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  • Hörnberg, Kristina, et al. (author)
  • Benefits of spinning exercise on cardiovascular risk factors in rheumatoid arthritis : a pilot study
  • 2014
  • In: Cardiopulmonary Physical Therapy Journal. - : Wolters Kluwer. - 1541-7891. ; 25:3, s. 68-74
  • Journal article (peer-reviewed)abstract
    • Purpose: Rheumatoid arthritis (RA) is associated with an increased risk of cardiovascular disease (CVD). Exercise is known to reduce this risk in the general population but the cardiovascular effects in patients with RA need further study. The purpose of this pilot study was to examine the effects of spinning exercise on the traditional risk factors for CVD, aerobic capacity and inflammation in patients with RA.Methods: Thirteen subjects (12 females, 1 male; median age 57 years) attended intensive spinning sessions lasting 45 minutes, 3 times per week for 10 weeks. Measurements at baseline and at 10 and 25 weeks were aerobic capacity, pulse wave analysis with aortic and peripheral blood pressure (BP), disease activity (CRP, ESR, tender and swollen joints and global health assessment), blood lipid levels, body mass index (BMI), functional ability, and subjective diary notes. Friedman's test and the paired Wilcoxon rank sum test were used to measure changes over time. Correlation analyses were made by the Spearman rank correlation method.Results: There were significant improvements over time in aerobic capacity, systolic BP, BMI and tender joint count (p<0.05). After 10 weeks the subjects showed significant improvements in terms of aerobic capacity (+7 ml O2/kg x min; p<0.05), systolic BP (-10.8 mm Hg; p<0.01) and tender joint count (p<0.05). After 25 weeks there was still a significant improvement in systolic BP (p<0.05) compared to baseline.Conclusions: Intensive spinning exercise for 10 weeks induced a clinically relevant improvement in aerobic capacity and BP. No detrimental effect on disease activity was recorded.
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  • Hörnberg, Kristina, et al. (author)
  • Isotemporal Substitution of Time Between Sleep and Physical Activity : Associations With Cardiovascular Risk Factors in Early Rheumatoid Arthritis
  • 2021
  • In: ACR Open Rheumatology. - : John Wiley & Sons. - 2578-5745. ; 3:3, s. 138-146
  • Journal article (peer-reviewed)abstract
    • Objective: We aimed to determine relationships between objectively measured nightly sleep, sedentary behavior (SB), light physical activity (LPA), and moderate to vigorous physical activity (MVPA) with risk factors for cardiovascular disease (CVD) in patients with early rheumatoid arthritis (RA). Furthermore, we aimed to estimate consequences for these risk factors of theoretical displacements of 30 minutes per day in one behavior with the same duration of time in another.Methods: This cross-sectional study included 78 patients with early RA. Nightly sleep, SB, LPA, and MVPA were assessed by a combined heart rate and accelerometer monitor. Associations with risk factors for CVD were analyzed using linear regression models and consequences of reallocating time between the behaviors by isotemporal substitution modeling.Results: Median (Q1-Q3) nightly sleep duration was 4.6 (3.6-5.8) hours. Adjusted for monitor wear time, age, and sex, 30-minutes-longer sleep duration was associated with favorable changes in the values β (95% confidence interval [CI]) for waist circumference by -2.2 (-3.5, -0.9) cm, body mass index (BMI) by -0.9 (-1.4, -0.4) kg/m2 , body fat by -1.5 (-2.3, -0.8)%, fat-free mass by 1.6 (0.8, 2.3)%, sleeping heart rate by -0.8 (-1.5, -0.1) beats per minute, and systolic blood pressure by -2.5 (-4.0, -1.0) mm Hg. Thirty-minute decreases in SB, LPA, or MVPA replaced with increased sleep was associated with decreased android fat and lower systolic blood pressure levels. Replacement of SB or LPA with MVPA yielded lower BMIs.Conclusion: Shorter sleep during the night is common among patients with early RA and is associated with adverse risk factors for CVD.
