Effects of regular exercise on asthma control

Abstract Uncontrolled asthma imposes a substantial burden for the individual, the healthcare system and society. Despite of major advances in pharmacotherapy, there has been limited evidence of the potential benefits of regular exercise on asthma control. The aim was to investigate the potential effects of regular exercise on asthma control in adults. Study I is a systematic review and meta-analysis of clinical trials from 1980 to 2011. In Study II, we conducted a population-based cross-sectional study of adults 20–27 years old with asthma (the 20-year follow-up from the Espoo Cohort Study, ECS). In Study III, we conducted a population-based cross-sectional study of adults 17–73 years old with asthma (the Northern-Finnish Asthma Study, NoFAS). In Study IV, we conducted a randomized controlled trial (REACT) to study the effects of a 24-week exercise intervention in adults 16–65 years old with mild to moderate asthma. In the ECS, asthma control was measured by the Asthma Symptom Score (range 0–12, 0 indicating completely controlled asthma). In the NoFAS and the REACT, asthma control was measured by the standardized Asthma Control Test (ACT, range 5–25, 25 indicating completely i.e., very well controlled asthma). Based on the systematic review and meta-analysis, regular exercise improves physical fitness in adults with asthma, but the results on asthma control remained inconclusive. In the ECS, regular exercise reduced the Asthma Symptom Score by 0.09 points per hour of exercise/week (95% CI 0.00 to −0.17). In the NoFAS, asthma control was better among subjects exercising > 5–10 hours a week (ACT = 21.0) compared to the “No exercise” category (ACT = 19.4, difference from the reference group −1.57, 95% CI −2.12 to −1.01). In the REACT, the ACT became better among 62% of the subjects in the exercise group and among 39% in the reference group. The effect of the intervention on improving asthma control was 23% (RD = 0.23, 95% CI 0.109 to 0.492, p = 0.003). In conclusion, adults with asthma benefit from regular exercise which is shown by improving aerobic fitness. Moderate to high regular exercise improves asthma control significantly in adults. A 24-week exercise program improves asthma control measured by the ACT in adults with mild to moderate asthma. Based on these results, regular exercise is recommended to be included in the management of adult asthma.Tiivistelmä Huonossa hoitotasapainossa oleva astma aiheuttaa merkittävää kuormitusta yksilölle, terveydenhuollolle ja yhteiskunnalle. Lääkehoidon kehityksestä huolimatta säännöllisen kuntoliikunnan merkityksestä astman hoidossa on ollut vain vähän tutkimustietoa. Tavoitteena oli tutkia säännöllisen kuntoliikunnan vaikutuksia astman tasapainoon aikuisilla. Ensimmäinen osajulkaisu on systemaattinen kirjallisuuskatsaus ja meta-analyysi kliinisistä kokeista vuosilta 1980–2011. Toinen osajulkaisu on väestöpohjainen poikittaistutkimus 20–27-vuotiailla astmaa sairastavilla (ECS). Kolmas osajulkaisu on väestöpohjainen poikittaistutkimus 17–73-vuotiailla astmaa sairastavilla (NoFAS). Neljäs osajulkaisu on satunnaistettu vertailukoe (REACT), jossa tutkittiin 24 viikon liikuntaohjelman vaikutuksia 16–65-vuotiailla lievää tai keskivaikeaa astmaa sairastavilla. ECS-tutkimuksessa astman tasapainoa mitattiin astmaoirein (Asthma Symptom Score, vaihteluväli 0–12, 0 merkitsee parasta mahdollista astman tasapainoa). NoFAS- ja REACT-tutkimuksissa astman tasapainoa mitattiin standardoidulla Astmatestillä (Asthma Control Test, ACT, vaihteluväli 5–25, 25 merkitsee parasta mahdollista astman tasapainoa). Systemaattisessa kirjallisuuskatsauksessa ja meta-analyysissä todettiin, että säännöllinen kuntoliikunta parantaa astmaa sairastavien fyysistä suorituskykyä, mutta liikunnan vaikutuksista astman tasapainoon ei voitu tehdä vielä johtopäätöksiä. ECS-tutkimuksessa säännöllinen kuntoliikunta vähensi astmaoireita 0,09 pistettä viikossa liikuttua tuntia kohden (95 % LV 0,00…−0,17). NoFAS-tutkimuksessa astman tasapaino oli parempi > 5–10 tuntia viikossa liikkuvien ryhmässä (ACT = 21,0) verrattuna ei lainkaan liikkuvien ryhmään (ACT = 19,4, ero vertailuryhmään −1,57, 95 % LV −2,12…−1,01). REACT-tutkimuksessa ACT parani liikuntaryhmässä 62 %:lla ja vertailuryhmässä 23 %:lla. Liikuntaohjelma paransi astman tasapainoa 23 % (riskiero = 0,23 95 % LV 0,109–0,492, p = 0,003). Astmaa sairastavat aikuiset hyötyvät säännöllisestä kuntoliikunnasta fyysisen suorituskyvyn paranemisen kautta. Kohtalaisesti ja paljon liikkuminen parantaa aikuisten astman tasapainoa. 24-viikon liikuntaohjelma parantaa ACT:llä mitattuna astman tasapainoa lievää tai keskivaikeaa astmaa sairastavilla. Tulosten perusteella suositellaan, että säännöllisen kuntoliikunnan tulisi sisältyä astman omahoito-ohjelmaan aikuisilla

