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: abstract Objectives : To determine whether perinatal nutrition influences cognitive function at 7 1/2 - 8 years in children born preterm . Design : R and omised , blinded nutritional intervention trial . Blinded follow up at 7 1/2 - 8 years . Setting : Intervention phase in two neonatal units ; follow up in a clinic or school setting . Subjects : 424 preterm infants who weighed under 1850 g at birth ; 360 of those who survived were tested at 7 1/2 - 8 years . Interventions : St and ard infant formula versus nutrient enriched preterm formula r and omly assigned as sole diet ( trial A ) or supplements to maternal milk ( trial B ) fed for a mean of 1 month . Main outcome measures : Intelligence quotient ( IQ ) at 7 1/2 - 8 years with abbreviated Weschler intelligence scale for children ( revised ) . Results : There was a major sex difference in the impact of diet . At 7 1/2 - 8 years boys previously fed st and ard versus preterm formula as sole diet had a 12.2 point disadvantage ( 95 % confidence interval 3.7 to 20.6 ; P<0.01 ) in verbal IQ . In those with highest intakes of trial diets corresponding figures were 9.5 point disadvantage and 14.4 point disadvantage in overall IQ ( 1.2 to 17.7 ; P<0.05 ) and verbal IQ ( 5.7 to 23.2 ; P<0.01 ) . Consequently , more infants fed term formula had low verbal IQ ( < 85 ) : 31 % versus 14 % for both sexes ( P=0.02 ) and 47 % versus 13 % in boys P=0.009 ) . There was a higher incidence of cerebral palsy in those fed term formula ; exclusion of such children did not alter the findings . Conclusions : Preterm infants are vulnerable to suboptimal early nutrition in terms of their cognitive performance — notably , language based skills — at 7 1/2 - 8 years , when cognitive scores are highly predictive of adult ones . Our data on cerebral palsy generate a new hypothesis that suboptimal nutritional management during a critical or plastic early period of rapid brain growth could impair functional compensation in those sustaining an earlier brain insult . Cognitive function , notably in males , may be permanently impaired by suboptimal neonatal nutrition BACKGROUND : Early postnatal head growth failure is well recognized in very preterm infants ( VPIs ) . This coincides with the characteristic nutritional deficits that occur in these  parenteral nutrition ( PN ) dependent infants in the first month of life .  Head circumference ( HC ) is correlated with brain volume and later neurodevelopmental outcome . We hypothesized that a St and ardized , Concentrated With Added Macronutrients Parenteral ( SCAMP ) nutrition regimen would improve early head growth . The aim was to compare the change in HC ( ΔHC ) and HC SD score ( ΔSDS ) achieved at day 28 in VPIs r and omly assigned to receive SCAMP nutrition or a control st and ardized , concentrated PN regimen . METHODS : Control PN ( 10 % glucose , 2.8 g/kg per day protein/lipid ) was started within 6 hours of birth . VPIs ( birth weight < 1200 g ; gestation < 29 weeks ) were r and omly assigned to either start SCAMP ( 12 % glucose , 3.8 g/kg per day protein/lipid ) or remain on the control regimen  . HC was measured weekly . Actual daily nutritional intake data were collected for days 1 to 28 . RESULTS : There were no differences in demographic data between SCAMP ( n = 74 ) and control ( n = 76 ) groups . Comparing cumulative 28-day intakes , the SCAMP group received 11 % more protein and 7 % more energy . The SCAMP group had a greater ΔHC at 28 days ( P < .001 ) . The difference between the means ( 95 % confidence interval ) for ΔHC was 5 mm ( 2 to 8) , and ΔSDS was 0.37 ( 0.17 to 0.58 ) . HC differences are still apparent at 36 weeks ’ corrected gestational age . CONCLUSIONS : Early postnatal head growth failure  in VPIs can be ameliorated by optimizing PN Objective : To study the possible influences of amino acid ( AA ) intakes on growth and bone status in preterms . Study Design : Newborns , weighing < 1250 g , received st and ard ( S ) or higher ( H ) parenteral AA intakes ( 3 or 4 g kg−1 per day ) . Anthropometry , biochemistry and quantitative ultrasound ( metacarpus bone transmission time ( mcBTT ) , in μs ) were measured prospect ively . Result : A total of 55 patients in group S and 60 in group H were studied . Significantly better growth rate was found in the H group during the study without signs of intolerance . We found a significant decrease in mcBTT from birth to 21 days in the H group ; nonetheless , mcBTT at 36 weeks of gestational age significantly positively correlated with early AA and energy intakes . A significant positive correlation between mcBTT and lower limb length ( LLL ) at 21 days was found . Conclusion : Early higher AA intakes  improved growth without short-term AA intolerance . Nutritional parameters could influence bone growth . LLL was the anthropometric parameter that best correlated to bone status OBJECTIVE To assess the efficacy and safety of early parenteral lipid and high-dose amino acid ( AA ) administration from birth onwards in very low birth weight ( VLBW , birth weight < 1500 g ) infants . STUDY DESIGN VLBW infants ( n = 144 ; birth weight 862 ± 218 g ; gestational age 27.4 ± 2.2 weeks ) were r and omized to receive 2.4 g of AA kg(-1 ) · d(-1 ) ( control group ) , or 2.4 g AA kg(-1 ) · d(-1 ) plus 2 - 3 g lipids kg(-1 ) · d(-1 ) ( AA + lipid group ) , or 3.6 g AA kg(-1 ) · d(-1 ) plus 2 - 3 g lipids kg(-1 ) · d(-1 ) ( high AA + lipid group ) from birth onwards . The primary outcome was nitrogen balance . The secondary outcomes were biochemical variables , urea rate of appearance , growth rates , and clinical outcome . RESULTS The nitrogen balance on day 2 was significantly greater in both intervention groups compared with the control group . Greater amounts of AA administration did not further improve nitrogen balance compared with st and ard AA dose plus lipids and was associated with high plasma urea concentrations and high rates of urea appearance . No differences in other biochemical variables , growth , or clinical outcomes were observed . CONCLUSIONS In VLBW infants , the administration of parenteral AA combined with lipids from birth onwards improved conditions for anabolism and growth , as shown by improved nitrogen balance . Greater levels of AA administration did not further improve the nitrogen balance but led to increased AA oxidation . Early lipid initiation and high-dose AA were well tolerated Background : We have shown that increasing protein intake using a st and ardized , concentrated , added macronutrients parenteral ( SCAMP ) nutrition regimen improves head growth in very preterm infants ( VPIs ) compared with a control parenteral nutrition ( PN ) regimen .  VPIs are at risk of conditionally essential amino acid ( CEAA ) deficiencies because of current neonatal PN amino acid ( AA ) formulations . We hypothesized that the SCAMP regimen would prevent low plasma levels of CEAAs . Aim : To compare the plasma AA profiles at approximately day 9 of life in VPIs receiving SCAMP vs a control PN regimen . Methods : VPIs ( < 29 weeks ’ gestation ) were r and omized to receive SCAMP ( 30 % more PN AA ) or a control regimen .  Data were collected to measure parenteral and enteral protein , energy , and individual AA intake and the first plasma AA profile . Plasma profiles of the 20 individual protogenic AA levels were measured using ion exchange chromatography . Results : Plasma AA profiles were obtained at median ( interquartile range [ IQR ] ) age of 9 ( 8–10 ) days in both SCAMP ( n = 59 ) and control ( n = 67 ) groups after r and omizing 150 VPIs . Median ( IQR ) plasma levels of individual essential AAs were higher than the reference population mean ( RPM ) in both groups , especially for threonine . SCAMP infants had higher plasma levels of essential AAs than did the controls . Median ( IQR ) plasma levels of glutamine , arginine , and cysteine ( CEAAs ) were lower than the RPM in both groups . Conclusion : Plasma AA levels in PN-dependent VPIs indicate there is an imbalance in essential and CEAA provision in neonatal PN AA formulations that is not improved by increasing protein intake Background : Infants born very preterm are at an increased risk of poor growth in the post-natal period . Poor brain growth in this critical period may result from inadequate nutrition , and has long-term effects on neurodevelopmental outcome . Aims : To examine the feasibility of providing macronutrients at amounts above current recommendations ( hyperalimentation ) to improve nutrition and head growth in preterm infants . Methods : 142 infants < 29 weeks ' gestation were r and omised to hyperalimented or st and ard parenteral and enteral nutrition .  