@article{PerezChaparroKangasZechetal.2022,
  author    = {P{\´e}rez Chaparro, Camilo Germ{\´a}n Alberto and Kangas, Maria and Zech, Philipp and Schuch, Felipe B. and Rapp, Michael A. and Heißel, Andreas},
  title     = {Recreational exercise is associated with lower prevalence of depression and anxiety and better quality of life in German people living with HIV},
  series = {AIDS care : psychological and socio-medical aspects of AIDS/HIV},
  volume    = {34},
  journal   = {AIDS care : psychological and socio-medical aspects of AIDS/HIV},
  number    = {2},
  publisher = {Taylor \& Francis Group},
  address   = {London [u.a.]},
  issn      = {1360-0451},
  doi       = {10.1080/09540121.2021.1889951},
  pages     = {182 -- 187},
  year      = {2022},
  abstract  = {Sedentarism is a risk factor for depression and anxiety. People living with the human immunodeficiency virus (PLWH) have a higher prevalence of anxiety and depression compared to HIV-negative individuals. This cross-sectional study (n = 450, median age 44 (19-75), 7.3\% females) evaluates the prevalence rates and prevalence ratio (PR) of anxiety and/or depression in PLWH associated with recreational exercise. A decreased likelihood of having anxiety (PR=0.57; 0.36-0.91; p = 0.01), depression (PR=0.41; 0.36-0.94; p=0.01), and comorbid anxiety and depression (PR = 0,43; 0.24-0.75; p=0.002) was found in exercising compared to non-exercising PLWH. Recreational exercise is associated with a lower risk for anxiety and/or depression. Further prospective studies are needed to provide insights on the direction of this association.},
  language  = {en}
}
@phdthesis{PerezChaparro2022,
  author    = {P{\´e}rez Chaparro, Camilo Germ{\´a}n Alberto},
  title     = {Non-HIV comorbidities and exercise in German people living with HIV},
  doi       = {10.25932/publishup-56084},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-560842},
  school      = {Universit{\"a}t Potsdam},
  pages     = {149},
  year      = {2022},
  abstract  = {The post-antiretroviral therapy era has transformed HIV into a chronic disease and non-HIV comorbidities (i.e., cardiovascular and mental diseases) are more prevalent in PLWH. The source of these non-HIV comorbidities aside from traditional risk factor include HIV infection, inflammation, distorted immune activation, burden of chronic diseases, and unhealthy lifestyle like sedentarism. Exercise is known for its beneficial effects in mental and physical health; reasons why exercise is recommended to prevent and treat difference cardiovascular and mental diseases in the general population. This cumulative thesis aimed to comprehend the relation exercise has to non-HIV comorbidities in German PLWH. Four studies were conducted to 1) understand exercise effects in cardiorespiratory fitness and muscle strength on PLWH through a systematic review and meta-analyses and 2) determine the likelihood of German PLWH developing non-HIV comorbidities, in a cross-sectional study. Meta-analytic examination indicates PLWH cardiorespiratory fitness (VO2max SMD = 0.61 ml·kg·min-1, 95\% CI: 0.35-0.88, z = 4.47, p < 0.001, I2 = 50\%) and strength (of remark lowerbody strength by 16.8 kg, 95\% CI: 13-20.6, p< 0.001) improves after an exercise intervention in comparison to a control group. Cross-sectional data suggest exercise has a positive effect on German PLWH mental health (less anxiety and depressive symptoms) and protects against the development of anxiety (PR: 0.57, 95\%IC: 0.36 - 0.91, p = 0.01) and depression (PR: 0.62, 95\%IC: 0.41 - 0.94, p = 0.01). Likewise, exercise duration is related to a lower likelihood of reporting heart arrhythmias (PR: 0.20, 95\%IC: 0.10 - 0.60, p < 0.01) and exercise frequency to a lower likelihood of reporting diabetes mellitus (PR: 0.40, 95\%IC: 0.10 - 1, p < 0.01) in German PLWH. A preliminary recommendation for German PLWH who want to engage in exercise can be to exercise ≥ 1 time per week, at an intensity of 5 METs per session or > 103 MET·min·day-1, with a duration ≥ 150 minutes per week. Nevertheless, further research is needed to comprehend exercise dose response and protective effect for cardiovascular diseases, anxiety, and depression in German PLWH.},
