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: Glutamine may be a conditionally essential amino acid in low-birth-weight ( LBW ) preterm neonates . Exogenously administered amino acids , by providing anaplerotic carbon into the tricarboxylic acid cycle , could result in greater cataplerotic efflux and glutamine de novo synthesis . The effect of dose and duration of amino acid infusion on glutamine and nitrogen ( N ) kinetics was examined in LBW infants in the period immediately after birth . Preterm neonates ( < 32 weeks gestation , birth weights 809 - 1,755 g ) were r and omized to initially receive either 480 or 960 micromol x kg(-1 ) x h(-1 ) of an intravenous amino acid solution for 19 - 24 hours , followed by a higher or lower amino acid load for either 5 h or 24 h. Glutamine de novo synthesis , leucine N , phenylalanine , and urea kinetics were determined using stable isotopic tracers . An increase in  amino acid infusion from 480 to 960 micromol x kg(-1 ) x h(-1 ) for 5 h result ed in decreased glutamine de novo synthesis in every neonate ( 384.4 + /- 38.0 to 368.9 + /- 38.2 micromol x kg(-1 ) x h(-1 ) , P < 0.01 ) and a lower whole body rate of proteolysis ( P < 0.001 ) and urea synthesis ( P < 0.001 ) . However , when the increased amino acid infusion was extended for 24 h , glutamine de novo synthesis increased ( 369.7 + /- 92.6 to 483.4 + /- 97.5 micromol x kg(-1 ) x h(-1 ) , P < 0.001 ) , whole body rate of proteolysis did not change , and urea production increased . Decreasing the amino acid load result ed in a decrease in glutamine rate of appearance ( R(a ) ) and leucine N R(a ) , but had no effect on phenylalanine R(a ) .  Acutely stressed LBW infants responded to an increase in amino acid load by transiently suppressing whole body rate of glutamine synthesis , proteolysis , and oxidation of protein . The mechanisms of this transient effect on whole body protein/nitrogen metabolism remain unknown 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 A controlled study comparing two intravenous fluid regimens was performed in sick , premature infants . The regimens were isocaloric at 60 calories/kg/day , one providing glucose alone , the other glucose plus 2.5 gm/kg of amino acids . There was no difference in changes in body weight between the two groups ; infants receiving glucose alone were in negative nitrogen balance ; those receiving glucose plus amino acids were in positive nitrogen balance . Plasma amino acid values were compared to published , postpr and ial normal values . The TEAA and TAA of infants receiving amino acids were not different from normal . Values of TEAA and TAA of infants receiving glucose alone were significantly lower . Essential fatty acid deficiency developed in infants receiving amino acids but not in those receiving glucose alone . It is concluded that the glucose plus amino acid regimen results in anabolism without undue metabolic costs 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 OBJECTIVE To evaluate the efficacy and safety of the parenteral administration of various quantities of amino acid in preterm infants . METHODS Preterm infants ( birth weight 1000 - 2000 g ) recruited into the study were r and omized into three groups . High amino acid group ( HP ) : 2.4 g/(kg.d ) of amino acid IV within 24 hours after birth increasing by increments of 1.2 g/(kg.d ) to a maximum of 3.6 g/(kg . d ) ; medium amino acid group ( MP ) : 1.0 g/(kg.d ) of amino acid IV 24 hours after birth , increasing by increments of 0.5 g/(kg.d ) until a maximum of 3.0 g/(kg.d ) ; and low amino acid group ( LP ) : 0.5 g/(kg.d ) of amino acid on D3 , increasing by increments of 0.5 g/(kg.d ) until a maximum of 3.0 g/(kg.d ) as the final dose . RESULTS Totally 96 preterm infants were recruited : HP 34 , MP 32 and LP 30 . There were no significant differences in demographic or clinical characteristics among the 3 groups . HP group showed lower postnatal weight loss ( 43.4 g , 95 % CI 74.3 , 12.6 ) and weight loss% ( 2.84 % , 95 % CI 4.79 % , 0.71 % ) than LP group . HP group showed shorter length of stay in NICU ( 5.25 d ) , days to reach 2000 g ( 7.03 d ) and days to tolerate 100 kcal/(kg.d ) enteral nutrition ( 4.52 d ) than