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 Weight lifting has generally been proscribed for women with breast-cancer-related lymphedema , preventing them from obtaining the well-established health benefits of weight lifting , including increases in bone density . METHODS We performed a r and omized , controlled trial of twice-weekly progressive weight lifting involving 141 breast-cancer survivors with stable lymphedema of the arm . The primary outcome was the change in arm and h and swelling at 1 year , as measured through displaced water volume of the affected and unaffected limbs . Secondary outcomes included the incidence of exacerbations of lymphedema , number and severity of lymphedema symptoms , and muscle strength . Participants were required to wear a well-fitted compression garment while weight lifting . RESULTS The proportion of women who had an increase of 5 % or more in limb swelling was similar in the weight-lifting group ( 11 % ) and the control group ( 12 % ) ( cumulative incidence ratio , 1.00 ; 95 % confidence interval , 0.88 to 1.13 ) . As compared with the control group , the weight-lifting group had greater improvements in self-reported severity of lymphedema symptoms ( P=0.03 ) and upper- and lower-body strength ( P<0.001 for both comparisons ) and a lower incidence of lymphedema exacerbations as assessed by a certified lymphedema specialist ( 14 % vs. 29 % , P=0.04 ) . There were no serious adverse events related to the intervention . CONCLUSIONS In breast-cancer survivors with lymphedema , slowly progressive weight lifting had no significant effect on limb swelling and result ed in a decreased incidence of exacerbations of lymphedema , reduced symptoms , and increased strength . ( Clinical Trials.gov number , NCT00194363 . PURPOSE Adjuvant chemotherapy for women with breast cancer has significantly improved the cure rate ; however , it has been associated with chemotherapy-related cognitive impact ( CRCI ) . The literature provides preliminary support for the feasibility and efficacy of yoga interventions for the general cancer population , however , controlled trials are scarce and no studies have examined the effect of yoga on cognition for women with breast cancer during chemotherapy . This case series aims to identify the impact of yoga on measures of cognition , functional outcomes , and quality of life ( QOL ) for breast cancer survivors ( BCS ) . METHODS Four women with a diagnosis of early-stage breast cancer prior to chemotherapy treatment were administered the following physiologic measures at baseline , 6 , and 12 weeks during chemotherapy , and at one and three months after the conclusion of the study : Functional Reach test ( balance ) and Sit and Reach test ( flexibility ) , and QOL , POMS ( Mood ) and FACT-B ( QOL ) , at baseline . Primary outcomes of cognition were measured with the Perceived Cognition Question naire ( PCQ ) and CogState , a computerized measurement of cognition . Women attended an Iyengar-inspired yoga program twice a week for 12 weeks . Qualitative question naires were administered after the completion of the study to determine perceived benefits and challenges of the yoga program . RESULTS Four women with Stage II breast cancer ranged in age from 44 - 65 years . CogState computerized testing showed changes in varying domains of cognition through treatment and follow-up . Improved balance , flexibility , and QOL were also noted over time . No adverse events were observed . Analysis of qualitative data revealed the yoga classes were helpful and subjects continued the practice elements of yoga including relaxation , breathing , and stretching . The most challenging aspect of the study was physical limitations due to various medical complications and included fatigue , decreased range of motion , and pain . CONCLUSION This case series suggests that yoga may impact various aspects of cognition during and after chemotherapy administration as noted through quantitative measures . Women describe yoga as improving various domains of QOL through the treatment trajectory . This mind-body intervention may stave off CRCI ; however , further investigation is needed for additional r and omized controlled trials on the effects of yoga on cognition for women with breast cancer undergoing adjuvant chemotherapy treatment We have recently shown that a single bout of acute cardiovascular exercise improves motor skill learning through an optimization of long-term motor memory . Here we exp and this previous finding , to explore potential exercise-related biomarkers and their association with measures of motor memory and skill acquisition .  