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 Raisins are a significant source of dietary fiber and polyphenols , which may reduce cardiovascular disease ( CVD ) risk by affecting lipoprotein metabolism and inflammation . Walking represents a low intensity exercise intervention that may also reduce CVD risk . The purpose of this study was to determine the effects of consuming raisins , increasing steps walked , or a combination of these interventions on blood pressure , plasma lipids , glucose , insulin and inflammatory cytokines . Results Thirty-four men and postmenopausal women were matched for weight and gender and r and omly assigned to consume 1 cup raisins/d ( RAISIN ) , increase the amount of steps walked/d ( WALK ) or a combination of both interventions ( RAISINS + WALK ) . The subjects completed a 2 wk run-in period , followed by a 6 wk intervention . Systolic blood pressure was reduced for all subjects ( P = 0.008 ) . Plasma total cholesterol was decreased by 9.4 % for all subjects ( P < 0.005 ) , which was explained by a 13.7 % reduction in plasma LDL cholesterol ( LDL-C ) ( P < 0.001 ) . Plasma triglycerides ( TG ) concentrations were decreased by 19.5 % for WALK ( P < 0.05 for group effect ) . Plasma TNF-α was decreased from 3.5 ng/L to 2.1 ng/L for RAISIN ( P < 0.025 for time and group × time effect ) . All subjects had a reduction in plasma sICAM-1 ( P < 0.01 ) . Conclusion This research shows that simple lifestyle modifications such as adding raisins to the diet or increasing steps walked have distinct beneficial effects on CVD risk Background National guidelines call for exercise of at least moderate intensity ; however , recommending self-paced exercise may lead to better adherence , particularly among overweight and obese adults . Purpose The purpose of this study was to test proof-of-concept for recommending self-paced exercise among overweight adults . Methods Fifty-nine healthy , low-active ( exercise < 60 min/week ) , overweight ( body mass index 25.0–39.9 ) adults ( 18–65 ) received a 6-month print-based exercise promotion program with the goal of walking 30–60 min/day . Participants were surreptitiously r and omly assigned to receive a recommendation for either self-paced ( n = 30 ) or moderate ( 64–76 % maximum heart rate ; n = 29 ) intensity exercise . All participants used electronic diaries and heart rate monitors to track exercise frequency , duration , and intensity . Results The self-paced condition reported more minutes/week of walking ( f2 = 0.17 , p = 0.045 ) and a trend toward greater exercise-related energy expenditure/week ( f2 = 0.12 , p = 0.243 ) , corresponding to approximately 26 additional minutes/week and 83 additional kilocalories/week over 6 months . Conclusions Explicit recommendation for self-paced exercise may improve adherence to exercise programs among overweight and obese adults INTRODUCTION Exercise can increase bone strength , but to be effective in reducing fracture risk , exercise must be feasible enough to be adopted into daily life and influence potentially vulnerable skeletal sites such as the superolateral cortex of the femoral neck , where thinning is associated with increased fracture risk . Brief , high-impact exercise increases femoral neck bone density but the optimal frequency of such exercise and the location of bone accrual is unknown . This study thus examined ( 1 ) the effectiveness of different weekly frequencies of exercise on femoral neck BMD and ( 2 ) whether BMD change differed between hip sites using a high-impact , unilateral intervention . METHODS Healthy premenopausal women were r and omly assigned to exercise 0 , 2 , 4 , or 7 days/week for 6 months . The exercise intervention incorporated 50 multidirectional hops on one r and omly selected leg . BMD was measured by DXA at baseline and after 6 months of exercise . Changes in the exercise leg were compared between groups using ANCOVA , with change in the control leg and baseline BMD as covariates . RM-MANOVA was conducted to determine whether bone changes from  exercise  differed between hip sites . RESULTS 61 women ( age 33.6+/-11.1 years ) completed the intervention .  