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  • Hörnberg, Kristina, et al. (author)
  • Physical activity in early and long-standing RA : relations to disease activity, cardiovascular risk factors and subclinicalatherosclerosis
  • Other publication (other academic/artistic)abstract
    • Background: The excess risk for cardiovascular disease (CVD) in Rheumatoid Arthritis (RA), is partly attributable to traditional cardiovascular risk factors for CVD and systemic inflammation, factors known to be modified by physical activity.Objectives: The aim of this cross-sectional study was to objectively measure and compare the level of physical activity in patients with early and long-standing RA, and to investigate its associations with disease activity, risk factors for CVD and measures of subclinical atherosclerosis.Methods: This study included 84 patients with early and 37 with long-standing RA (disease duration, mean [SD] 1.4 [0.4] and 16.3 [2.3] years respectively). Physical activity was measured using a combined accelerometer and heart rate monitor and included total physical activity (counts /min), proportion of moderate to vigorous physical activity (MVPA) and sedentary time. Further assessments were; disease activity (Erythrocyte sedimentation rate [ESR], Disease activity score [DAS28]), functional ability (Health Assessment Questionnaire [HAQ]), risk factors for CVD (blood lipids, i.e., triglycerides, high density lipoprotein [HDL], low density protein [LDL], blood glucose, blood pressure, waist circumference, body mass index [BMI]), body fat and subclinical atherosclerosis (pulse wave velocity [PWV], augmentation index [AIx] and carotid intima-media thickness [cIMT]).Results: Physical activity variables did not differ between patients with early and long-standing RA. Thirty- seven % of the patients with early and 43% of the patients with long-standing RA did not reach WHOs recommended levels of MVPA. Univariate linear regression analyses with the two groups combined, showed associations between total physical activity and younger age, lower values for HAQ and ESR, as well as more beneficial values for blood glucose, triglycerides, waist circumference, BMI, body fat, sleeping heart rate (SHR), systolic and diastolic blood pressure, aortic blood pressure and pulse pressure (PP), AIx, PWV, and cIMT. After adjusting each variable for age, sex, disease duration and Actiheart wear time, associations remained for all variables except triglycerides, aortic PP, PWV, AIx and cIMT. In a final regression model, the association with ESR was no longer evident. More time spent in MVPA was associated with younger age and with favourable values of blood glucose, HDL, LDL, waist circumference, SHR and PWV. After the same adjustments, associations remained for HAQ, HDL, blood glucose and SHR.Conclusions: Physical activity behaviour was similar in patients with early and long-standing RA. Total physical activity as well as more time spent in moderate to vigorous physical activity were associated with more favourable risk factors for CVD and measures of subclinical atherosclerosis. Patients with lower functional ability were less physically active. These results stress the importance of promoting physical activity in patients with RA. 
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6.
  • Hörnberg, Kristina, et al. (author)
  • Physical activity in rheumatoid arthritis : relationship to cardiovascular risk factors, subclinical atherosclerosis, and disease activity
  • 2020
  • In: Scandinavian Journal of Rheumatology. - : Taylor & Francis Group. - 0300-9742 .- 1502-7732. ; 49:2, s. 112-121
  • Journal article (peer-reviewed)abstract
    • Objective: To investigate associations between physical activity and risk factors for cardiovascular disease (CVD), subclinical atherosclerosis, and disease activity in patients with early and long-standing rheumatoid arthritis (RA).Method: This cross-sectional study included 84 patients with early and 37 with long-standing RA (disease duration, mean ± sd: 1.4 ± 0.4 and 16.3 ± 2.3 years, respectively). Physical activity was measured using a combined accelerometer and heart-rate monitor. Further assessments were disease activity (erythrocyte sedimentation rate, Disease Activity Score in 28 joints), functional ability (Health Assessment Questionnaire), risk factors for CVD (blood lipids, i.e. triglycerides, high-density lipoprotein, low-density lipoprotein; blood glucose, blood pressure, sleeping heart rate, waist circumference, body mass index, and body fat), and subclinical atherosclerosis (pulse-wave velocity, augmentation index, and carotid intima–media thickness).Results: Physical activity variables did not differ between patients with early and long-standing RA. However, 37% of the patients with early and 43% of those with long-standing RA did not reach the World Health Organization’s recommended levels of moderate to vigorous physical activity (MVPA). In a final multiple regression model, adjusted for age, gender, disease duration, and activity monitor wear time, higher total physical activity was associated with lower body fat and higher functional ability. With the same adjustments, more time spent in MVPA was associated with lower high-density lipoprotein and lower sleeping heart rate.Conclusions: Physical activity was associated with more favourable risk factors for CVD. However, many patients were physically inactive, stressing the importance of promoting physical activity in RA.
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  • Nilsson, Emma C, 1979-, et al. (author)
  • The GD1a glycan is a cellular receptor for adenoviruses causing epidemic keratoconjunctivitis (Letter)
  • 2011
  • In: Nature Medicine. - : Springer Science and Business Media LLC. - 1078-8956 .- 1546-170X. ; 17:1, s. 105-109
  • Journal article (peer-reviewed)abstract
    • Adenovirus type 37 (Ad37) is a leading cause of epidemic keratoconjunctivitis (EKC), a severe and highly contagious ocular disease. Whereas most other adenoviruses infect cells by engaging CD46 or the coxsackie and adenovirus receptor (CAR), Ad37 binds previously unknown sialic acid-containing cell surface molecules. By glycan array screening, we show here that the receptor-recognizing knob domain of the Ad37 fiber protein specifically binds a branched hexasaccharide that is present in the GD1a ganglioside and that features two terminal sialic acids. Soluble GD1a glycan and GD1a-binding antibodies efficiently prevented Ad37 virions from binding and infecting corneal cells. Unexpectedly, the receptor is constituted by one or more glycoproteins containing the GD1a glycan motif rather than the ganglioside itself, as shown by binding, infection and flow cytometry experiments. Molecular modeling, nuclear magnetic resonance and X-ray crystallography reveal that the two terminal sialic acids dock into two of three previously established sialic acid-binding sites in the trimeric Ad37 knob. Surface plasmon resonance analysis shows that the knob-GD1a glycan interaction has high affinity. Our findings therefore form a basis for the design and development of sialic acid-containing antiviral drugs for topical treatment of EKC.