Thirty-two healthy young male subjects were r and omly allocated into either an exercise or control group . Following either an intense bout of cycling or rest subjects practice d a visuomotor tracking task .  Motor skill acquisition was assessed during practice and retention 1 h , 24 h and 7 days after practice . Plasma levels of brain-derived neurotrophic factor ( BDNF ) , vascular endothelial growth factor ( VEGF ) , insulin-like growth factor ( IGF-1 ) , epinephrine , norepinephrine , dopamine and lactate were analyzed at baseline , immediately after exercise or rest and during motor practice . The exercise group showed significantly better skill retention 24h and 7 days after acquisition . The concentration of all blood compounds increased significantly immediately after exercise and remained significantly elevated for 15 min following exercise except for BDNF and VEGF . Higher concentrations of norepinephrine and lactate immediately after exercise were associated with better acquisition . Higher concentrations of BDNF correlated with better retention 1 h and 7 days after practice . Similarly , higher concentrations of norepinephrine were associated with better retention 7 days after practice whereas lactate correlated with better retention 1h as well as 24 h and 7 days after practice . Thus , improvements in motor skill acquisition and retention induced by acute cardiovascular exercise are associated with increased concentrations of biomarkers involved in memory and learning processes . More mechanistic studies are required to eluci date the specific role of each biomarker in the formation of motor memory PURPOSE Interventions to increase physical activity among breast cancer survivors are needed to improve health and quality of life and possibly to reduce the risk of disease recurrence and early mortality . Therefore , we report the feasibility and preliminary outcomes of a pilot r and omized trial design ed to increase physical activity in sedentary breast cancer survivors receiving hormone therapy . METHODS Forty-one sedentary women on estrogen receptor modulators or aromatase inhibitors for stage I , II , or IIIA breast cancer were r and omly assigned to receive a 12-wk multidisciplinary physical activity behavior change intervention or usual care . RESULTS Recruitment was 34 % , intervention adherence was 99 % , and complete follow-up data were obtained on 93 % . Most participants ( 93 % ) were white with mean age of 53 + /- 9 yr . Differences favoring the intervention group were noted for accelerometer physical activity counts ( mean difference = 72,103 ; 95 % confidence interval ( CI ) = 25,383 - 119,000 ; effect size ( d ) = 1.02 ; P = 0.004 ) , aerobic fitness ( mean difference = 2.9 ; 95 % CI = -0.1 to 5.8 ; d = 0.64 ; P = 0.058 ) , back/leg muscle strength ( mean difference = 12.3 ; 95 % CI = 0.4 - 15.9 ; d = 0.81 ; P = 0.017 ) , waist-to-hip ratio ( mean difference = -0.05 ; 95 % CI = -0.01 to -0.08 ; d = -0.77 ; P = 0.018 ) , and social well-being ( mean difference = 2.0 ; 95 % CI = 0.3 - 3.8 ; d = 0.76 ; P = 0.03 ) . However , the intervention group also reported a greater increase in joint stiffness ( mean difference = 1.1 ; 95 % CI = 0.1 - 2.2 ; d = 0.70 ; P = 0.04 ) . CONCLUSIONS A behavior change intervention for breast cancer survivors based on the social cognitive theory is feasible and results in potentially meaningful improvements in physical activity and selected health outcomes . Confirmation in a larger study is warranted OBJECTIVES Cancer survivors often report cognitive problems . Furthermore , decreases in physical activity typically occur over the course of cancer treatment . Although physical activity benefits cognitive function in noncancer population s , evidence linking physical activity to cognitive function in cancer survivors is limited . In our recent r and omized controlled trial , breast cancer survivors who received a yoga intervention  had lower fatigue and inflammation following the trial compared with a wait list control group . This secondary analysis of the parent trial addressed yoga 's impact on cognitive complaints . METHODS Posttreatment stage 0-IIIA breast cancer survivors ( n = 200 ) were r and omized to a 12-week , twice-weekly Hatha yoga intervention or a wait list control group . Participants reported cognitive complaints using the Breast Cancer Prevention Trial Cognitive Problems Scale at baseline , immediately postintervention , and 3-month follow-up . RESULTS Cognitive complaints did not differ significantly between groups immediately postintervention ( p = 0.250 ) . However , at 3-month follow-up , yoga participants ' Breast Cancer Prevention Trial Cognitive Problems Scale scores were an average of 23 % lower than wait list participants ' scores ( p = 0.003 ) . These group differences in cognitive complaints remained after controlling for psychological distress , fatigue , and sleep quality . Consistent with the primary results , those who practice d yoga more frequently reported significantly fewer cognitive problems at 3-month follow-up than those who practice d less frequently ( p < 0.001 ) . CONCLUSIONS These findings suggest that yoga can effectively reduce breast cancer survivors ' cognitive complaints and prompt further research on mind-body and physical activity interventions for improving cancer-related cognitive problems PURPOSE To evaluate the influence of adjuvant tamoxifen and exemestane on cognitive functioning in postmenopausal patients with breast cancer ( BC ) . PATIENTS AND METHODS Neuropsychological assessment s were performed before the start ( T1 ) and after 1 year of adjuvant endocrine treatment ( T2 ) in Dutch postmenopausal patients with BC , who did not receive chemotherapy .  Patients participated in the international Tamoxifen and Exemestane Adjuvant Multinational trial , a prospect i ve r and omized study investigating tamoxifen versus exemestane as adjuvant therapy for hormone-sensitive BC . RESULTS Participants included 80 tamoxifen users ( mean age , 68.7 years ; range 51 to 84 ) , 99 exemestane users ( mean age , 68.3 years ; range , 50 to 82 ) , and 120 healthy controls ( mean age , 66.2 years ; range , 49 to 86 ) . At T2 , after adjustment for T1 performance , exemestane users did not perform statistically significantly worse than healthy controls on any cognitive domain . In contrast , tamoxifen users performed statistically significantly worse than healthy controls on verbal memory ( P < .01 ; Cohen 's d = .43 ) and executive functioning ( P = .01 ; Cohen 's d = .40 ) , and statistically significantly worse than exemestane users on information processing speed ( P = .02 ; Cohen 's d = .36 ) . With respect to visual memory , working memory , verbal fluency , reaction speed , and motor speed , no significant differences between the three groups were found . CONCLUSION After 1 year of adjuvant therapy , tamoxifen use is associated with statistically significant lower functioning in verbal memory and executive functioning , whereas exemestane use is not associated with statistically significant lower cognitive functioning in postmenopausal patients with BC . Our results accentuate the need to include assessment s of cognitive effects of adjuvant endocrine treatment in long-term safety studies OBJECTIVE We conducted this study with the aim of demonstrating the feasibility and efficacy of speed-feedback therapy with a bicycle ergometer on cognitive function  in elderly cancer patients . METHODS The subjects were patients with breast or prostate cancer who were 65 years of age or over . Among 146 patients , 78 were r and omly assigned to the intervention group ( n = 38 ) or the control group ( n = 40 ) . The intervention group received speed-feedback therapy with a bicycle ergometer once a week for four successive weeks . The control group was advised to spend the 4-week period engaged in their routine activities . Evaluations were carried out at the baseline and 4 weeks after the baseline ( week 4 ) using the Frontal Assessment Battery , the Barthel Index , the Lawton and Brody Instrumental Activities of Daily Living , and the Functional Assessment of Cancer Therapy-General ver.4 . Data were analyzed by a two-way repeated- measures analysis of variance . RESULTS The mean score of Frontal Assessment Battery for the intervention group was higher than that for the control group at week 4 . In addition to significant main effects of time and group , we also found a significant interaction between the two groups ( p = 0.006 ) . Moreover , all of the subjects in the intervention group could complete all the four sessions of therapy without any pain or distress . CONCLUSION These results suggest that speed-feedback therapy with a bicycle ergometer may be feasible as well as effective for improving the cognitive function in elderly cancer patients Recently , virtual environments ( VEs ) are suggested to encourage users to exercise regularly . The benefits of chronic exercise on cognitive performance are well documented in non-VE neurophysiological and behavioural studies . Based on event-related potentials ( ERP ) such as the N200 and P300 , cognitive processing may be interpreted on a neuronal level . However , exercise-related 