Compliance amongst exercisers was 86.7+/-10.6 % . Peak ground reaction forces during exercise increased from 2.5 to 2.8 times body weight . The change in femoral neck BMD in the exercise limb ( adjusted for change in the control limb and baseline BMD ) differed between groups ( p=0.015 ) , being -0.3 % ( -1.2 to 0.6 ) , 0.0 % ( -1.0 to 1.0 ) , 0.9 % ( -0.1 to 2.0 ) and 1.8 % ( 0.8 to 2.8 ) in those exercising 0 , 2 , 4 and 7 days per week , respectively . When BMD changes at upper neck , lower neck and trochanter were compared using RM-MANOVA , a significant exercise effect was observed ( p=0.048 ) , but this did not differ significantly between sites ( p=0.439 ) despite greatest mean increases at the upper femoral neck . CONCLUSIONS Brief , daily hopping exercises increased femoral neck BMD in premenopausal women but less frequent exercise was not effective . Brief high-impact exercise may have a role in reducing hip fragility , but may need to be performed frequently for optimal response Aims To investigate the effect of 16 weeks of aerobic training performed at two different intensities on nitric oxide ( tNOx ) availability and iNOS/nNOS expression , oxidative stress ( OS ) and inflammation in obese humans with or without type 2 diabetes mellitus ( T2DM ) . Methods Twenty-five sedentary , obese ( BMI > 30 kg/m2 ) males ( 52.8 ± 7.2 years ) ; 12 controls versus 13 T2DM were r and omly allocated to four groups that exercised for 30 min , three times per week either at low ( Fat-Max ; 30–40 % VO2max ) or moderate ( Tvent ; 55–65 % VO2max ) intensity . Before and after training , blood and muscle sample s ( v. lateralis ) were collected . Results Baseline erythrocyte glutathione was lower ( 21.8 ± 2.8 vs. 32.7 ± 4.4 nmol/ml ) and plasma protein oxidative damage and IL-6 were higher in T2DM ( 141.7 ± 52.1 vs. 75.5 ± 41.6 nmol/ml ) . Plasma catalase increased in T2DM after Tvent training ( from 0.98 ± 0.22 to 1.96 ± 0.3 nmol/min/ml ) . T2DM groups demonstrated evidence of oxidative damage in response to training ( elevated protein carbonyls ) . Baseline serum tNOx were higher in controls than T2DM ( 18.68 ± 2.78 vs. 12.34 ± 3.56 μmol/l ) . Training at Tvent increased muscle nNOS and tNOx in the control group only . Pre-training muscle nNOS was higher in controls than in T2DMs , while the opposite was found for iNOS . No differences were found after training for plasma inflammatory markers . Conclusion Exercise training did not change body composition or aerobic fitness , but improved OS markers , especially when performed at Tvent . Non-diabetics responded to Tvent training by increasing muscle nNOS expression and tNOx levels in skeletal muscle while these parameters did not change in T2DM , perhaps due to higher insulin resistance ( unchanged after intervention ) Aims . High-intensity interval training ( HIIT ) leads to improvements in various markers of cardiometabolic health but adherence to HIIT following a supervised laboratory intervention has yet to be tested . We compared self-report and objective measures of physical activity after one month of independent exercise in individuals with prediabetes who were r and omized to HIIT ( n = 15 ) or traditional moderate-intensity continuous training ( MICT , n = 17 ) . Method . After completing 10 sessions of supervised training  participants were asked to perform HIIT or MICT three times per week for four weeks . Results . Individuals in HIIT ( 89 ± 11 % ) adhered to their prescribed protocol to a greater extent than individuals in MICT ( 71 ± 31 % ) as determined by training logs completed over one-month follow-up ( P = 0.05 , Cohen 's d = 0.75 ) . Minutes spent in vigorous physical activity per week measured by accelerometer were higher in HIIT ( 24 ± 18 ) as compared to MICT ( 11 ± 10 ) at one-month follow-up ( P = 0.049 , Cohen 's d = 0.92 ) . Cardiorespiratory fitness and systolic blood pressure assessed at one-month follow-up were equally improved ( P 's < 0.05 ) . Conclusions . This study provides preliminary evidence that individuals with prediabetes can adhere to HIIT over the short-term and do so at a level that is greater than MICT QUESTIONS Does the PEDro scale measure only one construct ie , the method ological quality of clinical trials ? What is the hierarchy of items of the PEDro scale from least to most adhered to ? Is there any effect of year of