % CI : [ euro ] 295–1476 ) . Conclusions : Sarcopenia is independently related to hospitalization costs . This condition is estimated to increase hospitalization costs by 58.5 % for patients aged < 65 years and 34 % for patients aged ⩾65 years BACKGROUND Age-associated declines in muscle mass and function are major risk factors for an impaired ability to carry out activities of daily living , falls , prolonged recovery time after hospitalization , and mortality in older adults . New strategies that can slow the age-related loss of muscle mass and function are needed to help older adults maintain adequate performance status to reduce these risks and maintain independence . OBJECTIVE We evaluated the efficacy of fish oil-derived n-3 ( ω-3 ) PUFA therapy to slow the age-associated loss of muscle mass and function . DESIGN Sixty healthy 60 - 85-y-old men and women were r and omly assigned to receive n-3 PUFA ( n = 40 ) or corn oil ( n = 20 ) therapy for 6 mo . Thigh muscle volume , h and grip strength , one-repetition maximum ( 1-RM ) lower- and upper-body strength , and average power during isokinetic leg exercises were evaluated before and after treatment . RESULTS Forty-four subjects completed the study [ 29 subjects ( 73 % ) in the n-3 PUFA group ; 15 subjects ( 75 % ) in the control group ] . Compared with the control group , 6 mo of n-3 PUFA therapy increased thigh muscle volume ( 3.6 % ; 95 % CI : 0.2 % , 7.0 % ) , h and grip strength ( 2.3 kg ; 95 % CI : 0.8 , 3.7 kg ) , and 1-RM muscle strength ( 4.0 % ; 95 % CI : 0.8 % , 7.3 % ) ( all P < 0.05 ) and tended to increase average isokinetic power ( 5.6 % ; 95 % CI : -0.6 % , 11.7 % ; P = 0.075 ) . CONCLUSION Fish oil-derived n-3 PUFA therapy slows the normal decline in muscle mass and function in older adults and should be considered a therapeutic approach for preventing sarcopenia and maintaining physical independence in older adults . This study was registered at clinical trials.gov as NCT01308957 OBJECTIVE To compare the effects of placebo and GLA on the course of mild diabetic neuropathy over 1 yr . RESEARCH DESIGN AND METHODS We entered 111 patients with mild diabetic ne 
    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: Adipose tissue ( AT ) fatty acid ( FA ) composition partly reflects habitual dietary intake . Circulating NEFA are mobilised from AT and might act as a minimally invasive surrogate marker of AT FA profile . Agreement between twenty-eight FA in AT and plasma NEFA was assessed using concordance coefficients in 204 male and female participants in a 12-month intervention using supplements to increase the intake of EPA and DHA . Concordance coefficients generally showed very poor agreement between AT FA and plasma NEFA at baseline SFA : 0·07 ; MUFA : 0·03 ; n-6 PUFA : 0·28 ; n-3 PUFA : 0·01 ) . Participants were r and omly divided into training ( 70 % ) and validation ( 30 % ) data sets , and models to predict AT and dietary FA were fitted using data from the training set , and their predictive ability was assessed using data from the validation set . AT n-6 PUFA and SFA were predicted from plasma NEFA with moderate accuracy ( mean absolute percentage error n-6 PUFA : 11 % and SFA : 8 % ) , but predicted values were unable to distinguish between low , medium and high FA values , with only 25 % of n-6 PUFA and 33 % of SFA predicted values correctly assigned to the appropriate tertile group . Despite an association between AT and plasma NEFA EPA ( P=0·001 ) and DHA ( P=0·01 ) at baseline , there was no association after the intervention . To conclude , plasma NEFA are not a suitable surrogate for AT FA Background : To test whether supplementary antioxidants and n–3 fatty acids , alone or in combination , could improve functional status in stroke survivors . Methods : We performed a r and omized , double-blind , placebo-controlled clinical trial in 72 stroke patients ( 47 males ; age 65.3 ± 12.9 years ) admitted to a rehabilitation hospital for sequelae of first-ever ischemic stroke , and divided them into 4 subgroups . Group 1 patients received daily oral antioxidants , group 2 received n–3 polyunsaturated fatty acids , group 3 both supplements , and group 4 placebo , all for 12 months . No difference at baseline was observed among groups in neurological severity or in disability . All measures were repeated after 6 and 12 months of treatment . All major clinical events were recorded . Results : At baseline , 25 % of the patients had a low plasma vitamin status , and 48.5 % was at risk of undernutrition . At the 1-year follow-up , we observed a trend for lower mortality ( p = 0.060 ) in subgroups treated with n–3 fatty acids , but without significant differences in rehabilitation result status among groups . Conclusions : Malnutrition