Association between regular exercise and asthma control among adults:the population-based Northern Finnish Asthma Study

Abstract Previously those with asthma were often advised to avoid strenuous exercise because of fear for exercise-induced asthmatic reactions, but recent findings suggest many beneficial effects on health related to exercise. We elaborated on the relation between regular exercise and asthma control among adults. This was a population-based cross-sectional Northern Finnish Asthma Study (NoFAS), in which altogether 1922 adult subjects 17–73 years old living in Northern Finland answered the NoFAS questionnaire. The determinant of interest was the total amount of regular exercise during leisure time, measured in hours per week and categorized into no, low (>0≤2h per week), medium (>2 ≤5h), high (>5≤10h) and very high (>10h) exercise categories. The outcome of interest was asthma control, which was assessed based on the Asthma Control Test (ACT). As statistical methods we applied analysis of variance (ANOVA) and Poisson regression. ACT score increased gradually, i.e. asthma control improved, with an increasing amount of exercise from no exercise (mean ACT = 19.4; difference from the reference: -1.57, 95% CI -2.12 to -1.01) to high exercise reference category (mean = 21.0), but was slightly lower (mean = 20.3; -0.64, 95% CI -1.27 to -0.02) in the very high exercise category. Such non-linear relation was present both in women and in men. In conclusion, we provide evidence that moderate to high regular exercise improves asthma control among adults with asthma. Advice about regular exercise should be included as an important part of asthma management for adults

White paper on 6G drivers and the UN SDGs

Executive summary The commercial launch of 6G communications systems and the United Nations’ Sustainable Development Goals (UN SDGs) are both targeted for 2030. 6G communications are expected to boost global growth and productivity, create new business models and transform many aspects of society. The UN SDGs are a way of framing opportunities and challenges of a desirable future world and cover topics as broad as ending poverty, building gender equality, the fight against climate change and developing smart cities. The relationship between these potentially mutually reinforcing forces is currently under-defined. Building on the vision for 6G, and a review of megatrends, ongoing studies on the relation of mobile communications to the UN SDGs and existing indicators, a novel linkage between 6G and the UN SDGs is proposed. This linkage is via a set of indicators. This white paper also initiates work on a new set of 6G related indicators to guide research on 6G systems. The novel linkage is built on the envisaged three-fold role of 6G as 1) a provider of services to help steer and support communities and countries towards reaching the UN SDGs, 2) a measuring tool for data collection to help the reporting of indicators with hyperlocal granularity, and 3) a reinforcer of new ecosystems based on 6G technology enablers and 6G networks of networks to be developed in line with the UN SDGs which incorporates future mobile communication technologies which will be available in 2030. Related challenges are also identified. An action plan is presented along with prioritized focus areas within the mobile communication sector technology and industry evolution to best support the achievement of the UN SDGs

FinnGen provides genetic insights from a well-phenotyped isolated population.

Population isolates such as those in Finland benefit genetic research because deleterious alleles are often concentrated on a small number of low-frequency variants (0.1% ≤ minor allele frequency < 5%). These variants survived the founding bottleneck rather than being distributed over a large number of ultrarare variants. Although this effect is well established in Mendelian genetics, its value in common disease genetics is less explored1,2. FinnGen aims to study the genome and national health register data of 500,000 Finnish individuals. Given the relatively high median age of participants (63 years) and the substantial fraction of hospital-based recruitment, FinnGen is enriched for disease end points. Here we analyse data from 224,737 participants from FinnGen and study 15 diseases that have previously been investigated in large genome-wide association studies (GWASs). We also include meta-analyses of biobank data from Estonia and the United Kingdom. We identified 30 new associations, primarily low-frequency variants, enriched in the Finnish population. A GWAS of 1,932 diseases also identified 2,733 genome-wide significant associations (893 phenome-wide significant (PWS), P < 2.6 × 10-11) at 2,496 (771 PWS) independent loci with 807 (247 PWS) end points. Among these, fine-mapping implicated 148 (73 PWS) coding variants associated with 83 (42 PWS) end points. Moreover, 91 (47 PWS) had an allele frequency of <5% in non-Finnish European individuals, of which 62 (32 PWS) were enriched by more than twofold in Finland. These findings demonstrate the power of bottlenecked populations to find entry points into the biology of common diseases through low-frequency, high impact variants