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Objective. Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) lead to inflammation in tendons and peritendinous tissues, but effects on biomechanical tendon function are unknown. This study investigated patellar tendon (PT) properties in stable, established RA and AS patients. Methods. We compared 18 RA patients (13 women, 59.0 ± 2.8 years, mean ± SEM) with 18 age- and sex-matched healthy controls (58.2 ± 3.2 years), and 12 AS patients (4 women, 52.9 ± 3.4 years) with 12 matched controls (54.5 ± 4.7 years). Assessments with electromyography, isokinetic dynamometry, and ultrasound included quadriceps muscle force and cross-sectional area (CSA), PT stiffness, and PT CSA. Additionally, measures of physical function and disease activity were performed. Results. PT stiffness and physical function were lower in RA and AS patients compared to healthy controls, without a significant difference in force production. PT CSA was significantly larger leading to reduction in Young's modulus (YM) in AS, but not in RA. Conclusion. The adverse changes in PT properties in RA and AS may contribute to their impaired physical function. AS, but not RA, leads to PT thickening without increasing PT stiffness, suggesting that PT thickening in AS is a disorganised repair process. Longitudinal studies need to investigate the time course of these changes and their response to exercise training. © 2013 Verena Matschke et al.

Purpose. Exercise tests represent an important clinical tool to evaluate cardio-respiratory fitness and to predict future adverse cardiovascular events. However, use of such tests in patients with rheumatoid arthritis (RA) is relatively uncommon despite well-established evidence that low exercise capacity and high CVD mortality are features of this disease. Therefore, this study examined the validity and reliability of a sub-maximal step test for use in RA patients. Methods. Thirty patients (24 females) (mean ± SD age 53 ± 10 years) performed a sub-maximal step test on two occasions to estimate the criterion measure of cardio-respiratory fitness (V. O 2 max). A further maximal cycling test provided a direct fitness measurement (V. O 2 peak). Pearson correlation coefficient, intraclass correlation coefficient (ICC), Bland and Altman plots, and 95% limits of agreement (LOA) were used to determine the validity and reliability of the sub-maximal test. Results. Estimated V. O 2 max correlated well with directly measured V. O 2 peak (r = 0.79, LoA ±5.7 mL·kg-1·min-1). Test-retest reproducibility for estimated V. O 2 max was excellent (I C C = 0.97, LoA ±2.2 mL·kg-1·min-1). Conclusion. The sub-maximal step test studied here represents a valid and reproducible method to estimate cardio-respiratory fitness in RA patients. This test may be useful for the assessment and management of CVD risk in a clinical setting. © 2013 Jennifer K. Cooney et al.

This paper aims to highlight the importance of exercise in patients with rheumatoid arthritis (RA) and to demonstrate the multitude of beneficial effects that properly designed exercise training has in this population. RA is a chronic, systemic, autoimmune disease characterised by decrements to joint health including joint pain and inflammation, fatigue, increased incidence and progression of cardiovascular disease, and accelerated loss of muscle mass, that is, "rheumatoid cachexia". These factors contribute to functional limitation, disability, comorbidities, and reduced quality of life. Exercise training for RA patients has been shown to be efficacious in reversing cachexia and substantially improving function without exacerbating disease activity and is likely to reduce cardiovascular risk. Thus, all RA patients should be encouraged to include aerobic and resistance exercise training as part of routine care. Understanding the perceptions of RA patients and health professionals to exercise is key to patients initiating and adhering to effective exercise training. Copyright © 2011 Jennifer K. Cooney et al.

The growth and structure of fullerene-like CNx films produced by laser ablation of graphite in low pressure nitrogen were investigated. Deposition conditions were selected based on investigations of CN and C-2 concentration at the condensation surface, vibrational temperature of CN radicals, and kinetic energies of atomic and molecular species. Films were characterized with x-ray photoelectron spectroscopy, Raman spectroscopy, high-resolution transmission electron microscopy, nanoindentation, and stress analyses. The nitrogen content in CNx films directly depended on the concentration of CN radicals at the condensation surface. Formation of fullerene-like structures required a high vibrational temperature of these radicals, which was maximized at about 4 eV for depositions at 10 mTorr N-2 and laser fluences of similar to7 J/cm(2). The presence of C-2 had only a minor effect on film composition and structure. Optimization of plasma characteristics and a substrate temperature of 300 degreesC helped to produce about 1-mum-thick solid films of CNx (N/C ratioapproximate to0.2-0.3) and pure carbon consisting of fullerene-like fragments and packages. In contrast to carbon films, fullerene-like CNx films exhibited a high elastic recovery of about 80% in using a Berkovich tip at 5 mN load and indentation depths up to 150 nm. Their elastic modulus was about 160 GPa measured from the unloading portion of an indentation curve, and about 250 GPa measured with a 40 Hz tip oscillation during nanoindentation tests. The difference was related to time dependent processes of shape restoration of fullerene-like fragments, and an analogy was made to the behavior of elastomer polymers. However, unlike elastomers, CNx film hardness was as high as 30 GPa, which was twice that of fullerene-like carbon films. The unusual combination of high elasticity and hardness of CNx films was explained by crosslinking of fullerene fragments induced by the incorporated nitrogen and stored compressive str