  language  = {en}
}
@misc{PerezChaparroSchuchZechetal.2021,
  author    = {P{\´e}rez Chaparro, Camilo Germ{\´a}n Alberto and Schuch, Felipe Barreto and Zech, Philipp and Kangas, Maria and Rapp, Michael Armin and Heißel, Andreas},
  title     = {Recreational Exercising and Self-Reported Cardiometabolic Diseases in German People Living with HIV: A Cross-Sectional Study},
  series = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  volume    = {18},
  journal   = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  edition   = {21},
  publisher = {Universit{\"a}tsverlag Potsdam},
  address   = {Potsdam},
  issn      = {1866-8364},
  doi       = {10.25932/publishup-55204},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-552049},
  pages     = {1 -- 10},
  year      = {2021},
  abstract  = {Exercise is known for its beneficial effects on preventing cardiometabolic diseases (CMDs) in the general population. People living with the human immunodeficiency virus (PLWH) are prone to sedentarism, thus raising their already elevated risk of developing CMDs in comparison to individuals without HIV. The aim of this cross-sectional study was to determine if exercise is associated with reduced risk of self-reported CMDs in a German HIV-positive sample (n = 446). Participants completed a self-report survey to assess exercise levels, date of HIV diagnosis, CD4 cell count, antiretroviral therapy, and CMDs. Participants were classified into exercising or sedentary conditions. Generalized linear models with Poisson regression were conducted to assess the prevalence ratio (PR) of PLWH reporting a CMD. Exercising PLWH were less likely to report a heart arrhythmia for every increase in exercise duration (PR: 0.20: 95\% CI: 0.10-0.62, p < 0.01) and diabetes mellitus for every increase in exercise session per week (PR: 0.40: 95\% CI: 0.10-1, p < 0.01). Exercise frequency and duration are associated with a decreased risk of reporting arrhythmia and diabetes mellitus in PLWH. Further studies are needed to elucidate the mechanisms underlying exercise as a protective factor for CMDs in PLWH.},
  language  = {en}
}
@article{PerezChaparroSchuchZechetal.2021,
  author    = {P{\´e}rez Chaparro, Camilo Germ{\´a}n Alberto and Schuch, Felipe Barreto and Zech, Philipp and Kangas, Maria and Rapp, Michael Armin and Heißel, Andreas},
  title     = {Recreational exercising and self-reported cardiometabolic diseases in German people living with HIV},
  series = {International journal of environmental research and public health : IJERPH / Molecular Diversity Preservation International},
  volume    = {18},
  journal   = {International journal of environmental research and public health : IJERPH / Molecular Diversity Preservation International},
  number    = {21},
  publisher = {MDPI},
  address   = {Basel, Schweiz},
  issn      = {1660-4601},
  doi       = {10.3390/ijerph182111579},
  pages     = {1 -- 10},
  year      = {2021},
  abstract  = {Exercise is known for its beneficial effects on preventing cardiometabolic diseases (CMDs) in the general population. People living with the human immunodeficiency virus (PLWH) are prone to sedentarism, thus raising their already elevated risk of developing CMDs in comparison to individuals without HIV. The aim of this cross-sectional study was to determine if exercise is associated with reduced risk of self-reported CMDs in a German HIV-positive sample (n = 446). Participants completed a self-report survey to assess exercise levels, date of HIV diagnosis, CD4 cell count, antiretroviral therapy, and CMDs. Participants were classified into exercising or sedentary conditions. Generalized linear models with Poisson regression were conducted to assess the prevalence ratio (PR) of PLWH reporting a CMD. Exercising PLWH were less likely to report a heart arrhythmia for every increase in exercise duration (PR: 0.20: 95\% CI: 0.10-0.62, p < 0.01) and diabetes mellitus for every increase in exercise session per week (PR: 0.40: 95\% CI: 0.10-1, p < 0.01). Exercise frequency and duration are associated with a decreased risk of reporting arrhythmia and diabetes mellitus in PLWH. Further studies are needed to elucidate the mechanisms underlying exercise as a protective factor for CMDs in PLWH.},