    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 Weight lifting has generally been proscribed for women with breast-cancer-related lymphedema , preventing them from obtaining the well-established health benefits of weight lifting , including increases in bone density . METHODS We performed a r and omized , controlled trial of twice-weekly progressive weight lifting involving 141 breast-cancer survivors with stable lymphedema of the arm . The primary outcome was the change in arm and h and swelling at 1 year , as measured through displaced water volume of the affected and unaffected limbs . Secondary outcomes included the incidence of exacerbations of lymphedema , number and severity of lymphedema symptoms , and muscle strength . Participants were required to wear a well-fitted compression garment while weight lifting . RESULTS The proportion of women who had an increase of 5 % or more in limb swelling was similar in the weight-lifting group ( 11 % ) and the control group ( 12 % ) ( cumulative incidence ratio , 1.00 ; 95 % confidence interval , 0.88 to 1.13 ) . As compared with the control group , the weight-lifting group had greater improvements in self-reported severity of lymphedema symptoms ( P=0.03 ) and upper- and lower-body strength ( P<0.001 for both comparisons ) and a lower incidence of lymphedema exacerbations as assessed by a certified lymphedema specialist ( 14 % vs. 29 % , P=0.04 ) . There were no serious adverse events related to the intervention . CONCLUSIONS In breast-cancer survivors with lymphedema , slowly progressive weight lifting had no significant effect on limb swelling and result ed in a decreased incidence of exacerbations of lymphedema , reduced symptoms , and increased strength . ( Clinical Trials.gov number , NCT00194363 . PURPOSE Adjuvant chemotherapy for women with breast cancer has significantly improved the cure rate ; however , it has been associated with chemotherapy-related cognitive impact ( CRCI ) . The literature provides preliminary support for the feasibility and efficacy of yoga interventions for the general cancer population , however , controlled trials are scarce and no studies have examined the effect of yoga on cognition for women with breast cancer during chemotherapy . This case series aims to identify the impact of yoga on measures of cognition , functional outcomes , and quality of life ( QOL ) for breast cancer survivors ( BCS ) . METHODS Four women with a diagnosis of early-stage breast cancer prior to chemotherapy treatment were administered the following physiologic measures at baseline , 6 , and 12 weeks during chemotherapy , and at one and three months after the conclusion of the study : Functional Reach test ( balance ) and Sit and Reach test ( flexibility ) , and QOL , POMS ( Mood ) and FACT-B ( QOL ) , at baseline . Primary outcomes of cognition were measured with the Perceived Cognition Question naire ( PCQ ) and CogState , a computerized measurement of cognition . Women attended an Iyengar-inspired yoga program twice a week for 12 weeks . Qualitative question naires were administered after the completion of the study to determine perceived benefits and challenges of the yoga program . RESULTS Four women with Stage II breast cancer ranged in age from 44 - 65 years . CogState computerized testing showed changes in varying domains of cognition through treatment and follow-up . Improved balance , flexibility , and QOL were also noted over time . No adverse events were observed . Analysis of qualitative data revealed the yoga classes were helpful and subjects continued the practice elements of yoga including relaxation , breathing , and stretching . The most challenging aspect of the study was physical limitations due to various medical complications and included fatigue , decreased range of motion , and pain . CONCLUSION This case series suggests that yoga may impact various aspects of cognition during and after chemotherapy administration as noted through quantitative measures . Women describe yoga as improving various domains of QOL through the treatment trajectory . This mind-body intervention may stave off CRCI ; however , further investigation is needed for additional r and omized controlled trials on the effects of yoga on cognition for women with breast cancer undergoing adjuvant chemotherapy treatment We have recently shown that a single bout of acute cardiovascular exercise improves motor skill learning through an optimization of long-term motor memory . Here we exp and this previous finding , to explore potential exercise-related biomarkers and their association with measures of motor memory and skill acquisition .  