publication of trials on item adherence ? Are PEDro scale ordinal scores equivalent to interval data ? DESIGN Rasch analysis of two independent sample s of 100 clinical trials from the PEDro data base scored using the PEDro scale . RESULTS Both sample s of PEDro data showed fit to the Rasch model with no item misfit . The  PEDro scale item hierarchy was the same in both sample s , ranging from the most adhered to item r and om allocation , to the least adhered to item therapist blinding . There was no differential item functioning by year of publication . Original PEDro ordinal scores were highly correlated with transformed PEDro interval scores ( r = 0.99 ) . CONCLUSION The PEDro scale is a valid measure of the method ological quality of clinical trials . It is valid to sum PEDro scale item scores to obtain a total score that can be treated as interval level measurement and subjected to parametric statistical analysis OBJECTIVE To evaluate short- ( 3 months ) and long-term ( 9 months ) effects of home-based exercise on adiponectin , exercise behavior and metabolic risk factors in middle-aged adults at diabetic risk . METHODS One hundred and thirty-five middle-aged adults ( 38 men , 97 women ) with at least one diabetic risk factor were r and omly assigned to either a home-based exercise group ( Ex-group ) or a usual care group ( C-group ) . Outcome measures included plasma adiponectin , exercise self-efficacy , physical activity , and metabolic risk factors , as follows : insulin levels , insulin resistance by homeostasis model assessment ( HOMA-IR ) , physical fitness , and components of metabolic syndrome . This study was conducted in metropolitan Taipei from 2004 to 2005 . RESULTS The Ex-group had improvements in exercise self-efficacy ( + 2.5 , p = 0.01 ) , body mass index ( BMI ) ( -0.6 kg/m2 , p < 0.001 ) and flexibility ( + 2.4 cm , p < 0.001 ) at 3-month follow-up and maintained BMI and flexibility at 9-month follow-up . The Ex-group exhibited significantly increased physical activity while the C-group exhibited decreased physical activity at 9-month follow-up ( p < 0.001 ) . No intervention effect was found on adiponectin ( p = 0.64 ) or other outcome measures over time . CONCLUSIONS Home-based exercise did not improve adiponectin levels , but significantly improved exercise behavior , and certain metabolic risk factors , with the effects maintained for 9-months in subjects with type 2 diabetic risk The combination of low physical activity rates and increased cardiovascular deaths indicate the overwhelming need for behaviour change interventions that can effectively promote physical activity among sedentary women . This 11-week r and omised controlled trial examined the effects of an implementation intentions intervention on sedentary women 's walking behaviour . Seventy-five women ( M age = 48.17 ) were r and omly assigned to either a control group where they were required to self-monitor their daily pedometer-determined step count or to an experimental group where they were asked to form specific walking plans ( i.e. implementation intentions ) every 6 weeks and to self-monitor their daily pedometer-determined step count .  Measures of  exercise intentions , perceived behavioural control , scheduling and barrier self-efficacy were administered at baseline , week 6 and week 11 . Analyses indicated higher step counts over the first 6 weeks for women in the experimental condition ( p < 0.02 ) . Furthermore , higher self-efficacy to schedule ( p < 0.01 ) and overcome walking barriers ( p < 0.03 ) , as well as higher perceptions of behavioural control ( p < 0.02 ) were found at week 11 for women in the experimental versus control condition . However , none of the control beliefs were found to mediate the effects of the intervention on the women 's walking behaviour . Furthermore , the intervention did not have any effect on the strength of the goal intention – behaviour relationship . The findings suggest implementation intentions are an effective strategy for initiating leisure-time walking within sedentary women This r and 
    Output:
    
agent
This review summarised in detail the effects  SD exercise interventions had on sedentary middle-aged individuals alongside the adherence to the prescriptions .