Growth was monitored from birth to 36 weeks ' postmenstrual age ( PMA ) . The primary outcome measure was occipitofrontal circumference ( OFC ) at 36 weeks ' PMA . Results : 55 infants in the intervention group and 59 infants in the control group survived to 36 weeks ' PMA . 11 ( 16 % ) infants in the intervention group and 13 ( 18 % ) infants in the control group were small for gestational age ( SGA ) . There was no statistically significant difference between the two groups in the primary outcome measure or other growth variables . Babies in the intervention group received significantly more energy and protein , but 80 % were still in a cumulative protein/energy deficit at the end of 4 weeks . 20 ( 24 % , p = 0.008 ) of those in deficit at 4 weeks had an OFC of more than 2 SD below the mean at 36 weeks ' PMA , as opposed to none of those not in deficit . Conclusion : Cumulative energy/protein deficit is predictive of poor head growth , but the delivery of adequate intakes remains a challenge in the preterm Objective : The aim of the present study was to examine the effects of early and high intravenous ( IV ) amino acid ( AA ) supplementation on growth , health , and neurodevelopment of extremely-low-birth-weight ( ELBW ) infants throughout their first 2 years of life . Methods : Infants were prospect ively r and omized in a double-masked fashion and treated for 7 days with either IV AA starting at 0.5 g · kg−1 · day−1 and increased by 0.5 g · kg−1 every day to 3 g · kg−1 · day−1 or starting at 2 g · kg−1 · day−1 of IV AA and advanced by 1 g · kg−1 every day to 4 g · kg−1 · day−1 . Plasma AA concentrations were determined by reverse-phase high-performance liquid chromatography . Survivors were longitudinally assessed with Bayley II Scales of Infant Development and physical , social , and global health . Results : Forty-three of 51 survivors were studied . Mental Developmental Index ( MDI ) and Psychomotor Developmental Index were similar between groups ; however , the early and high AA group had a lower MDI at 18 months . This difference disappeared at 2 years of age . The early and high AA group z score means for weight , length , and head circumferences were significantly lower than the st and ard AA group at most visits . Cumulative and single plasma AA concentrations correlated negatively with MDI and postnatal growth . Conclusions : ELBW infants who received early and high IV AA during the first week of life were associated with poor overall growth at 2 years OBJECTIVE To determine if postnatal growth failure exerts an adverse effect on subsequent growth and neurodevelopment . STUDY DESIGN A secondary analysis of 1018 infants who were enrolled in a r and omized , clinical trial of glutamine supplementation  was performed to determine whether early provision of parenteral amino acids ( AA ) is associated with better growth and neurodevelopmental outcomes . Infants were stratified by whether they were provided > or =3 g/kg per day of AA at < or = 5 days of life ( early ; n = 182 ) or not ( late ; n = 836 ) . RESULTS At 36 weeks ' postmenstrual age , significant differences were found in weight , length , and head circumference in favor of the infants who received early AA ; the odds of having weight less than the 10(th ) percentile for age was 4-fold higher for infants in the late group . At 18 months ' CA , there were no differences in weight , length , or measures of neurodevelopment between the groups ; however , male infants in the late group were twice as likely to have head circumference less than the 10(th ) percentile . CONCLUSIONS Early AA were associated with significantly better growth outcomes at 36 weeks ' postmenstrual age , and fewer infants who received early AA were found to have suboptimal head growth at 18 months ' CA BACKGROUND The goal of nutrition in the preterm infant is to achieve postnatal growth approximating normal fetal growth . During the early 