LP group . Cost of hospitalization was significantly lower in HP group than in LP group ( -6275 RMB , 1 US$ = 8 RMB ) and MP group ( -5715 RMB ) . Mean serum RBP ( D4 ) , threonine and tyrosine levels were significantly higher in HP group than in LP group . Serum insulin levels were similar ; mean serum glucose level was lower in HP group than in LP group . HP infants had lower incidence of sepsis than LP infants ( 21.9 % vs 40.0 % ) . There were no significant differences in the levels of blood ammonia , acid-base balance ( as determined by pH and NaHCO3- ) , BUN , Cr , AST , and ALT . CONCLUSIONS Intensive and early administration of intravenous amino acid [ 2.4 g/(kg.d ) ] improves  preterm infants ' growth and the tolerance of enteral feeding . It also reduces the cost of hospitalization , and the incidence of sepsis In order to determine the intravenous energy and nitrogen intakes required to achieve intrauterine rates of nitrogen accretion and growth , 30 studies were completed in 22 premature infants who were provided with various intakes of amino acids and energy ( glucose + /- lipid ) by peripheral vein infusion .  At constant nitrogen intake , increasing energy intake ( as lipid ) from 50 to 80 nonprotein kcal/kg/day result ed in significant increases in nitrogen retention and weight gain . Increasing nitrogen intake from 494 to 655 mg/kg/day at constant low energy intake ( mean = 53 kcal/kg/day ) had no effect on nitrogen retention or weight change ; however , at higher energy intakes ( mean = 81 kcal/kg/day ) increasing nitrogen intake correlated significantly with increasing nitrogen retention . At energy intakes greater than 70 kcal/kg/day the major determinant of nitrogen retention was nitrogen intake . When energy intake was greater than 70 kcal/kg/day , the infusion of nitrogen providing 430 to 560 mg/kg/day ( 2.7 to 3.5 gm protein/kg/day ) result ed in the duplication of intrauterine nitrogen accretion rates OBJECTIVE : To examine the influence of the macronutrient intake in early life on the development of  overweight in children . DESIGN AND SUBJECTS : An ongoing longitudinal study including 147 r and omized healthy children followed up from birth . MEASUREMENTS : Anthropometric parameters were measured at birth , 1 and 5 y of age . Dietary habits at the age of 1 and 5 were assessed by age-adjusted food-frequency question naires and 24 h recalls .  Parents ’ body mass index ( BMI ) was also recorded . RESULTS :  Parental overweight was observed for 51 % children . The prevalence of overweight at the age of 5 y was higher in children with than without parental overweight ( 37.3 % vs 8.3 % , P<0.0001 ) . Five-year old overweight children had a higher percentage intake of proteins at the age of 1 y than non overweight children ( 22 % vs 20 % , P=0.024 ) and lower intake of carbohydrates ( 44 % vs 47 % , P=0.031 ) . Multiple logistic analysis confirmed that protein intake at 1 y of age was associated with overweight at 5 y ( P=0.05 ) . In children born from overweight mothers , prevalence of overweight at the age of 5 y tended to be higher in bottle-fed than in breast-fed ones ( 62.5 % vs 23.3 % , P=0.08 ) . CONCLUSION : Parental overweight is a major risk factor for childhood overweight in the first years of life , but an early high protein intake may also influence the development of adiposity Objectives : To evaluate the effect of trace elements ( TEs ) , when added to total parenteral nutrition ( TPN ) solutions , on peroxides load , and to test the hypothesis that protection of TPN from light can decrease peroxides load and is associated with improvement in oxidant-related clinical outcomes in preterm infants . Subjects and Methods : A total of 80 preterm infants were r and omized to 1 of 4 groups ( n = 20 each ) : group 1 received a mixture of dextrose and amino acids ; group 2 received a mixture of dextrose , amino acids , and lipid emulsion ; group 3 received dextrose , amino acids , lipid emulsion , and multivitamins ( MVP ) ; and group 4 received dextrose , amino acids , lipid emulsion , MVP , and TEs . Each group was subdivided into photo-protected and photo-exposed subgroups ( n = 10 each ) . Using ferrous oxidation of xy 