SD exercise was seen to be beneficial for improving metabolic outcomes physical characteristics , cardiorespiratory fitness and functional measures
***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 Raisins are a significant source of dietary fiber and polyphenols , which may reduce cardiovascular disease ( CVD ) risk by affecting lipoprotein metabolism and inflammation . Walking represents a low intensity exercise intervention that may also reduce CVD risk . The purpose of this study was to determine the effects of consuming raisins , increasing steps walked , or a combination of these interventions on blood pressure , plasma lipids , glucose , insulin and inflammatory cytokines . Results Thirty-four men and postmenopausal women were matched for weight and gender and r and omly assigned to consume 1 cup raisins/d ( RAISIN ) , increase the amount of steps walked/d ( WALK ) or a combination of both interventions ( RAISINS + WALK ) . The subjects completed a 2 wk run-in period , followed by a 6 wk intervention . Systolic blood pressure was reduced for all subjects ( P = 0.008 ) . Plasma total cholesterol was decreased by 9.4 % for all subjects ( P < 0.005 ) , which was explained by a 13.7 % reduction in plasma LDL cholesterol ( LDL-C ) ( P < 0.001 ) . Plasma triglycerides ( TG ) concentrations were decreased by 19.5 % for WALK ( P < 0.05 for group effect ) . Plasma TNF-α was decreased from 3.5 ng/L to 2.1 ng/L for RAISIN ( P < 0.025 for time and group × time effect ) . All subjects had a reduction in plasma sICAM-1 ( P < 0.01 ) . Conclusion This research shows that simple lifestyle modifications such as adding raisins to the diet or increasing steps walked have distinct beneficial effects on CVD risk Background National guidelines call for exercise of at least moderate intensity ; however , recommending self-paced exercise may lead to better adherence , particularly among overweight and obese adults . Purpose The purpose of this study was to test proof-of-concept for recommending self-paced exercise among overweight adults . Methods Fifty-nine healthy , low-active ( exercise < 60 min/week ) , overweight ( body mass index 25.0–39.9 ) adults ( 18–65 ) received a 6-month print-based exercise promotion program with the goal of walking 30–60 min/day . Participants were surreptitiously r and omly assigned to receive a recommendation for either self-paced ( n = 30 ) or moderate ( 64–76 % maximum heart rate ; n = 29 ) intensity exercise . All participants used electronic diaries and heart rate monitors to track exercise frequency , duration , and intensity . Results The self-paced condition reported more minutes/week of walking ( f2 = 0.17 , p = 0.045 ) and a trend toward greater exercise-related energy expenditure/week ( f2 = 0.12 , p = 0.243 ) , corresponding to approximately 26 additional minutes/week and 83 additional kilocalories/week over 6 months . Conclusions Explicit recommendation for self-paced exercise may improve adherence to exercise programs among overweight and obese adults INTRODUCTION Exercise can increase bone strength , but to be effective in reducing fracture risk , exercise must be feasible enough to be adopted into daily life and influence potentially vulnerable skeletal sites such as the superolateral cortex of the femoral neck , where thinning is associated with increased fracture risk . Brief , high-impact exercise increases femoral neck bone density but the optimal frequency of such exercise and the location of bone accrual is unknown . This study thus examined ( 1 ) the effectiveness of different weekly frequencies of exercise on femoral neck BMD and ( 2 ) whether BMD change differed between hip sites using a high-impact , unilateral intervention . METHODS Healthy premenopausal women were r and omly assigned to exercise 0 , 2 , 4 , or 7 days/week for 6 months . The exercise intervention incorporated 50 multidirectional hops on one r and omly selected leg . BMD was measured by DXA at baseline and after 6 months of exercise . Changes in the exercise leg were compared between groups using ANCOVA , with change in the control leg and baseline BMD as covariates . RM-MANOVA was conducted to determine whether bone changes from  exercise  differed between hip sites . RESULTS 61 women ( age 33.6+/-11.1 years ) completed the intervention .  