  language  = {en}
}
@phdthesis{Zech2021,
  author    = {Zech, Philipp},
  title     = {Effects of exercise on different parameters in people living with HIV},
  school      = {Universit{\"a}t Potsdam},
  pages     = {28},
  year      = {2021},
  abstract  = {Hintergrund. Personen, die mit der chronischen Erkrankung HIV leben (PWH), m{\"u}ssen ihr Leben lang die sog. antiretrovirale Therapie (ART) einnehmen, um einen Ausbruch der Erkrankung in das Vollbild AIDS (Akquiriertes Immun-Defizienz-Syndrom) zu vermeiden. Gleichzeitig ist die ART und HIV selbst assoziiert mit dem Auftreten zus{\"a}tzlicher Erkrankungen (Komorbidit{\"a}ten) kardiovaskul{\"a}rer oder psychologischer Natur. Die Pr{\"a}valenz von Komorbidit{\"a}ten und schlechter Lebensqualit{\"a}t ist im Vergleich zu HIV-negativen Personen deutlich h{\"o}her. Methoden. Es wurden zwei Metaanalysen zu sportlicher Bet{\"a}tigung, PWH und (1) kardiovaskul{\"a}ren und (2) psychologischen Parametern sowie eine Querschnittsstudie (HIBES-Studie, HIV-Begleiterkrankungen und Sport) durchgef{\"u}hrt. F{\"u}r die Auswertung der metaanalytischen Daten wurde der Review Manager 5.3, f{\"u}r die Auswertung der Daten der HIBES-Studie das Analyseprogramm „R" verwendet. In den Metaanalysen wurden, neben den Hauptanalysen verschiedener Parameter, erstmals spezifische Subgruppenanalysen durchgef{\"u}hrt. Die HIBES-Studie untersuchte Unterschiede zwischen kumulativen (2-3 verschiedenen Sportarten pro Woche) und einfachen (eine Sportart pro Woche) Freizeitsport und analysiert die Zusammenh{\"a}nge von Parametern des Freizeitsports (Trainingsh{\"a}ufigkeit, -Minuten und -Intensit{\"a}t), Komorbidit{\"a}ten und der Lebensqualit{\"a}t. Ergebnisse. Ausdauer- und Krafttraining haben einen mittel-starken bis starken positiven Effekt auf die maximale Sauerstoffaufnahme (SMD= 0.66, p< .00001), den 6-Minuten-Walk-Test (6MWT) (SMD= 0.59, p= .02), die maximale Watt Zahl (SMD= 0.80, p= .009). Kein Effekt wurde bei der maximalen Herzfrequenz und dem systolischen sowie diastolischen Blutdruck gefunden. Subgruppenanalysen zu ≥3 Einheiten/Woche, ≥150 Min./Woche ergaben hohe Effektst{\"a}rken in der maximalen Watt Zahl und 6MWT. Ausdauer- und Krafttraining zusammen mit Yoga haben einen starken Effekt auf Symptome der Depression (SMD= -0.84, p= .02) und Angstst{\"o}rungen (SMD= -1.23, p= .04). Die Subanalyse der Depression zu professioneller Supervision und sportlicher Bet{\"a}tigung wiesen einen sehr starken Effekt (SMD= -1.40, p= .03). Die HIBES-Studie wies ein sehr differenziertes Bild im Sportverhalten von PWH in Deutschland auf. 49\% der Teilnehmer {\"u}bten mehr als eine Sportart pro Woche aus. Es wurden keine Unterschiede zwischen kumuliertem (CTE) und einfachem Sport (STE) in der Lebensqualit{\"a}t gefunden. Die Freizeitsportparameter (H{\"a}ufigkeiten/Woche, Minuten/Woche, Intensit{\"a}t/Woche) waren in der CTE-Gruppe deutlich h{\"o}her als in der STE-Gruppe. Trainingsminuten und die -Intensit{\"a}t zeigten beim Vorhandensein einer Komorbidit{\"a}t einen großen Zusammenhang mit der Lebensqualit{\"a}t. Die Minuten und die Intensit{\"a}t des durchgef{\"u}hrten Sportes zeigten einen pr{\"a}diktiven Zusammenhang mit der Lebensqualit{\"a}t. Konklusion: Sportliche Bet{\"a}tigung verbessert die maximale Sauerstoffaufnahme und Symptome der Depression und Angstst{\"o}rungen. Die Aussagekraft der Subanalysen ist aufgrund der geringen Studienzahl, vorsichtig zu interpretieren. Erh{\"o}hte Trainingsparameter finden sich eher bei PWH, die mehr als eine Sportart pro Woche treiben. Daher kann kumulierter Sport als mediierender Faktor zur Steigerung der Lebensqualit{\"a}t interpretiert werden; zumindest bei PWH mit einer psychologischen Komorbidit{\"a}t.},