is widely observed in patients admitted to a rehabilitative hospital for stroke rehabilitation , and dietary supplementation , even if not able to improve rehabilitation results , is likely to reduce mortality at the 1-year follow-up Background Some studies have suggested an association between omega-3 long-chain polyunsaturated fatty acids ( n-3 LC PUFAs ) and better cognitive outcomes in older adults . To date , only two r and omised , controlled trials have assessed the effect of n-3 LC PUFA supplementation on cognitive function in older cognitively healthy population s. Of these trials only one found a benefit , in the subgroup carrying the ApoE-ε4 allele . The benefits of n-3 LC PUFA supplementation on cognitive function in older normal population s thus still remain unclear . The main objective of the current study was to provide a comprehensive assessment of the potential of n-3 LC PUFAs to slow cognitive decline in normal elderly people , and included ApoE-ε4 allele carriage as a potential moderating factor . The detailed methodology of the trial is reported herein . Methods The study was a parallel , 18-month , r and omised , double-blind , placebo-controlled intervention with assessment at baseline and repeated 6-monthly . Participants ( N = 391 , 53.7 % female ) aged 65 - 90 years , English-speaking and with normal cognitive function , were recruited from metropolitan Adelaide , South Australia . Participants in the intervention arm received capsules containing fish-oil at a daily dosage of 1720 mg of docosahexaenoic acid and 600 mg of eicosapentaenoic acid while the placebo arm received the equivalent amount of olive oil in their capsules . The primary outcome is rate of change in cognitive performance , as measured by latent variables for the cognitive constructs ( encompassing Reasoning , Working Memory , Short-term Memory , Retrieval Fluency , Inhibition , Simple and Choice-Reaction Time , Perceptual Speed , Odd-man-out Reaction Time , Speed of Memory Scanning , and Psychomotor Speed ) and assessed by latent growth curve modeling . Secondary outcomes are change in the Mini-mental State Examination , functional capacity and well-being ( including health status , depression , mood , and self-report cognitive functioning ) , blood pressure , and biomarkers of n-3 LC PUFA status , glucose , lipid metabolism , inflammation , oxidative stress , and DNA damage . Trial registration Australia and New Zeal and Clinical Trials Register ( ANZCTR ) : OBJECTIVES To study the effects of omega (Omega)-3 fatty acid ( FA ) supplements on weight and appetite in patients with mild to moderate Alzheimer 's disease ( AD ) in relation to inflammatory biomarkers and apolipoprotein E epsilon4 ( APOEepsilon4 ) . DESIGN R and omized , double-blind , placebo-controlled trial . SETTING Specialist memory clinics in the Stockholm catchment area . PARTICIPANTS Two hundred four patients ( aged 73+/-9 , 52 % women ) with mild to moderate AD . INTERVENTION Patients with AD received 1.7 g of docosahexaenoic acid ( DHA ) and 0.6 g of eicosapentaenoic acid ( EPA ) ( Omega-3/Omega-3 group ; n=89 , aged 73+/-9 , 57 % women ) or placebo 0.6 g of linoleic acid per day ( placebo/Omega-3 group ; n=85 , aged 73+/-9 , 46 % women ) for 6 months . After 6 months , all patients received DHA and EPA for another 6 months . MEASUREMENTS Anthropometry , biochemical nutritional and inflammatory markers , and appetite assessed by caregiver . RESULTS Mean weight and body mass index ( kg/m(2 ) ) at baseline were 70.0+/-11.8 kg and 24.3+/-3.0 kg/m(2 ) , respectively . At 6- and 12-month follow-up , weight had increased 0.7+/-2.5 kg ( P=.02 ) and 1.4+/-2.9 kg ( P<.001 ) in the Omega-3/Omega-3 group . In the placebo group , weight was unchanged at 6 months but had increased ( P=.01 ) at 12 months follow-up after Omega-3 supplementation was initiated . Appetite improved in the Omega-3/Omega-3 group over the treatment period ( P=.01 ) . In logistic regression analyses , not carrying the APOEepsilon4 allele and high plasma DHA concentrations were independently related to weight gain in the combined group of patients at 6 months follow-up . CONCLUSION A DHA-enriched Omega-3 FA supplement may positively affect weight and appetite in patients with mild to moderate AD . Not carrying the APOEepsilon4 allele and high DHA were independently associated with weight gain Depressive symptoms may increase the risk of progressing from mild cognitive impairment ( MCI ) to dementia . Consumption of n-3 PUFA may alleviate both cognitive decline and depression . The aim of the present study was to investigate the benefits of supplementing a diet with n-3 PUFA , DHA and EPA , for depressive symptoms , quality of life ( QOL ) and cognition in elderly people with MCI . We conducted