Compliance amongst exercisers was 86.7+/-10.6 % . Peak ground reaction forces during exercise increased from 2.5 to 2.8 times body weight . The change in femoral neck BMD in the exercise limb ( adjusted for change in the control limb and baseline BMD ) differed between groups ( p=0.015 ) , being -0.3 % ( -1.2 to 0.6 ) , 0.0 % ( -1.0 to 1.0 ) , 0.9 % ( -0.1 to 2.0 ) and 1.8 % ( 0.8 to 2.8 ) in those exercising 0 , 2 , 4 and 7 days per week , respectively . When BMD changes at upper neck , lower neck and trochanter were compared using RM-MANOVA , a significant exercise effect was observed ( p=0.048 ) , but this did not differ significantly between sites ( p=0.439 ) despite greatest mean increases at the upper femoral neck . CONCLUSIONS Brief , daily hopping exercises increased femoral neck BMD in premenopausal women but less frequent exercise was not effective . Brief high-impact exercise may have a role in reducing hip fragility , but may need to be performed frequently for optimal response Aims To investigate the effect of 16 weeks of aerobic training performed at two different intensities on nitric oxide ( tNOx ) availability and iNOS/nNOS expression , oxidative stress ( OS ) and inflammation in obese humans with or without type 2 diabetes mellitus ( T2DM ) . Methods Twenty-five sedentary , obese ( BMI > 30 kg/m2 ) males ( 52.8 ± 7.2 years ) ; 12 controls versus 13 T2DM were r and omly allocated to four groups that exercised for 30 min , three times per week either at low ( Fat-Max ; 30–40 % VO2max ) or moderate ( Tvent ; 55–65 % VO2max ) intensity . Before and after training , blood and muscle sample s ( v. lateralis ) were collected . Results Baseline erythrocyte glutathione was lower ( 21.8 ± 2.8 vs. 32.7 ± 4.4 nmol/ml ) and plasma protein oxidative damage and IL-6 were higher in T2DM ( 141.7 ± 52.1 vs. 75.5 ± 41.6 nmol/ml ) . Plasma catalase increased in T2DM after Tvent training ( from 0.98 ± 0.22 to 1.96 ± 0.3 nmol/min/ml ) . T2DM groups demonstrated evidence of oxidative damage in response to training ( elevated protein carbonyls ) . Baseline serum tNOx were higher in controls than T2DM ( 18.68 ± 2.78 vs. 12.34 ± 3.56 μmol/l ) . Training at Tvent increased muscle nNOS and tNOx in the control group only . Pre-training muscle nNOS was higher in controls than in T2DMs , while the opposite was found for iNOS . No differences were found after training for plasma inflammatory markers . Conclusion Exercise training did not change body composition or aerobic fitness , but improved OS markers , especially when performed at Tvent . Non-diabetics responded to Tvent training by increasing muscle nNOS expression and tNOx levels in skeletal muscle while these parameters did not change in T2DM , perhaps due to higher insulin resistance ( unchanged after intervention ) Aims . High-intensity interval training ( HIIT ) leads to improvements in various markers of cardiometabolic health but adherence to HIIT following a supervised laboratory intervention has yet to be tested . We compared self-report and objective measures of physical activity after one month of independent exercise in individuals with prediabetes who were r and omized to HIIT ( n = 15 ) or traditional moderate-intensity continuous training ( MICT , n = 17 ) . Method . After completing 10 sessions of supervised training  participants were asked to perform HIIT or MICT three times per week for four weeks . Results . Individuals in HIIT ( 89 ± 11 % ) adhered to their prescribed protocol to a greater extent than individuals in MICT ( 71 ± 31 % ) as determined by training logs completed over one-month follow-up ( P = 0.05 , Cohen 's d = 0.75 ) . Minutes spent in vigorous physical activity per week measured by accelerometer were higher in HIIT ( 24 ± 18 ) as compared to MICT ( 11 ± 10 ) at one-month follow-up ( P = 0.049 , Cohen 's d = 0.92 ) . Cardiorespiratory fitness and systolic blood pressure assessed at one-month follow-up were equally improved ( P 's < 0.05 ) . Conclusions . This study provides preliminary evidence that individuals with prediabetes can adhere to HIIT over the short-term and do so at a level that is greater than MICT QUESTIONS Does the PEDro scale measure only one construct ie , the