***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: Psychoneuroimmunology is a framework for mind-body practice and research that combines cutting-edge scientific exploration with holistic philosophy to appreciate and underst and stress responses . The rapidly growing research literature provides a foundation for building an integrative stress management model with the potential to positively influence the stress-disease relationship and , ultimately , health outcomes . This article introduces a novel tai chi intervention and provides quantitative and qualitative data from a r and omized clinical trial indicating its effects on psychosocial variables in individuals living with various stages of HIV disease Purpose of review This review highlights recent work evaluating the relationship between exercise , physical activity and physical and mental health . Both cross-sectional and longitudinal studies , as well as r and omized clinical trials , are included . Special attention is given to physical conditions , including obesity , cancer , cardiovascular disease and sexual dysfunction . Furthermore , studies relating physical activity to depression and other mood states are review ed . The studies include diverse ethnic population s , including men and women , as well as several age groups ( e.g. adolescents , middle-aged and older adults ) . Recent findings Results of the studies continue to support a growing literature suggesting that exercise , physical activity and physical-activity interventions have beneficial effects across several physical and mental-health outcomes . Generally , participants engaging in regular physical activity display more desirable health outcomes across a variety of physical conditions . Similarly , participants in r and omized clinical trials of physical-activity interventions show better health outcomes , including better general and health-related quality of life , better functional capacity and better mood states . Summary The studies have several implication s for clinical practice and research . Most work suggests that exercise and physical activity are associated with better quality of life and health outcomes . Therefore , assessment and promotion of exercise and physical activity may be beneficial in achieving desired benefits across several population s. Several limitations were noted , particularly in research involving r and omized clinical trials . These trials tend to involve limited sample sizes with short follow-up periods , thus limiting the clinical implication s of the benefits associated with physical activity . Abbreviations CAD : coronary artery disease ; COPD : chronic obstructive pulmonary disease ; CRP : cardiac rehabilitation program ; CVD : cardiovascular disease ; GMCB : group-mediated cognitive – behavioural ; HRQOL : health-related quality of life Objective Our objective was to examine the effects of exercise training ( EXS ) on quality of life ( QoL ) in highly active antiretroviral therapy (HAART)-treated HIV-positive ( HIV+ ) subjects with body fat redistribution ( BFR ) in Rw and a. Methods The effects of a r and omised controlled trial of EXS on QoL were measured using World Health Organisation Quality of Life (WHOQOL)-BREF  in HIV+ subjects with BFR r and omised to EXS ( n = 50 ; BFR + EXS ) or no exercise training ( n = 50 ; BFR + noEXS ) . Results At 6 months , scores on the psychological [ 1.3 ( 0.3 ) vs. 0.5 ( 0.1 ) ; P < 0.0001 ] , independence [ 0.6 ( 0.1 ) vs. 0.0 ( 0.0 ) ; P < 0.0001 ] , social relationships [ 0.6 ( 0.2 ) vs. 0.0 ( 0.0 ) ; P < 0.0001 ] and HIV HAART-specific QoL domains [ 1.4 ( 0.2 ) vs. −0.1 ( 0.2 ) ; P < 0.0001 ] improved more in BFR + EXS than BFR + noEXS group , respectively . Self-esteem [ 1.3 ( 0.8 ) vs. 0.1 ( 0.6 ) ; P < 0.001 ] , body image [ 1.5 ( 0.6 ) vs. 0.0 ( 0.5 ) ; P < 0.001 ] and emotional stress [ 1.6 ( 0.7 ) vs. 0.2 ( 0.5 ) ; P < 0.001 ] improved more in the BFR + EXS group than BFR + noEXS group , respectively . Psychological [ 1.5 ( 0.2 ) vs. 1.1 ( 0.3 ) ; P < 0.0001 ] , social relationship [ 0.8 ( 0.2 ) vs. 0.4 ( 0.2 ) ; P < 0.0001 ] , and HIV HAART-specific well-being [ 1.8 ( 0.2 ) vs. 1.0 ( 0.0 ) ; P < 0.0001 ] improved more in BFR + EXS female than male subjects . Conclusions Exercise training improved several components of QoL in HAART-treated HIV+ African subjects with BFR .  