  language  = {de}
}
@article{ZechPerezChaparroSchuchetal.2019,
  author    = {Zech, Philipp and Perez Chaparro, Camilo Germ{\´a}n Alberto and Schuch, Felipe and Wolfarth, Bernd and Rapp, Michael Armin and Heissel, Andreas},
  title     = {Effects of Aerobic and Resistance Exercise on Cardiovascular Parameters for People Living With HIV},
  series = {JANAC-Journal of the Association of Nurses in AIDS Care},
  volume    = {30},
  journal   = {JANAC-Journal of the Association of Nurses in AIDS Care},
  number    = {2},
  publisher = {Lippincott Williams \& Wilkins},
  address   = {Philadelphia},
  issn      = {1055-3290},
  doi       = {10.1097/JNC.0000000000000006},
  pages     = {186 -- 205},
  year      = {2019},
  abstract  = {People living with HIV (PLWH) have limited exercise capacity because of anemia, neuromuscular disorders, and pulmonary limitations. We used a meta-analysis to examine the effect of aerobic and resistance exercise alone and in combination on cardiovascular parameters. Subgroup meta-analyses were conducted and long-term effects of exercise were investigated. A systematic literature search was conducted up to July/August 2017. The Physiotherapy Evidence Database-scale was used to rate quality and assess the risk of bias on the papers. Standardized mean differences (SMDs) were calculated to assess the effect of exercise. Posttreatment comparison between the exercise and control groups revealed moderate and large effect sizes in favor of the intervention group for VO2max (SMD50.66, p < .0001) and the 6-minute walk test (SMD = 1.11, p = .0001). Exercise had a positive effect on cardiovascular parameters in PLWH. Exercise can be a prevention factor for PLWH dealing with multiple comorbidities.},
  language  = {en}
}
@article{ZechSchuchPerezChaparroetal.2020,
  author    = {Zech, Philipp and Schuch, Felipe and P{\´e}rez Chaparro, Camilo Germ{\´a}n Alberto and Kangas, Maria and Rapp, Michael Armin and Heissel, Andreas},
  title     = {Exercise, Comorbidities, and Health-Related Quality of Life in People Living with HIV},
  series = {International Journal of Environmental Research and Public Health},
  volume    = {17},
  journal   = {International Journal of Environmental Research and Public Health},
  number    = {14},
  publisher = {MDPI AG},
  address   = {Basel},
  issn      = {1660-4601},
  doi       = {10.3390/ijerph17145138},
  pages     = {15},
  year      = {2020},
  abstract  = {(1) Background: People with HIV (PWH) may perform more than one type of exercise cumulatively. The objective of this study is to investigate recreational exercise and its association with health-related quality of life (HRQOL) and comorbidities in relation to potential covariates. (2) Methods: The HIBES study (HIV-Begleiterkrankungen-Sport) is a cross-sectional study for people with HIV. The differences between non-exercisers versus exercisers (cumulated vs. single type of exercises) were investigated using regression models based on 454 participants. (3) Results: Exercisers showed a higher HRQOL score compared to non-exercisers (Wilcox r = 0.2 to 0.239). Psychological disorders were identified as the main covariate. Participants performing exercise cumulatively showed higher scores in duration, frequency, and intensity when compared to participants performing only one type of exercise. The mental health summary score was higher for the cumulated and single type of exercise if a psychological disorder existed. Duration and intensity were associated with an increase of HRQOL, whilst a stronger association between psychological disorders and exercise variables were evident. Exercise duration (minutes) showed a significant effect on QOL (standardized beta = 0.1) and for participants with psychological disorders (standardized beta = 0.3), respectively. (4) Conclusions: Psychological disorders and other covariates have a prominent effect on HRQOL and its association with exercise. For PWH with a psychological disorder, a stronger relationship between HRQOL with exercise duration and intensity emerged. However, differentiation of high-HRQOL individuals warrants further investigation by considering additional factors.},