a 6-month double-blind , r and omised controlled trial . A total of fifty people aged > 65 years with MCI were allocated to receive a supplement rich in EPA ( 1·67 g EPA + 0·16 g DHA/d ; n 17 ) , DHA ( 1·55 g DHA + 0·40 g EPA/d ; n 18 ) or the n-6 PUFA linoleic acid ( LA ; 2·2 g/d ; n 15 ) . Treatment allocation was by minimisation based on age , sex and depressive symptoms ( Geriatric Depression Scale , GDS ) . Physiological and cognitive assessment s , question naires and fatty acid composition of erythrocytes were obtained at baseline and 6 months ( completers : n 40 ; EPA n 13 , DHA n 16 , LA n 11 ) . Compared with the LA group , GDS scores improved in the EPA ( P=0·04 ) and DHA ( P=0·01 ) groups and verbal fluency ( Initial Letter Fluency ) in the DHA group ( P=0·04 ) . Improved GDS scores were correlated with increased DHA plus EPA ( r 0·39 , P=0·02 ) . Improved self-reported physical health was associated with increased DHA . There were no treatment effects on other cognitive or QOL parameters . Increased intakes of DHA and EPA benefited mental health in older people with MCI . Increasing n-3 PUFA intakes may reduce depressive symptoms and the risk of progressing to dementia . This needs to be investigated in larger , depressed sample s with MCI Background / Objectives : This study aims to increase knowledge regarding the association of sarcopenia with hospitalization costs among a wide-ranging sample of adult hospitalized patients .Subjects/ Methods : A prospect i ve study was conducted among hospitalized adult patients . Sarcopenia was identified according to the European Working Group on Sarcopenia in Older People , as low muscle mass , assessed by bioelectrical impedance analysis and low muscle function evaluated by h and grip strength .  Hospitalization cost was calculated for each patient based on discharge diagnosis-related group codes and determined on the basis of a relative weight value . Costs were defined as the percentage of deviation from the cost of a patient with a relative weight equal to one . Multivariable linear regression models were performed to identify the factors independently associated with hospitalization costs . Results : A total of 656 hospitalized patients aged ⩾18 years ( 24.2 % sarcopenic ) composed the study sample . Sarcopenia increased hospitalization costs by [ euro ] 1240 ( 95 % confidence interval ( CI ) : [ euro ] 596–1887 ) for patients aged < 65 years and [ euro ] 721 ( 95 % CI : [ euro ] 13–1429 ) for patients aged ⩾65 years . Sarcopenic overweight was related to an increase in hospitalization costs of [ euro ] 884 ( 95 % CI : [ euro ] 295–1476 ) . Conclusions : Sarcopenia is independently related to hospitalization costs . This condition is estimated to increase hospitalization costs by 58.5 % for patients aged < 65 years and 34 % for patients aged ⩾65 years BACKGROUND Age-associated declines in muscle mass and function are major risk factors for an impaired ability to carry out activities of daily living , falls , prolonged recovery time after hospitalization , and mortality in older adults . New strategies that can slow the age-related loss of muscle mass and function are needed to help older adults maintain adequate performance status to reduce these risks and maintain independence . OBJECTIVE We evaluated the efficacy of fish oil-derived n-3 ( ω-3 ) PUFA therapy to slow the age-associated loss of muscle mass and function . DESIGN Sixty healthy 60 - 85-y-old men and women were r and omly assigned to receive n-3 PUFA ( n = 40 ) or corn oil ( n = 20 ) therapy for 6 mo . Thigh muscle volume , h and grip strength , one-repetition maximum ( 1-RM ) lower- and upper-body strength , and average power during isokinetic leg exercises were evaluated before and after treatment . RESULTS Forty-four subjects completed the study [ 29 subjects ( 73 % ) in the n-3 PUFA group ; 15 subjects ( 75 % ) in the control group ] . Compared with the control group , 6 mo of n-3 PUFA therapy increased thigh muscle volume ( 3.6 % ; 95 % CI : 0.2 % , 7.0 % ) , h and grip strength ( 2.3 kg ; 95 % CI : 0.8 , 3.7 kg ) , and 1-RM muscle strength ( 4.0 % ; 95 % CI : 0.8 % , 7.3 % ) ( all P < 0.05 ) and tended to increase average isokinetic power ( 5.6 % ; 95 % CI : -0.6 % , 11.7 % ; P = 0.075 ) . CONCLUSION Fish oil-derived n-3 PUFA therapy slows the normal decline in muscle mass and function in older adults and should be considered a therapeutic approach for preventing sarcopenia and maintaining physical independence in older adults . This study was registered at clinical trials.gov as NCT01308957 OBJECTIVE To compare the effects of placebo and GLA on the course of mild diabetic neuropathy over 1 yr . RESEARCH DESIGN AND METHODS We entered 111 patients with mild diabetic ne 
    Output:
    