Exercise training is an inexpensive and efficacious strategy for improving QoL in HIV+ African subjects , which may improve HAART adherence and treatment initiatives in re source -limited areas of sub-Saharan Africa The prevalence and incidence of insulin resistance and type 2 diabetes mellitus ( DM ) are higher in people treated for human immunodeficiency virus-1 ( HIV ) infection than in the general population . Identifying safe and effective interventions is a high priority . We evaluated whether the peroxisome proliferator-activated receptor-γ agonist pioglitazone with exercise training improves central and peripheral insulin sensitivity more than pioglitazone alone in HIV-infected adults with insulin resistance and central adiposity . Forty-four HIV-infected adults with baseline insulin resistance and central adiposity were r and omly assigned to 4 mo of pioglitazone ( 30 mg/day ) with or without supervised , progressive aerobic , and resistance exercise training ( 1.5 - 2 h/day , 3 days/wk ) . The hyperinsulinemic euglycemic clamp was used to evaluate alterations in central and peripheral insulin sensitivity . Thirty-nine participants completed the study . Hepatic insulin sensitivity improved similarly in both groups . Exercise training augmented the beneficial effects of pioglitazone on peripheral insulin sensitivity . Greater improvements in peripheral insulin sensitivity were associated with reductions in total body and limb adipose content rather than increases in limb adiposity or pioglitazone-induced increases in adiponectin concentration . We conclude that supplementing pioglitazone with increased physical activity improved insulin sensitivity more effectively than pioglitazone alone in HIV-infected adults with insulin resistance and central adiposity . Pioglitazone alone did not significantly increase limb adipose content . Potential cardiovascular benefits of these interventions in HIV need investigation Neurocognitive impairment ( NCI ) remains prevalent in HIV infection . R and omized trials have shown that physical exercise improves NCI in non-HIV-infected adults , but data on HIV-infected population s are limited . Community-dwelling HIV-infected participants ( n = 335 ) completed a comprehensive neurocognitive battery that was utilized to define both global and domain-specific NCI . Participants were divided into “ exercise ” ( n = 83 ) and “ no exercise ” ( n = 252 ) groups based on whether they self-reported engaging in any activity that increased heart rate in the last 72 h or not . We also measured and evaluated a series of potential confounding factors , including demographics , HIV disease characteristics , substance use and psychiatric comorbidities , and physical functioning . Lower rates of global NCI were observed among the exercise group ( 15.7 % ) as compared to those in the no exercise group ( 31.0 % ; p < 0.01 ) . A multivariable logistic regression controlling for potential confounds ( i.e. , education , AIDS status , current CD4 + lymphocyte count , self-reported physical function , current depression ) showed that being in the exercise group remained significantly associated with lower global NCI ( odds ratio = 2.63 , p < 0.05 ) . Similar models of domain-specific NCI showed that exercise was associated with reduced impairment in working memory ( p < 0.05 ) and speed of information processing ( p < 0.05 ) . The present findings suggest that HIV-infected adults who exercise are approximately half as likely to show NCI as compared to those who do not . Future longitudinal studies might be best suited to address causality , and intervention trials in HIV-infected individuals will determine whether exercise can prevent or ameliorate NCI in this population Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more OBJECTIVES : Human Immunodeficiency Virus ( HIV ) infection worsens the frailty of elderly people , compromising their quality of life . In this study we prospect ively evaluated eleven patients living with HIV and 21 controls older than 60 years and without prior regular physical activity , who engaged in a one-year progressive resistance exercise program  to compare its effects on muscular strength , physical fitness and body composition . METHODS : Exercises for major muscular groups were performed 2 times/week , under professional supervision . Strength increase was evaluated bimonthly , while body composition , lipid and glycaemic profiles ( only of those living with HIV ) and physical fitness were evaluated before and after the one-year training . RESULTS : The participants living with HIV were lighter , had smaller Body Mass Index and were initially much weaker than controls . However , their strength increased more ( 1.52 - 2.33 times the baseline values for those living with HIV x 1.21 - 1.48 times for controls , p<0.01 ) , nullifying the differences initially seen . These effects were seen independently of gender , age or baseline physical activity . In addition , those living with HIV improved their fasting glucose levels and showed a tendency to improve their lipids after the one year training program . These effects were slightly more pronounced among those not using protease inhibitors , although not significantly . CONCLUSIONS : Resistance exercise safely increased the strength of older patients living with HIV adults , allowing them to achieve performance levels observed among otherwise healthy controls . These findings favor the recommendation of resistance exercise for elderly adults living with HIV adults CONTEXT HIV patients on antiretroviral therapy ( ART ) have a unique dyslipidemia [ elevated triglycerides and non-high-density lipoprotein-cholesterol ( HDL-C ) , low HDL-C ] with insulin resistance ( characterized by hypoadiponectinemia ) . OBJECTIVE The aim was to test a targeted , comprehensive , additive approach to treating the dyslipidemia . DESIGN AND SETTING We conducted a r and omized , double-blind , placebo-controlled , 24-wk trial of lifestyle modification , fenofibrate , and niacin in multiethnic HIV clinics at an academic center . PARTICIPANTS Hypertriglyceridemic adult patients were stratified on three combinations of ART classes . Subjects retained at the first measurement ( 2 wk ) after entry were included in the analysis ( n = 191 ) . INTERVENTIONS Subjects were r and omized into five treatment groups : usual care ( group 1 ) ; low-saturated-fat diet and exercise ( D/E ; group 2 ) ; D/E + fenofibrate ( group 3 ) ; D/E + niacin ( group 4 ) ; or D/E + fenofibrate + niacin ( group 5 ) . MAIN OUTCOME MEASURES We measured changes in fasting triglycerides , HDL-C , and non-HDL-C ( primary ) , and in insulin sensitivity , glycemia , adiponectin , C-reactive protein , energy expenditure , and body composition ( secondary ) . Data were analyzed as a factorial set of treatment combinations using a mixed repeated measures model , last observation carried forward , and complete case approaches ( groups 2 - 5 ) , and as an unstructured set of treatments ( groups 1 - 5 ) . RESULTS Fenofibrate improved triglycerides ( P = 0.002 ) , total cholesterol ( P = 0.02 ) , and non-HDL-C ( P = 0.003 ) , whereas niacin improved HDL-C ( P = 0.03 ) , and both drugs decreased the total cholesterol-to-HDL-C ratio ( P = 0.005 - 0.01 ) . The combination of D/E , fenofibrate , and niacin provided maximal benefit , markedly reducing triglycerides ( -52 % compared to usual care ; P = 0.003 ) , increasing HDL-C ( + 12 % ; P < 0.001 ) , and decreasing non-HDL-C ( -18.5 % ; P = 0.003 ) and total cholesterol-to-HDL-C ratio ( -24.5 % ; P < 0.001 ) . Niacin doubled adiponectin levels . CONCLUSIONS A combination of fenofibrate and niacin with low-saturated-fat D/E is effective and safe in increasing HDL-C , decreasing non-HDL-C and hypertriglyceridemia , and ameliorating hypoadiponectinemia in patients with HIV/ART-associated dyslipidemia PURPOSE The purpose s of the present study were to assess the effects of a 12-wk laboratory based aerobic exercise program on cardiopulmonary function , CD4 cell count , and physician-assessed health status among symptomatic pre-AIDS HIV-infected individuals ( N = 28 ) and to assess the degree to which ill health was associated with exercise relapse . METHODS Responses to grade d exercise test , physician-assessed health status , and CD4 cell counts were determined 
    Output:
    
Main results indicated statistically significant improvements in selected outcomes of cardiorespiratory status ( maximum oxygen consumption , exercise time ) , strength ( chest press , knee flexion ) , body composition ( lean body mass , percent body fat , leg muscle area ) , depression symptoms , and quality of life ( SF-36 question naire ) among exercisers compared with non-exercisers .
No significant differences in change in CD4 count and viral load were found .
Conclusions Performing aerobic exercise or a combination of aerobic and resistive exercise at least three times per week for at least five weeks is safe and can lead to improvements in cardiorespiratory fitness , strength , body composition and quality of life for adults with HIV .
Aerobic exercise is safe and beneficial for adults living with HIV who are medically stable