  language  = {en}
}
@misc{ZechSchuchPerezChaparroetal.2020,
  author    = {Zech, Philipp and Schuch, Felipe and P{\´e}rez Chaparro, Camilo Germ{\´a}n Alberto and Kangas, Maria and Rapp, Michael Armin and Heissel, Andreas},
  title     = {Exercise, Comorbidities, and Health-Related Quality of Life in People Living with HIV},
  series = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  journal   = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  number    = {661},
  issn      = {1866-8364},
  doi       = {10.25932/publishup-48028},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-480289},
  pages     = {15},
  year      = {2020},
  abstract  = {(1) Background: People with HIV (PWH) may perform more than one type of exercise cumulatively. The objective of this study is to investigate recreational exercise and its association with health-related quality of life (HRQOL) and comorbidities in relation to potential covariates. (2) Methods: The HIBES study (HIV-Begleiterkrankungen-Sport) is a cross-sectional study for people with HIV. The differences between non-exercisers versus exercisers (cumulated vs. single type of exercises) were investigated using regression models based on 454 participants. (3) Results: Exercisers showed a higher HRQOL score compared to non-exercisers (Wilcox r = 0.2 to 0.239). Psychological disorders were identified as the main covariate. Participants performing exercise cumulatively showed higher scores in duration, frequency, and intensity when compared to participants performing only one type of exercise. The mental health summary score was higher for the cumulated and single type of exercise if a psychological disorder existed. Duration and intensity were associated with an increase of HRQOL, whilst a stronger association between psychological disorders and exercise variables were evident. Exercise duration (minutes) showed a significant effect on QOL (standardized beta = 0.1) and for participants with psychological disorders (standardized beta = 0.3), respectively. (4) Conclusions: Psychological disorders and other covariates have a prominent effect on HRQOL and its association with exercise. For PWH with a psychological disorder, a stronger relationship between HRQOL with exercise duration and intensity emerged. However, differentiation of high-HRQOL individuals warrants further investigation by considering additional factors.},
  language  = {en}
}
@misc{HeisselZechRappetal.2019,
  author    = {Heissel, Andreas and Zech, Philipp and Rapp, Michael Armin and Schuch, Felipe B. and Lawrence, Jimmy B. and Kangas, Maria and Heinzel, Stephan},
  title     = {Effects of exercise on depression and anxiety in persons living with HIV: A meta-analysis},
  series = {Journal of psychosomatic research},
  volume    = {126},
  journal   = {Journal of psychosomatic research},
  publisher = {Elsevier},
  address   = {Oxford},
  issn      = {0022-3999},
  doi       = {10.1016/j.jpsychores.2019.109823},
  pages     = {12},
  year      = {2019},
  abstract  = {Objective: The purpose of this systematic review and meta-analysis was to examine the effects of exercise on depression and anxiety in people living with HIV (PLWH), and to evaluate, through subgroup analysis, the effects of exercise type, frequency, supervision by exercise professionals, study quality, and control group conditions on these outcomes. Method: A literature search was conducted through four electronic databases from inception to February 2019. Considered for inclusion were randomized controlled trials (RCTs) investigating exercise interventions and depression or anxiety as outcomes in people living with HIV (>= 18 years of age). Ten