    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: Glutamine may be a conditionally essential amino acid in low-birth-weight ( LBW ) preterm neonates . Exogenously administered amino acids , by providing anaplerotic carbon into the tricarboxylic acid cycle , could result in greater cataplerotic efflux and glutamine de novo synthesis . The effect of dose and duration of amino acid infusion on glutamine and nitrogen ( N ) kinetics was examined in LBW infants in the period immediately after birth . Preterm neonates ( < 32 weeks gestation , birth weights 809 - 1,755 g ) were r and omized to initially receive either 480 or 960 micromol x kg(-1 ) x h(-1 ) of an intravenous amino acid solution for 19 - 24 hours , followed by a higher or lower amino acid load for either 5 h or 24 h. Glutamine de novo synthesis , leucine N , phenylalanine , and urea kinetics were determined using stable isotopic tracers . An increase in  amino acid infusion from 480 to 960 micromol x kg(-1 ) x h(-1 ) for 5 h result ed in decreased glutamine de novo synthesis in every neonate ( 384.4 + /- 38.0 to 368.9 + /- 38.2 micromol x kg(-1 ) x h(-1 ) , P < 0.01 ) and a lower whole body rate of proteolysis ( P < 0.001 ) and urea synthesis ( P < 0.001 ) . However , when the increased amino acid infusion was extended for 24 h , glutamine de novo synthesis increased ( 369.7 + /- 92.6 to 483.4 + /- 97.5 micromol x kg(-1 ) x h(-1 ) , P < 0.001 ) , whole body rate of proteolysis did not change , and urea production increased . Decreasing the amino acid load result ed in a decrease in glutamine rate of appearance ( R(a ) ) and leucine N R(a ) , but had no effect on phenylalanine R(a ) .  Acutely stressed LBW infants responded to an increase in amino acid load by transiently suppressing whole body rate of glutamine synthesis , proteolysis , and oxidation of protein . The mechanisms of this transient effect on whole body protein/nitrogen metabolism remain unknown 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 A controlled study comparing two intravenous fluid regimens was performed in sick , premature infants . The regimens were isocaloric at 60 calories/kg/day , one providing glucose alone , the other glucose plus 2.5 gm/kg of amino acids . There was no difference in changes in body weight between the two groups ; infants receiving glucose alone were in negative nitrogen balance ; those receiving glucose plus amino acids were in positive nitrogen balance . Plasma amino acid values were compared to published , postpr and ial normal values . The TEAA and TAA of infants receiving amino acids were not different from normal . Values of TEAA and TAA of infants receiving glucose alone were significantly lower . Essential fatty acid deficiency developed in infants receiving amino acids but not in those receiving glucose alone . It is concluded that the glucose plus amino acid regimen results in anabolism without undue metabolic costs 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 OBJECTIVE To evaluate the efficacy and safety of the parenteral administration of various quantities of amino acid in preterm infants . METHODS Preterm infants ( birth weight 1000 - 2000 g ) recruited into the study were r and omized into three groups . High amino acid group ( HP ) : 2.4 g/(kg.d ) of amino acid IV within 24 hours after birth increasing by increments of 1.2 g/(kg.d ) to a maximum of 3.6 g/(kg . d ) ; medium amino acid group ( MP ) : 1.0 g/(kg.d ) of amino acid IV 24 hours after birth , increasing by increments of 0.5 g/(kg.d ) until a maximum of 3.0 g/(kg.d ) ; and low amino acid group ( LP ) : 0.5 g/(kg.d ) of amino acid on D3 , increasing by increments of 0.5 g/(kg.d ) until a maximum of 3.0 g/(kg.d ) as the final dose . RESULTS Totally 96 preterm infants were recruited : HP 34 , MP 32 and LP 30 . There were no significant differences in demographic or clinical characteristics among the 3 groups . HP group showed lower postnatal weight loss ( 43.4 g , 95 % CI 74.3 , 12.6 ) and weight loss% ( 2.84 % , 95 % CI 4.79 % , 0.71 % ) than LP group . HP group showed shorter length of stay in NICU ( 5.25 d ) , days to reach 2000 g ( 7.03 d ) and days to tolerate 100 kcal/(kg.d ) enteral nutrition ( 4.52 d ) than LP group . Cost of hospitalization was significantly lower in HP group than in LP group ( -6275 RMB , 1 US$ = 8 RMB ) and MP group ( -5715 RMB ) . Mean serum RBP ( D4 ) , threonine and tyrosine levels were significantly higher in HP group than in LP group . Serum insulin levels were similar ; mean serum glucose level was lower in HP group than in LP group . HP infants had lower incidence of sepsis than LP infants ( 21.9 % vs 40.0 % ) . There were no significant differences in the levels of blood ammonia , acid-base balance ( as determined by pH and NaHCO3- ) , BUN , Cr , AST , and ALT . CONCLUSIONS Intensive and early administration of intravenous amino acid [ 2.4 g/(kg.d ) ] improves  preterm infants ' growth and the tolerance of enteral feeding . It also reduces the cost of hospitalization , and the incidence of sepsis In order to determine the intravenous energy and nitrogen intakes required to achieve intrauterine rates of nitrogen accretion and growth , 30 studies were completed in 22 premature infants who were provided with various intakes of amino acids and energy ( glucose + /- lipid ) by peripheral vein infusion .  At constant nitrogen intake , increasing energy intake ( as lipid ) from 50 to 80 nonprotein kcal/kg/day result ed in significant increases in nitrogen retention and weight gain . Increasing nitrogen intake from 494 to 655 mg/kg/day at constant low energy intake ( mean = 53 kcal/kg/day ) had no effect on nitrogen retention or weight change ; however , at higher energy intakes ( mean = 81 kcal/kg/day ) increasing nitrogen intake correlated significantly with increasing nitrogen retention . At energy intakes greater than 70 kcal/kg/day the major determinant of nitrogen retention was nitrogen intake . When energy intake was greater than 70 kcal/kg/day , the infusion of nitrogen providing 430 to 560 mg/kg/day ( 2.7 to 3.5 gm protein/kg/day ) result ed in the duplication of intrauterine nitrogen accretion rates OBJECTIVE : To examine the influence of the macronutrient intake in early life on the development of  overweight in children . DESIGN AND SUBJECTS : An ongoing longitudinal study including 147 r and omized healthy children followed up from birth . MEASUREMENTS : Anthropometric parameters were measured at birth , 1 and 5 y of age . Dietary habits at the age of 1 and 5 were assessed by age-adjusted food-frequency question naires and 24 h recalls .  Parents ’ body mass index ( BMI ) was also recorded . RESULTS :  Parental overweight was observed for 51 % children . The prevalence of overweight at the age of 5 y was higher in children with than without parental overweight ( 37.3 % vs 8.3 % , P<0.0001 ) . Five-year old overweight children had a higher percentage intake of proteins at the age of 1 y than non overweight children ( 22 % vs 20 % , P=0.024 ) and lower intake of carbohydrates ( 44 % vs 47 % , P=0.031 ) . Multiple logistic analysis confirmed that protein intake at 1 y of age was associated with overweight at 5 y ( P=0.05 ) . In children born from overweight mothers , prevalence of overweight at the age of 5 y tended to be higher in bottle-fed than in breast-fed ones ( 62.5 % vs 23.3 % , P=0.08 ) . CONCLUSION : Parental overweight is a major risk factor for childhood overweight in the first years of life , but an early high protein intake may also influence the development of adiposity Objectives : To evaluate the effect of trace elements ( TEs ) , when added to total parenteral nutrition ( TPN ) solutions , on peroxides load , and to test the hypothesis that protection of TPN from light can decrease peroxides load and is associated with improvement in oxidant-related clinical outcomes in preterm infants . Subjects and Methods : A total of 80 preterm infants were r and omized to 1 of 4 groups ( n = 20 each ) : group 1 received a mixture of dextrose and amino acids ; group 2 received a mixture of dextrose , amino acids , and lipid emulsion ; group 3 received dextrose , amino acids , lipid emulsion , and multivitamins ( MVP ) ; and group 4 received dextrose , amino acids , lipid emulsion , MVP , and TEs . Each group was subdivided into photo-protected and photo-exposed subgroups ( n = 10 each ) . Using ferrous oxidation of xy 
    Output:
    