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 : This r and omized controlled trial assessed the safety and effects of twice-weekly weight training among recent breast cancer survivors . Outcomes included body size and biomarkers hypothesized to link exercise and breast cancer risk . Methods : A convenience sample of 85 recent survivors was r and omized into immediate and delayed treatment groups . The immediate group trained from months 0 to 12 ; the delayed treatment group served as a no exercise parallel comparison group from months 0 to 6 and trained from months 7 to 12 . Measures at baseline , 6 and 12 months included body weight , height , body fat , lean mass , body fat % , and waist circumference , as well as fasting glucose , insulin , insulin resistance , insulin-like growth factor-I ( IGF-I ) , IGF-II , and IGF-binding protein-1 , IGFBP-2 , and IGFBP-3 . Injury reporting was st and ardized . Results : The intervention result ed in significant increases in lean mass ( 0.88 versus 0.02 kg , P < 0.01 ) , as well as significant decreases in body fat % ( −1.15 % versus 0.23 % , P = 0.03 ) and IGF-II ( −6.23 versus 28.28 ng/mL , P = 0.02 ) comparing immediate with delayed treatment from baseline to 6 months . Within-person changes experienced by delayed treatment group participants during training versus no training were similar . Only one participant experienced a study related injury that prevented continued participation . Conclusion : Twice-weekly weight training is a safe exercise program for recent breast cancer survivors that may result in increased muscle mass , as well as decreased body fat % and IGF-II . The implication s of these results on cancer recurrence or survival may become more evident with longer exercise intervention trials among breast cancer survivors Background : Insulin-like growth factors ( IGFs ) and their binding proteins ( BPs ) regulate cell differentiation , proliferation and apoptosis , and may have a role in the aetiology of various cancers . Information on their role in pancreatic cancer is limited and was examined here in a case – control study nested within the European Prospect i ve Investigation into Cancer and Nutrition . Methods : Serum concentrations of IGF-I and IGFBP-3  were measured using enzyme-linked immunosorbent assays in 422 cases and 422 controls matched on age , sex , study centre , recruitment date , and time since last meal . Conditional logistic regression was used to compute odds ratios ( OR ) and 95 % confidence intervals ( CI ) adjusted for confounding variables . Results : Neither circulating levels of IGF-I ( OR=1.21 , 95 % CI 0.75–1.93 for top vs bottom quartile , P-trend 0.301 ) , IGFBP-3 ( OR=1.00 , 95 % CI 0.66–1.51 , P-trend 0.79 ) , nor the molar IGF-I/IGFBP-3 ratio , an indicator of free IGF-I level ( OR=1.22 , 95 % CI 0.75–1.97 , P-trend 0.27 ) , were statistically significantly associated with the risk of pancreatic cancer . In a cross-classification , however , a high concentration of IGF-I with concurrently low levels of IGFBP-3 was related to an increased risk of pancreatic cancer ( OR=1.72 , 95 % CI 1.05–2.83 ; P-interaction=0.154 ) . Conclusion : On the basis of these results , circulating levels of components of the IGF axis do not appear to be the risk factors for pancreatic cancer . However , on the basis of the results of a sub analysis , it can not be excluded that a relatively large amount of IGF-1 together with very low levels of IGFBP-3 might still be associated with an increase in pancreatic cancer risk The objective was to determine the effects of exercise training on changes in blood immune function in postmenopausal breast cancer survivors . Fifty-three postmenopausal breast cancer survivors were r and omly assigned to an exercise ( n=25 ) or control group ( n=28 ) . The exercise group trained on cycle ergometers three times per week for 15 wk . The control group did not train . The primary end point was change in natural killer cell cytotoxic activity in isolated peripheral blood mononuclear cells . Secondary end points were changes in st and ard hematological variables , whole blood neutrophil function , the phenotypes of isolated mononuclear cells , estimations of unstimulated and phytohemaglutinin-stimulated mononuclear cell function ( rate of [3H]thymidine uptake ) , and the production of proinflammatory [ interleukin (IL)-1alpha , tumor necrosis factor-alpha , IL-6 ] and anti-inflammatory cytokines ( IL-4 , IL-10 , transforming growth factor-beta1 ) . Statistical tests were two-sided ( alpha < 0.05 ) . Fifty-two participants completed the trial . Intention-to-treat analyses , which included the baseline value as a covariate , showed significant differences between groups for change in percent specific lysis of a target natural killer cell at all five effector-to-target ratios ( adjusted mean between-group change over all 5 effector-to-target ratios = + 6.34 % ; P < 0.05 for all comparisons ) , the lytic activity per cell ( adjusted mean between-group change = -2.72 lytic units ; P=0.035 ) , and unstimulated [3H]thymidine uptake by peripheral blood lymphocytes ( adjusted mean between-group change = + 218 per dpm x 10(6 ) cells ; P = 0.007 ) . There were no significant differences between groups for change in any other end point . Exercise training increased natural killer cell cytotoxic activity and unstimulated [3H]thymidine uptake by peripheral blood lymphocytes in postmenopausal breast cancer survivors Insulin , insulin-like growth factors ( IGFs ) I and II , and IGF binding proteins ( IGFBPs ) 1 and 3 have been implicated in breast cancer outcomes . We conducted a r and omized controlled trial to determine the physiological effects of exercise training on changes in these biological markers in postmenopausal breast cancer survivors . Fifty-three postmenopausal breast cancer survivors were r and omly assigned to an exercise ( n = 25 ) or control group ( n = 28 ) . The exercise group trained on cycle ergometers three times per week for 15 weeks . The control group did not train . End points included changes in fasting insulin , glucose , insulin resistance , IGF-I , IGF-II , IGFBP-1 , IGFBP-3 , and IGF-I : IGFBP-3 molar ratio between baseline and week 15 . All of the statistical tests were two-sided ( alpha = 0.05 ) . Fifty-two participants completed the trial . The exercise group completed 44.3 of 45 ( 98.4 % ) prescribed exercise sessions . Baseline hormone concentrations did not differ between groups except that IGF-II was higher in the exercise group ( P = 0.011 ) . No significant differences between groups were observed for changes in fasting insulin ( + 6.3 pmol/liter ; P = 0.941 ) , glucose ( + 0.09 mmol/liter ; P = 0.824 ) , insulin resistance ( + 0.4 ; P = 0.247 ) , IGF-II ( -40.7 ng/ml ; P = 0.101 ) , or IGFBP-1 ( + 1.4 ng/ml ; P = 0.774 ) . However , significant differences between groups were observed for changes in IGF-I ( -7.4 ng/ml ; P = 0.045 ) , IGFBP-3 ( + 180.5 ng/ml ; P = 0.021 ) , and IGF-I : IGFBP-3 molar ratio ( -0.006 ; P = 0.017 ) . Exercise training had significant physiological effects on IGF-I , IGFBP-3 , and IGF-I : IGFBP-3 molar ratio in postmenopausal breast cancer survivors . The clinical implication s of these findings remain to be defined Background : High insulin and insulin-like growth factor-I ( IGF-I ) levels may be associated with an increased breast cancer risk and /or death . Given the need to identify modifiable factors that decrease insulin , IGF-I , and breast cancer risk and death , we investigated the effects of a 6-month r and omized controlled aerobic exercise intervention versus usual care on fasting insulin , IGF-I , and its binding protein ( IGFBP-3 ) in postmenopausal breast cancer survivors . Methods : Seventy-five postmenopausal breast cancer survivors were identified from the Yale-New Haven Hospital Tumor Registry and r and omly assigned to an exercise ( n = 37 ) or usual care  ( n = 38 ) group . The exercise group participated in 150 minutes per week of moderate-intensity aerobic exercise . The usual care group was instructed