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  • Risberg, Per A., et al. (author)
  • Development of a heavy duty nozzle coking test
  • 2013
  • In: SAE Technical Papers. - 400 Commonwealth Drive, Warrendale, PA, United States : SAE International.
  • Conference paper (peer-reviewed)abstract
    • The diesel engine is still one of the most common and most efficient mobile energy converters. Nevertheless, it is troubled by many problems, one of them being nozzle coking. This is not a new problem; however, due to the introduction of more advanced injection systems and a more diverse fuel matrix, including biofuels, the problem has become more complex. The nozzle holes are also much narrower today than when the problem first appeared and are therefore more sensitive to coking. Two CEC sanctioned coking tests exist for diesel engines, but no universally accepted test for heavy duty engines. In this paper, tests have been performed with B10 doped with 1 ppm zinc on a single cylinder engine, based on a heavy duty engine, with the purpose to develop a simple accelerated coking test. To have relevance to real usage, the test was based on real engine load points from a high power Euro V engine calibration. The coking propensity was studied in an engine speed sweep at max load. Based on this, a repeatable, convenient, single load point, 6 hour test with a one hour soak time in the middle, that managed to produce significant coking, was established. The average nozzle temperature was measured to around 255 °C with a thermocouple instrumented injector. Coking was evaluated based on the measured power loss during the tests and validated in a flow rig were the nozzle was disassembled from the injector and the flow was measured separately before and after the coking tests to isolate the effects of nozzle coking. Since the start of the tests are is of major importance, to condition the engine is very important. Running the engine on half load was concluded not to have significant effect on nozzle coking. It was also found that overnight engine soak lead to on average an increase in power output of around 1.2 % and that shorter soak periods did not significantly influence the deposit build up.
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  • Ångström, Lars, 1965- (author)
  • Aerobic capacity in rheumatoid arthritis : aspects of associations with cardiovascular risk factors and disease activity
  • 2018
  • Licentiate thesis (other academic/artistic)abstract
    • Rheumatoid arthritis (RA) is a systemic and inflammatory disease that has been associated with an increased morbidity and mortality in cardiovascular disease (CVD). Low aerobic capacity is one of the strongest independent risk factors for CVD and all-cause mortality in the general population. In patients with longstanding RA, low aerobic capacity has been related with a worse cardiovascular profile and an increased risk of CVD mortality. As a consequence of this, low aerobic capacity might provide an additional risk factor for CVD in patients with RA. The aim of this thesis was to describe the associations between aerobic capacity and risk factors for CVD as well as disease activity in patients with early RA, and also the effects of intensive exercise therapy on traditional risk factors for CVD and disease activity in patients with longstanding RA.Paper I, a cross-sectional study including 67 patients with early RA, mean (SD) age 53.1 (14.4), assessments of aerobic capacity, CVD risk factors, disease activity and functional ability were taken. Data were analysed for the associations between aerobic capacity and CVD risk factors and disease activity. In paper II, an intervention study, including 13 patients with RA, median age (Q1-Q3) 57 (44-64) years, aerobic capacity, pulse wave analysis (PWA), CVD risk factors, and disease activity were analysed for changes after 10 weeks of intensive exercise therapy. Additional follow-up was made after 25 weeks.In paper I, the mean (SD) aerobic capacity was 31.6 (8.7) ml O2/kg/min. CVD risk factors and disease activity were all in favour of patients with higher aerobic capacity. In a multiple regression model, adjusted for age and sex, aerobic capacity was significantly associated with percent body fat (β=-0.502, 95%CI=-0.671;-0.333) and triglycerides (β=-2.365, 95%CI=-4.252;-0.479). In paper II, intensive exercise over ten weeks was shown to be a feasible method to significantly improve aerobic capacity (p=≤0.05), systolic blood pressure (p=≤0.01) and the number of tender joints (p=≤0.05). No detrimental effect on disease activity was recorded.This thesis adds further knowledge of aerobic capacity and its associations with CVD risk factors and disease activity in patients with RA. Also, intensive exercise therapy was a feasible intervention to improve CVD risk factors. To include assessment of aerobic capacity in regular clinical practice may improve patient management as well as patient outcome in patients with RA.
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