Thirty-two healthy young male subjects were r and omly allocated into either an exercise or control group . Following either an intense bout of cycling or rest subjects practice d a visuomotor tracking task .  Motor skill acquisition was assessed during practice and retention 1 h , 24 h and 7 days after practice . Plasma levels of brain-derived neurotrophic factor ( BDNF ) , vascular endothelial growth factor ( VEGF ) , insulin-like growth factor ( IGF-1 ) , epinephrine , norepinephrine , dopamine and lactate were analyzed at baseline , immediately after exercise or rest and during motor practice . The exercise group showed significantly better skill retention 24h and 7 days after acquisition . The concentration of all blood compounds increased significantly immediately after exercise and remained significantly elevated for 15 min following exercise except for BDNF and VEGF . Higher concentrations of norepinephrine and lactate immediately after exercise were associated with better acquisition . Higher concentrations of BDNF correlated with better retention 1 h and 7 days after practice . Similarly , higher concentrations of norepinephrine were associated with better retention 7 days after practice whereas lactate correlated with better retention 1h as well as 24 h and 7 days after practice . Thus , improvements in motor skill acquisition and retention induced by acute cardiovascular exercise are associated with increased concentrations of biomarkers involved in memory and learning processes . More mechanistic studies are required to eluci date the specific role of each biomarker in the formation of motor memory PURPOSE Interventions to increase physical activity among breast cancer survivors are needed to improve health and quality of life and possibly to reduce the risk of disease recurrence and early mortality . Therefore , we report the feasibility and preliminary outcomes of a pilot r and omized trial design ed to increase physical activity in sedentary breast cancer survivors receiving hormone therapy . METHODS Forty-one sedentary women on estrogen receptor modulators or aromatase inhibitors for stage I , II , or IIIA breast cancer were r and omly assigned to receive a 12-wk multidisciplinary physical activity behavior change intervention or usual care . RESULTS Recruitment was 34 % , intervention adherence was 99 % , and complete follow-up data were obtained on 93 % . Most participants ( 93 % ) were white with mean age of 53 + /- 9 yr . Differences favoring the intervention group were noted for accelerometer physical activity counts ( mean difference = 72,103 ; 95 % confidence interval ( CI ) = 25,383 - 119,000 ; effect size ( d ) = 1.02 ; P = 0.004 ) , aerobic fitness ( mean difference = 2.9 ; 95 % CI = -0.1 to 5.8 ; d = 0.64 ; P = 0.058 ) , back/leg muscle strength ( mean difference = 12.3 ; 95 % CI = 0.4 - 15.9 ; d = 0.81 ; P = 0.017 ) , waist-to-hip ratio ( mean difference = -0.05 ; 95 % CI = -0.01 to -0.08 ; d = -0.77 ; P = 0.018 ) , and social well-being ( mean difference = 2.0 ; 95 % CI = 0.3 - 3.8 ; d = 0.76 ; P = 0.03 ) . However , the intervention group also reported a greater increase in joint stiffness ( mean difference = 1.1 ; 95 % CI = 0.1 - 2.2 ; d = 0.70 ; P = 0.04 ) . CONCLUSIONS A behavior change intervention for breast cancer survivors based on the social cognitive theory is feasible and results in potentially meaningful improvements in physical activity and selected health outcomes . Confirmation in a larger study is warranted OBJECTIVES Cancer survivors often report cognitive problems . Furthermore , decreases in physical activity typically occur over the course of cancer treatment . Although physical activity benefits cognitive function in noncancer population s , evidence linking physical activity to cognitive function in cancer survivors is limited . In our recent r and omized controlled trial , breast cancer survivors who received a yoga intervention  had lower fatigue and inflammation following the trial compared with a wait list control group . This secondary analysis of the parent trial addressed yoga 's impact on cognitive complaints . METHODS Posttreatment stage 0-IIIA breast cancer survivors ( n = 200 ) were r and omized to a 12-week , twice-weekly Hatha yoga intervention or a wait list control group . Participants reported cognitive complaints using the Breast Cancer Prevention Trial Cognitive Problems Scale at baseline , immediately postintervention , and 3-month follow-up . RESULTS Cognitive complaints did not differ significantly between groups immediately postintervention ( p = 0.250 ) . However , at 3-month follow-up , yoga participants ' Breast Cancer Prevention Trial Cognitive Problems Scale scores were an average of 23 % lower than wait list participants ' scores ( p = 0.003 ) . These group differences in cognitive complaints remained after controlling for psychological distress , fatigue , and sleep quality . Consistent with the primary results , those who practice d yoga more frequently reported significantly fewer cognitive problems at 3-month follow-up than those who practice d less frequently ( p < 0.001 ) . CONCLUSIONS These findings suggest that yoga can effectively reduce breast cancer survivors ' cognitive complaints and prompt further research on mind-body and physical activity interventions for improving cancer-related cognitive problems PURPOSE To evaluate the influence of adjuvant tamoxifen and exemestane on cognitive functioning in postmenopausal patients with breast cancer ( BC ) . PATIENTS AND METHODS Neuropsychological assessment s were performed before the start ( T1 ) and after 1 year of adjuvant endocrine treatment ( T2 ) in Dutch postmenopausal patients with BC , who did not receive chemotherapy .  Patients participated in the international Tamoxifen and Exemestane Adjuvant Multinational trial , a prospect i ve r and omized study investigating tamoxifen versus exemestane as adjuvant therapy for hormone-sensitive BC . RESULTS Participants included 80 tamoxifen users ( mean age , 68.7 years ; range 51 to 84 ) , 99 exemestane users ( mean age , 68.3 years ; range , 50 to 82 ) , and 120 healthy controls ( mean age , 66.2 years ; range , 49 to 86 ) . At T2 , after adjustment for T1 performance , exemestane users did not perform statistically significantly worse than healthy controls on any cognitive domain . In contrast , tamoxifen users performed statistically significantly worse than healthy controls on verbal memory ( P < .01 ; Cohen 's d = .43 ) and executive functioning ( P = .01 ; Cohen 's d = .40 ) , and statistically significantly worse than exemestane users on information processing speed ( P = .02 ; Cohen 's d = .36 ) . With respect to visual memory , working memory , verbal fluency , reaction speed , and motor speed , no significant differences between the three groups were found . CONCLUSION After 1 year of adjuvant therapy , tamoxifen use is associated with statistically significant lower functioning in verbal memory and executive functioning , whereas exemestane use is not associated with statistically significant lower cognitive functioning in postmenopausal patients with BC . Our results accentuate the need to include assessment s of cognitive effects of adjuvant endocrine treatment in long-term safety studies OBJECTIVE We conducted this study with the aim of demonstrating the feasibility and efficacy of speed-feedback therapy with a bicycle ergometer on cognitive function  in elderly cancer patients . METHODS The subjects were patients with breast or prostate cancer who were 65 years of age or over . Among 146 patients , 78 were r and omly assigned to the intervention group ( n = 38 ) or the control group ( n = 40 ) . The intervention group received speed-feedback therapy with a bicycle ergometer once a week for four successive weeks . The control group was advised to spend the 4-week period engaged in their routine activities . Evaluations were carried out at the baseline and 4 weeks after the baseline ( week 4 ) using the Frontal Assessment Battery , the Barthel Index , the Lawton and Brody Instrumental Activities of Daily Living , and the Functional Assessment of Cancer Therapy-General ver.4 . Data were analyzed by a two-way repeated- measures analysis of variance . RESULTS The mean score of Frontal Assessment Battery for the intervention group was higher than that for the control group at week 4 . In addition to significant main effects of time and group , we also found a significant interaction between the two groups ( p = 0.006 ) . Moreover , all of the subjects in the intervention group could complete all the four sessions of therapy without any pain or distress . CONCLUSION These results suggest that speed-feedback therapy with a bicycle ergometer may be feasible as well as effective for improving the cognitive function in elderly cancer patients Recently , virtual environments ( VEs ) are suggested to encourage users to exercise regularly . The benefits of chronic exercise on cognitive performance are well documented in non-VE neurophysiological and behavioural studies . Based on event-related potentials ( ERP ) such as the N200 and P300 , cognitive processing may be interpreted on a neuronal level . However , exercise-related 
    Output:
    