to maintain their current physical activity level . A fasting blood sample was collected on each study participant at baseline and 6 months . Blood levels of insulin and IGF were measured with ELISA . Results : On average , exercisers increased  aerobic exercise  by 129 minutes per week compared with 45 minutes per week among usual care participants ( P < 0.001 ) . Women r and omized to exercise experienced decreases in insulin , IGF-I , and IGFBP-3 , whereas women r and omized to usual care had increases in these hormones . Between-group differences in insulin , IGF-I , and IGFBP-3 were 20.7 % ( P = 0.089 ) , 8.9 % ( P = 0.026 ) , and 7.9 % ( P = 0.006 ) , respectively . Conclusions : Moderate-intensity aerobic exercise , such as brisk walking , decreases IGF-I and IGFBP-3 . The exercise-induced decreases in IGF may mediate the observed association between higher levels of physical activity and improved survival in women diagnosed with breast cancer . ( Cancer Epidemiol Biomarkers Prev 2009;18(1):306–13 Introduction Inflammatory status may be an important prognostic factor for breast cancer . Correlates of markers of inflammation in breast cancer survivors have not been thoroughly evaluated . Methods Using data from , the Health , Eating , Activity , and Lifestyle ( HEAL ) Study ( a population -based , multiethnic prospect i ve cohort study of female breast cancer patients ) we evaluated the associations between circulating markers of inflammation ( C-reactive protein [ CRP ] and  serum amyloid A  [ SAA ] , measured ∼31 months after diagnosis ) and several demographic , lifestyle , and clinical characteristics in 741 disease-free breast cancer survivors . Analysis of variance and regression methods were used for statistical analyses of log-transformed values of CRP and SAA . Results After adjusting for age , BMI , ethnicity , and study site , higher concentrations of CRP were associated with increasing concentration of SAA ( P-trend < 0.0001 ) , increasing age ( P-trend < 0.0001 ) , increasing BMI ( P-trend < 0.0001 ) , increasing waist circumference ( P-trend < 0.0001 ) , positive history of heart failure ( P = 0.0007 ) , decreasing physical activity ( P-trend = 0.005 ) , Hispanic ethnicity ( P = 0.05 vs. non-Hispanic white ) , and current smoking ( P = 0.03 vs. never smoking ) . Vitamin E supplementation ( P = 0.0005 ) , tamoxifen use ( P = 0.008 ) , and radiation treatment ( compared to no chemotherapy or radiation ; P = 0.04 ) were associated with reduced CRP . Associations of CRP with clinical characteristics were not significant in the adjusted models . In a multivariate analysis , CRP showed significant associations with waist circumference , BMI , age , history of heart failure , tamoxifen use , and vitamin E supplementation ( R2 = 0.35 ) . Similar , yet fewer , associations were observed for SAA ( R2 = 0.19 ) . Conclusions This study highlights important correlates of inflammatory status in breast cancer patients . Our results are consistent with those from similar studies of healthy women PURPOSE / OBJECTIVES To compare the effectiveness of a prescribed home-based walking exercise intervention with usual care in older women receiving hormonal treatment for breast cancer , and to examine relationships among levels of the cortisol , serotonin , interleukin-6 , and bilirubin biomarkers and fatigue , sleep disturbances , and depressive symptoms . DESIGN Longitudinal r and omized clinical trial . SETTING A National Cancer Institute- design ated cancer center in the southeastern United States . SAMPLE 20 women ( aged 55 years or older ) with breast cancer receiving hormonal treatment . METHODS Participants were r and omized to a walking exercise intervention or usual care . Laboratory sample s and the Pittsburgh Sleep Quality Index ( PSQI ) , the Piper Revised Fatigue Scale , and the Center for Epidemiological Studies -Depression Scale were collected at the initial clinic visit and at 12 weeks from the groups . Question naires also were collected at weeks 2 and 14 . MAIN 