    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: abstract Objectives : To determine whether perinatal nutrition influences cognitive function at 7 1/2 - 8 years in children born preterm . Design : R and omised , blinded nutritional intervention trial . Blinded follow up at 7 1/2 - 8 years . Setting : Intervention phase in two neonatal units ; follow up in a clinic or school setting . Subjects : 424 preterm infants who weighed under 1850 g at birth ; 360 of those who survived were tested at 7 1/2 - 8 years . Interventions : St and ard infant formula versus nutrient enriched preterm formula r and omly assigned as sole diet ( trial A ) or supplements to maternal milk ( trial B ) fed for a mean of 1 month . Main outcome measures : Intelligence quotient ( IQ ) at 7 1/2 - 8 years with abbreviated Weschler intelligence scale for children ( revised ) . Results : There was a major sex difference in the impact of diet . At 7 1/2 - 8 years boys previously fed st and ard versus preterm formula as sole diet had a 12.2 point disadvantage ( 95 % confidence interval 3.7 to 20.6 ; P<0.01 ) in verbal IQ . In those with highest intakes of trial diets corresponding figures were 9.5 point disadvantage and 14.4 point disadvantage in overall IQ ( 1.2 to 17.7 ; P<0.05 ) and verbal IQ ( 5.7 to 23.2 ; P<0.01 ) . Consequently , more infants fed term formula had low verbal IQ ( < 85 ) : 31 % versus 14 % for both sexes ( P=0.02 ) and 47 % versus 13 % in boys P=0.009 ) . There was a higher incidence of cerebral palsy in those fed term formula ; exclusion of such children did not alter the findings . Conclusions : Preterm infants are vulnerable to suboptimal early nutrition in terms of their cognitive performance — notably , language based skills — at 7 1/2 - 8 years , when cognitive scores are highly predictive of adult ones . Our data on cerebral palsy generate a new hypothesis that suboptimal nutritional management during a critical or plastic early period of rapid brain growth could impair functional compensation in those sustaining an earlier brain insult . Cognitive function , notably in males , may be permanently impaired by suboptimal neonatal nutrition BACKGROUND : Early postnatal head growth failure is well recognized in very preterm infants ( VPIs ) . This coincides with the characteristic nutritional deficits that occur in these  parenteral nutrition ( PN ) dependent infants in the first month of life .  Head circumference ( HC ) is correlated with brain volume and later neurodevelopmental outcome . We hypothesized that a St and ardized , Concentrated With Added Macronutrients Parenteral ( SCAMP ) nutrition regimen would improve early head growth . The aim was to compare the change in HC ( ΔHC ) and HC SD score ( ΔSDS ) achieved at day 28 in VPIs r and omly assigned to receive SCAMP nutrition or a control st and ardized , concentrated PN regimen . METHODS : Control PN ( 10 % glucose , 2.8 g/kg per day protein/lipid ) was started within 6 hours of birth . VPIs ( birth weight < 1200 g ; gestation < 29 weeks ) were r and omly assigned to either start SCAMP ( 12 % glucose , 3.8 g/kg per day protein/lipid ) or remain on the control regimen  . HC was measured weekly . Actual daily nutritional intake data were collected for days 1 to 28 . RESULTS : There were no differences in demographic data between SCAMP ( n = 74 ) and control ( n = 76 ) groups . Comparing cumulative 28-day intakes , the SCAMP group received 11 % more protein and 7 % more energy . The SCAMP group had a greater ΔHC at 28 days ( P < .001 ) . The difference between the means ( 95 % confidence interval ) for ΔHC was 5 mm ( 2 to 8) , and ΔSDS was 0.37 ( 0.17 to 0.58 ) . HC differences are still apparent at 36 weeks ’ corrected gestational age . CONCLUSIONS : Early postnatal head growth failure  in VPIs can be ameliorated by optimizing PN Objective : To study the possible influences of amino acid ( AA ) intakes on growth and bone status in preterms . Study Design : Newborns , weighing < 1250 g , received st and ard ( S ) or higher ( H ) parenteral AA intakes ( 3 or 4 g kg−1 per day ) . Anthropometry , biochemistry and quantitative ultrasound ( metacarpus bone transmission time ( mcBTT ) , in μs ) were measured prospect ively . Result : A total of 55 patients in group S and 60 in group H were studied . Significantly better growth rate was found in the H group during the study without signs of intolerance . We found a significant decrease in mcBTT from birth to 21 days in the H group ; nonetheless , mcBTT at 36 weeks of gestational age significantly positively correlated with early AA and energy intakes . A significant positive correlation between mcBTT and lower limb length ( LLL ) at 21 days was found . Conclusion : Early higher AA intakes  improved growth without short-term AA intolerance . Nutritional parameters could influence bone growth . LLL was the anthropometric parameter that best correlated to bone status OBJECTIVE To assess the efficacy and safety of early parenteral lipid and high-dose amino acid ( AA ) administration from birth onwards in very low birth weight ( VLBW , birth weight < 1500 g ) infants . STUDY DESIGN VLBW infants ( n = 144 ; birth weight 862 ± 218 g ; gestational age 27.4 ± 2.2 weeks ) were r and omized to receive 2.4 g of AA kg(-1 ) · d(-1 ) ( control group ) , or 2.4 g AA kg(-1 ) · d(-1 ) plus 2 - 3 g lipids kg(-1 ) · d(-1 ) ( AA + lipid group ) , or 3.6 g AA kg(-1 ) · d(-1 ) plus 2 - 3 g lipids kg(-1 ) · d(-1 ) ( high AA + lipid group ) from birth onwards . The primary outcome was nitrogen balance . The secondary outcomes were biochemical variables , urea rate of appearance , growth rates , and clinical outcome . RESULTS The nitrogen balance on day 2 was significantly greater in both intervention groups compared with the control group . Greater amounts of AA administration did not further improve nitrogen balance compared with st and ard AA dose plus lipids and was associated with high plasma urea concentrations and high rates of urea appearance . No differences in other biochemical variables , growth , or clinical outcomes were observed . CONCLUSIONS In VLBW infants , the administration of parenteral AA combined with lipids from birth onwards improved conditions for anabolism and growth , as shown by improved nitrogen balance . Greater levels of AA administration did not further improve the nitrogen balance but led to increased AA oxidation . Early lipid initiation and high-dose AA were well tolerated Background : We have shown that increasing protein intake using a st and ardized , concentrated , added macronutrients parenteral ( SCAMP ) nutrition regimen improves head growth in very preterm infants ( VPIs ) compared with a control parenteral nutrition ( PN ) regimen .  VPIs are at risk of conditionally essential amino acid ( CEAA ) deficiencies because of current neonatal PN amino acid ( AA ) formulations . We hypothesized that the SCAMP regimen would prevent low plasma levels of CEAAs . Aim : To compare the plasma AA profiles at approximately day 9 of life in VPIs receiving SCAMP vs a control PN regimen . Methods : VPIs ( < 29 weeks ’ gestation ) were r and omized to receive SCAMP ( 30 % more PN AA ) or a control regimen .  Data were collected to measure parenteral and enteral protein , energy , and individual AA intake and the first plasma AA profile . Plasma profiles of the 20 individual protogenic AA levels were measured using ion exchange chromatography . Results : Plasma AA profiles were obtained at median ( interquartile range [ IQR ] ) age of 9 ( 8–10 ) days in both SCAMP ( n = 59 ) and control ( n = 67 ) groups after r and omizing 150 VPIs . Median ( IQR ) plasma levels of individual essential AAs were higher than the reference population mean ( RPM ) in both groups , especially for threonine . SCAMP infants had higher plasma levels of essential AAs than did the controls . Median ( IQR ) plasma levels of glutamine , arginine , and cysteine ( CEAAs ) were lower than the RPM in both groups . Conclusion : Plasma AA levels in PN-dependent VPIs indicate there is an imbalance in essential and CEAA provision in neonatal PN AA formulations that is not improved by increasing protein intake Background : Infants born very preterm are at an increased risk of poor growth in the post-natal period . Poor brain growth in this critical period may result from inadequate nutrition , and has long-term effects on neurodevelopmental outcome . Aims : To examine the feasibility of providing macronutrients at amounts above current recommendations ( hyperalimentation ) to improve nutrition and head growth in preterm infants . Methods : 142 infants < 29 weeks ' gestation were r and omised to hyperalimented or st and ard parenteral and enteral nutrition .  