studies were included (n = 479 participants, 49.67\% females at baseline), and the standardized mean difference (SMD) and heterogeneity were calculated using random-effect models. An additional pre-post meta-analysis was also conducted. Results: A large effect in favor of exercise when compared to controls was found for depression (SMD = -0.84, 95\%CI = [-1.57, -0.11], p = 0.02) and anxiety (SMD = -1.23, 95\%CI = [-2.42, 0.04], p = -0.04). Subgroup analyses for depression revealed large effects on depression for aerobic exercise only (SMD = -0.96, 95\%CI = [-1.63, -0.30], p = 0.004), a frequency of >= 3 exercise sessions per week (SMD = -1.39, 95\%CI = [-2.24, -0.54], p < 0.001), professionally supervised exercise (SMD = -1.40, 95\%CI = [-2.46, -0.17], p = 0.03]), and high-quality studies (SMD = -1.31, 95\%CI = [-2.46, -0.17], p = 0.02). Conclusion: Exercise seems to decrease depressive symptoms and anxiety in PLWH, but other larger and high-quality studies are needed to verify these effects.},
  language  = {en}
}
@phdthesis{Hoelscher2020,
  author    = {Hoelscher, Matthijs Pieter},
  title     = {The production of antimicrobial polypeptides in chloroplasts},
  school      = {Universit{\"a}t Potsdam},
  pages     = {xiii, 114},
  year      = {2020},
  abstract  = {Plants are an attractive platform for the production of medicinal compounds because of their potential to generate large amounts of biomass cheaply. The use of chloroplast transformation is an attractive way to achieve the recombinant production of proteins in plants, because of the chloroplasts' high capacity to produce foreign proteins in comparison to nuclear transformed plants. In this thesis, the production of two different types of antimicrobial polypeptides in chloroplasts is explored. The first example is the production of the potent HIV entry inhibitor griffithsin. Griffithsin has the potential to prevent HIV infections by blocking the entry of the virus into human cells. Here the use of transplastomic plants as an inexpensive production method for griffithsin was explored. Transplastomic plants grew healthily and were able to accumulate griffithsin to up to 5\% of the total soluble protein. Griffithsin could easily be purified from tobacco leaf tissue and had a similarly high neutralization activity as griffithsin recombinantly produced in bacteria. Griffithsin could be purified from dried tobacco leaves, demonstrating that dried leaves could be used as a storable starting material for griffithsin purification, circumventing the need for immediate purification after harvest. The second example is the production of antimicrobial peptides (AMPs) that have the capacity to kill bacteria and are an attractive alternative to currently used antibiotics that are increasingly becoming ineffective. The production of antimicrobial peptides was considerably more challenging than the production of griffithsin. Small AMPs are prone to degradation in plastids. This problem was overcome by fusing AMPs to generate larger polypeptides. In one approach, AMPs were fused to each other to increase size and combine the mode of action of multiple AMPs. This improved the accumulation of AMPs but also resulted in impaired plant growth. This was solved by the use of two different inducible systems, which could largely restore plant growth. Fusions of multiple AMPs were insoluble and could not be purified. In addition to fusing AMPs to each other, the fusion of AMPs to small ubiquitin-like modifier (SUMO), was tested as an approach to improve the accumulation, facilitate purification, and reduce the toxicity of AMPs to chloroplasts. Fusion of AMPs to SUMO indeed increased accumulation while reducing the toxicity to the plants. SUMO fusions produced inside chloroplasts could be purified, and SUMO could be efficiently cleaved off with the SUMO protease. Such fusions therefore provide a promising strategy for the production of AMPs and other small polypeptides inside chloroplasts.},
  language  = {en}
}