    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 : This r and omized controlled trial assessed the safety and effects of twice-weekly weight training among recent breast cancer survivors . Outcomes included body size and biomarkers hypothesized to link exercise and breast cancer risk . Methods : A convenience sample of 85 recent survivors was r and omized into immediate and delayed treatment groups . The immediate group trained from months 0 to 12 ; the delayed treatment group served as a no exercise parallel comparison group from months 0 to 6 and trained from months 7 to 12 . Measures at baseline , 6 and 12 months included body weight , height , body fat , lean mass , body fat % , and waist circumference , as well as fasting glucose , insulin , insulin resistance , insulin-like growth factor-I ( IGF-I ) , IGF-II , and IGF-binding protein-1 , IGFBP-2 , and IGFBP-3 . Injury reporting was st and ardized . Results : The intervention result ed in significant increases in lean mass ( 0.88 versus 0.02 kg , P < 0.01 ) , as well as significant decreases in body fat % ( −1.15 % versus 0.23 % , P = 0.03 ) and IGF-II ( −6.23 versus 28.28 ng/mL , P = 0.02 ) comparing immediate with delayed treatment from baseline to 6 months . Within-person changes experienced by delayed treatment group participants during training versus no training were similar . Only one participant experienced a study related injury that prevented continued participation . Conclusion : Twice-weekly weight training is a safe exercise program for recent breast cancer survivors that may result in increased muscle mass , as well as decreased body fat % and IGF-II . The implication s of these results on cancer recurrence or survival may become more evident with longer exercise intervention trials among breast cancer survivors Background : Insulin-like growth factors ( IGFs ) and their binding proteins ( BPs ) regulate cell differentiation , proliferation and apoptosis , and may have a role in the aetiology of various cancers . Information on their role in pancreatic cancer is limited and was examined here in a case – control study nested within the European Prospect i ve Investigation into Cancer and Nutrition . Methods : Serum concentrations of IGF-I and IGFBP-3  were measured using enzyme-linked immunosorbent assays in 422 cases and 422 controls matched on age , sex , study centre , recruitment date , and time since last meal . Conditional logistic regression was used to compute odds ratios ( OR ) and 95 % confidence intervals ( CI ) adjusted for confounding variables . Results : Neither circulating levels of IGF-I ( OR=1.21 , 95 % CI 0.75–1.93 for top vs bottom quartile , P-trend 0.301 ) , IGFBP-3 ( OR=1.00 , 95 % CI 0.66–1.51 , P-trend 0.79 ) , nor the molar IGF-I/IGFBP-3 ratio , an indicator of free IGF-I level ( OR=1.22 , 95 % CI 0.75–1.97 , P-trend 0.27 ) , were statistically significantly associated with the risk of pancreatic cancer . In a cross-classification , however , a high concentration of IGF-I with concurrently low levels of IGFBP-3 was related to an increased risk of pancreatic cancer ( OR=1.72 , 95 % CI 1.05–2.83 ; P-interaction=0.154 ) . Conclusion : On the basis of these results , circulating levels of components of the IGF axis do not appear to be the risk factors for pancreatic cancer . However , on the basis of the results of a sub analysis , it can not be excluded that a relatively large amount of IGF-1 together with very low levels of IGFBP-3 might still be associated with an increase in pancreatic cancer risk The objective was to determine the effects of exercise training on changes in blood immune function in postmenopausal breast cancer survivors . Fifty-three postmenopausal breast cancer survivors were r and omly assigned to an exercise ( n=25 ) or control group ( n=28 ) . The exercise group trained on cycle ergometers three times per week for 15 wk . The control group did not train . The primary end point was change in natural killer cell cytotoxic activity in isolated peripheral blood mononuclear cells . Secondary end points were changes in st and ard hematological variables , whole blood neutrophil function , the phenotypes of isolated mononuclear cells , estimations of unstimulated and phytohemaglutinin-stimulated mononuclear cell function ( rate of [3H]thymidine uptake ) , and the production of proinflammatory [ interleukin (IL)-1alpha , tumor necrosis factor-alpha , IL-6 ] and anti-inflammatory cytokines ( IL-4 , IL-10 , transforming growth factor-beta1 ) . Statistical tests were two-sided ( alpha < 0.05 ) . Fifty-two participants completed the trial . Intention-to-treat analyses , which included the baseline value as a covariate , showed significant differences between groups for change in percent specific lysis of a target natural killer cell at all five effector-to-target ratios ( adjusted mean between-group change over all 5 effector-to-target ratios = + 6.34 % ; P < 0.05 for all comparisons ) , the lytic activity per cell ( adjusted mean between-group change = -2.72 lytic units ; P=0.035 ) , and unstimulated [3H]thymidine uptake by peripheral blood lymphocytes ( adjusted mean between-group change = + 218 per dpm x 10(6 ) cells ; P = 0.007 ) . There were no significant differences between groups for change in any other end point . Exercise training increased natural killer cell cytotoxic activity and unstimulated [3H]thymidine uptake by peripheral blood lymphocytes in postmenopausal breast cancer survivors Insulin , insulin-like growth factors ( IGFs ) I and II , and IGF binding proteins ( IGFBPs ) 1 and 3 have been implicated in breast cancer outcomes . We conducted a r and omized controlled trial to determine the physiological effects of exercise training on changes in these biological markers in postmenopausal breast cancer survivors . Fifty-three postmenopausal breast cancer survivors were r and omly assigned to an exercise ( n = 25 ) or control group ( n = 28 ) . The exercise group trained on cycle ergometers three times per week for 15 weeks . The control group did not train . End points included changes in fasting insulin , glucose , insulin resistance , IGF-I , IGF-II , IGFBP-1 , IGFBP-3 , and IGF-I : IGFBP-3 molar ratio between baseline and week 15 . All of the statistical tests were two-sided ( alpha = 0.05 ) . Fifty-two participants completed the trial . The exercise group completed 44.3 of 45 ( 98.4 % ) prescribed exercise sessions . Baseline hormone concentrations did not differ between groups except that IGF-II was higher in the exercise group ( P = 0.011 ) . No significant differences between groups were observed for changes in fasting insulin ( + 6.3 pmol/liter ; P = 0.941 ) , glucose ( + 0.09 mmol/liter ; P = 0.824 ) , insulin resistance ( + 0.4 ; P = 0.247 ) , IGF-II ( -40.7 ng/ml ; P = 0.101 ) , or IGFBP-1 ( + 1.4 ng/ml ; P = 0.774 ) . However , significant differences between groups were observed for changes in IGF-I ( -7.4 ng/ml ; P = 0.045 ) , IGFBP-3 ( + 180.5 ng/ml ; P = 0.021 ) , and IGF-I : IGFBP-3 molar ratio ( -0.006 ; P = 0.017 ) . Exercise training had significant physiological effects on IGF-I , IGFBP-3 , and IGF-I : IGFBP-3 molar ratio in postmenopausal breast cancer survivors . The clinical implication s of these findings remain to be defined Background : High insulin and insulin-like growth factor-I ( IGF-I ) levels may be associated with an increased breast cancer risk and /or death . Given the need to identify modifiable factors that decrease insulin , IGF-I , and breast cancer risk and death , we investigated the effects of a 6-month r and omized controlled aerobic exercise intervention versus usual care on fasting insulin , IGF-I , and its binding protein ( IGFBP-3 ) in postmenopausal breast cancer survivors . Methods : Seventy-five postmenopausal breast cancer survivors were identified from the Yale-New Haven Hospital Tumor Registry and r and omly assigned to an exercise ( n = 37 ) or usual care  ( n = 38 ) group . The exercise group participated in 150 minutes per week of moderate-intensity aerobic exercise . The usual care group was instructed