method ological quality of clinical trials ? What is the hierarchy of items of the PEDro scale from least to most adhered to ? Is there any effect of year of publication of trials on item adherence ? Are PEDro scale ordinal scores equivalent to interval data ? DESIGN Rasch analysis of two independent sample s of 100 clinical trials from the PEDro data base scored using the PEDro scale . RESULTS Both sample s of PEDro data showed fit to the Rasch model with no item misfit . The  PEDro scale item hierarchy was the same in both sample s , ranging from the most adhered to item r and om allocation , to the least adhered to item therapist blinding . There was no differential item functioning by year of publication . Original PEDro ordinal scores were highly correlated with transformed PEDro interval scores ( r = 0.99 ) . CONCLUSION The PEDro scale is a valid measure of the method ological quality of clinical trials . It is valid to sum PEDro scale item scores to obtain a total score that can be treated as interval level measurement and subjected to parametric statistical analysis OBJECTIVE To evaluate short- ( 3 months ) and long-term ( 9 months ) effects of home-based exercise on adiponectin , exercise behavior and metabolic risk factors in middle-aged adults at diabetic risk . METHODS One hundred and thirty-five middle-aged adults ( 38 men , 97 women ) with at least one diabetic risk factor were r and omly assigned to either a home-based exercise group ( Ex-group ) or a usual care group ( C-group ) . Outcome measures included plasma adiponectin , exercise self-efficacy , physical activity , and metabolic risk factors , as follows : insulin levels , insulin resistance by homeostasis model assessment ( HOMA-IR ) , physical fitness , and components of metabolic syndrome . This study was conducted in metropolitan Taipei from 2004 to 2005 . RESULTS The Ex-group had improvements in exercise self-efficacy ( + 2.5 , p = 0.01 ) , body mass index ( BMI ) ( -0.6 kg/m2 , p < 0.001 ) and flexibility ( + 2.4 cm , p < 0.001 ) at 3-month follow-up and maintained BMI and flexibility at 9-month follow-up . The Ex-group exhibited significantly increased physical activity while the C-group exhibited decreased physical activity at 9-month follow-up ( p < 0.001 ) . No intervention effect was found on adiponectin ( p = 0.64 ) or other outcome measures over time . CONCLUSIONS Home-based exercise did not improve adiponectin levels , but significantly improved exercise behavior , and certain metabolic risk factors , with the effects maintained for 9-months in subjects with type 2 diabetic risk The combination of low physical activity rates and increased cardiovascular deaths indicate the overwhelming need for behaviour change interventions that can effectively promote physical activity among sedentary women . This 11-week r and omised controlled trial examined the effects of an implementation intentions intervention on sedentary women 's walking behaviour . Seventy-five women ( M age = 48.17 ) were r and omly assigned to either a control group where they were required to self-monitor their daily pedometer-determined step count or to an experimental group where they were asked to form specific walking plans ( i.e. implementation intentions ) every 6 weeks and to self-monitor their daily pedometer-determined step count .  Measures of  exercise intentions , perceived behavioural control , scheduling and barrier self-efficacy were administered at baseline , week 6 and week 11 . Analyses indicated higher step counts over the first 6 weeks for women in the experimental condition ( p < 0.02 ) . Furthermore , higher self-efficacy to schedule ( p < 0.01 ) and overcome walking barriers ( p < 0.03 ) , as well as higher perceptions of behavioural control ( p < 0.02 ) were found at week 11 for women in the experimental versus control condition . However , none of the control beliefs were found to mediate the effects of the intervention on the women 's walking behaviour . Furthermore , the intervention did not have any effect on the strength of the goal intention – behaviour relationship . The findings suggest implementation intentions are an effective strategy for initiating leisure-time walking within sedentary women This r and 
    Output:
    