Growth was monitored from birth to 36 weeks ' postmenstrual age ( PMA ) . The primary outcome measure was occipitofrontal circumference ( OFC ) at 36 weeks ' PMA . Results : 55 infants in the intervention group and 59 infants in the control group survived to 36 weeks ' PMA . 11 ( 16 % ) infants in the intervention group and 13 ( 18 % ) infants in the control group were small for gestational age ( SGA ) . There was no statistically significant difference between the two groups in the primary outcome measure or other growth variables . Babies in the intervention group received significantly more energy and protein , but 80 % were still in a cumulative protein/energy deficit at the end of 4 weeks . 20 ( 24 % , p = 0.008 ) of those in deficit at 4 weeks had an OFC of more than 2 SD below the mean at 36 weeks ' PMA , as opposed to none of those not in deficit . Conclusion : Cumulative energy/protein deficit is predictive of poor head growth , but the delivery of adequate intakes remains a challenge in the preterm Objective : The aim of the present study was to examine the effects of early and high intravenous ( IV ) amino acid ( AA ) supplementation on growth , health , and neurodevelopment of extremely-low-birth-weight ( ELBW ) infants throughout their first 2 years of life . Methods : Infants were prospect ively r and omized in a double-masked fashion and treated for 7 days with either IV AA starting at 0.5 g · kg−1 · day−1 and increased by 0.5 g · kg−1 every day to 3 g · kg−1 · day−1 or starting at 2 g · kg−1 · day−1 of IV AA and advanced by 1 g · kg−1 every day to 4 g · kg−1 · day−1 . Plasma AA concentrations were determined by reverse-phase high-performance liquid chromatography . Survivors were longitudinally assessed with Bayley II Scales of Infant Development and physical , social , and global health . Results : Forty-three of 51 survivors were studied . Mental Developmental Index ( MDI ) and Psychomotor Developmental Index were similar between groups ; however , the early and high AA group had a lower MDI at 18 months . This difference disappeared at 2 years of age . The early and high AA group z score means for weight , length , and head circumferences were significantly lower than the st and ard AA group at most visits . Cumulative and single plasma AA concentrations correlated negatively with MDI and postnatal growth . Conclusions : ELBW infants who received early and high IV AA during the first week of life were associated with poor overall growth at 2 years OBJECTIVE To determine if postnatal growth failure exerts an adverse effect on subsequent growth and neurodevelopment . STUDY DESIGN A secondary analysis of 1018 infants who were enrolled in a r and omized , clinical trial of glutamine supplementation  was performed to determine whether early provision of parenteral amino acids ( AA ) is associated with better growth and neurodevelopmental outcomes . Infants were stratified by whether they were provided > or =3 g/kg per day of AA at < or = 5 days of life ( early ; n = 182 ) or not ( late ; n = 836 ) . RESULTS At 36 weeks ' postmenstrual age , significant differences were found in weight , length , and head circumference in favor of the infants who received early AA ; the odds of having weight less than the 10(th ) percentile for age was 4-fold higher for infants in the late group . At 18 months ' CA , there were no differences in weight , length , or measures of neurodevelopment between the groups ; however , male infants in the late group were twice as likely to have head circumference less than the 10(th ) percentile . CONCLUSIONS Early AA were associated with significantly better growth outcomes at 36 weeks ' postmenstrual age , and fewer infants who received early AA were found to have suboptimal head growth at 18 months ' CA BACKGROUND The goal of nutrition in the preterm infant is to achieve postnatal growth approximating normal fetal growth . During the early 
    Output:
    