to maintain their current physical activity level . A fasting blood sample was collected on each study participant at baseline and 6 months . Blood levels of insulin and IGF were measured with ELISA . Results : On average , exercisers increased  aerobic exercise  by 129 minutes per week compared with 45 minutes per week among usual care participants ( P < 0.001 ) . Women r and omized to exercise experienced decreases in insulin , IGF-I , and IGFBP-3 , whereas women r and omized to usual care had increases in these hormones . Between-group differences in insulin , IGF-I , and IGFBP-3 were 20.7 % ( P = 0.089 ) , 8.9 % ( P = 0.026 ) , and 7.9 % ( P = 0.006 ) , respectively . Conclusions : Moderate-intensity aerobic exercise , such as brisk walking , decreases IGF-I and IGFBP-3 . The exercise-induced decreases in IGF may mediate the observed association between higher levels of physical activity and improved survival in women diagnosed with breast cancer . ( Cancer Epidemiol Biomarkers Prev 2009;18(1):306–13 Introduction Inflammatory status may be an important prognostic factor for breast cancer . Correlates of markers of inflammation in breast cancer survivors have not been thoroughly evaluated . Methods Using data from , the Health , Eating , Activity , and Lifestyle ( HEAL ) Study ( a population -based , multiethnic prospect i ve cohort study of female breast cancer patients ) we evaluated the associations between circulating markers of inflammation ( C-reactive protein [ CRP ] and  serum amyloid A  [ SAA ] , measured ∼31 months after diagnosis ) and several demographic , lifestyle , and clinical characteristics in 741 disease-free breast cancer survivors . Analysis of variance and regression methods were used for statistical analyses of log-transformed values of CRP and SAA . Results After adjusting for age , BMI , ethnicity , and study site , higher concentrations of CRP were associated with increasing concentration of SAA ( P-trend < 0.0001 ) , increasing age ( P-trend < 0.0001 ) , increasing BMI ( P-trend < 0.0001 ) , increasing waist circumference ( P-trend < 0.0001 ) , positive history of heart failure ( P = 0.0007 ) , decreasing physical activity ( P-trend = 0.005 ) , Hispanic ethnicity ( P = 0.05 vs. non-Hispanic white ) , and current smoking ( P = 0.03 vs. never smoking ) . Vitamin E supplementation ( P = 0.0005 ) , tamoxifen use ( P = 0.008 ) , and radiation treatment ( compared to no chemotherapy or radiation ; P = 0.04 ) were associated with reduced CRP . Associations of CRP with clinical characteristics were not significant in the adjusted models . In a multivariate analysis , CRP showed significant associations with waist circumference , BMI , age , history of heart failure , tamoxifen use , and vitamin E supplementation ( R2 = 0.35 ) . Similar , yet fewer , associations were observed for SAA ( R2 = 0.19 ) . Conclusions This study highlights important correlates of inflammatory status in breast cancer patients . Our results are consistent with those from similar studies of healthy women PURPOSE / OBJECTIVES To compare the effectiveness of a prescribed home-based walking exercise intervention with usual care in older women receiving hormonal treatment for breast cancer , and to examine relationships among levels of the cortisol , serotonin , interleukin-6 , and bilirubin biomarkers and fatigue , sleep disturbances , and depressive symptoms . DESIGN Longitudinal r and omized clinical trial . SETTING A National Cancer Institute- design ated cancer center in the southeastern United States . SAMPLE 20 women ( aged 55 years or older ) with breast cancer receiving hormonal treatment . METHODS Participants were r and omized to a walking exercise intervention or usual care . Laboratory sample s and the Pittsburgh Sleep Quality Index ( PSQI ) , the Piper Revised Fatigue Scale , and the Center for Epidemiological Studies -Depression Scale were collected at the initial clinic visit and at 12 weeks from the groups . Question naires also were collected at weeks 2 and 14 . MAIN 
    Output:
    