Background Glucose management is challenging in patients who require nutritional support in hospital. We aimed to assess whether fully closed-loop insulin delivery would improve glycaemic control compared with conventional subcutaneous insulin therapy in inpatients receiving enteral or parenteral nutrition or both. Methods We did a two-centre (UK and Switzerland), open-label, randomised controlled trial in adult inpatients receiving enteral or parenteral nutrition (or both) who required subcutaneous insulin therapy. Patients recruited from non-critical care surgical and medical wards were randomly assigned (1:1) using a computer-generated minimisation schedule (stratified by type of nutritional support [parenteral nutrition on or off] and pre-study total daily insulin dose [<50 or ≥50 units]) to receive fully closed-loop insulin delivery with faster-acting insulin aspart (closed-loop group) or conventional subcutaneous insulin therapy (control group) given in accordance with local clinical practice. Continuous glucose monitoring in the control group was masked to patients, ward staff, and investigators. Patients were followed up for a maximum of 15 days or until hospital discharge. The primary endpoint was the proportion of time that sensor glucose concentration was in target range (5•6-10•0 mmol/L), assessed in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, number NCT01774565.

BackgroundThe most important limiting factor in kidney transplantation is the scarcity of donor organs. Consequently, there is an increased use worldwide of kidneys from older deceased donors. High donor age is a known risk factor for acute cellular rejection and premature graft failure, and the optimal immunosuppressive regimen in these circumstances remains to be established.MethodsWe investigated whether induction treatment with an interleukin 2 (IL-2) receptor antagonist improves graft survival and reduces rejection episodes in recipients of kidneys from deceased donors aged ≥ 60 years. Data were retrieved for all recipients transplanted at our center from 2004 to 2009 with a kidney from a deceased donor aged > 60 years. The outcome was compared between recipients treated with (IL-2 plus) or without (IL-2 minus) an IL-2 receptor antagonist. All recipients received a calcineurin inhibitor, steroids and mycophenolate.ResultsA total of 232 first-transplant recipients were included (IL-2 plus = 149, IL-2 minus = 83). IL-2 minus was associated with increased risk of early acute rejection (OR 2.42; 95% CI 1.25 to 4.68, P = 0.009) and steroid-resistant rejection (OR 8.04; 2.77 to 23.25, P< 0.001). IL-2 plus patients had superior two-year estimated uncensored (87% versus 70%, P = 0.001) and death-censored (95% versus 79%, P< 0.001) graft survival.ConclusionsInduction treatment with IL-2 receptor antagonist was associated with a reduction in acute rejection episodes and improved two-year graft survival in patients transplanted with kidneys from older deceased donors.

The evidence-based hamstring strengthening programme for prevention of hamstring injuries is not adopted by football teams because of its high training volume. This study on female football players investigated if high-volume training with the Nordic hamstring exercise is more effective on hamstring strength, jump height, and sprint performance than low-volume training. We also examined the time course of changes in muscle strength during the intervention period. Forty-five female football players were randomised to a high- (21 sessions, 538 total reps) or low-volume group (10 sessions, 144 total reps) and performed an 8-week training intervention with the Nordic hamstring exercise during the preseason. We tested hamstring strength (maximal eccentric force with NordBord and maximal eccentric torque with isokinetic dynamometer), jump height, and 40 m sprint before and after the intervention. The NordBord test was also performed during training weeks 4 and 6. Both groups increased maximal eccentric force (high-volume: 29 N (10%), 95% CI: 19–38 N, p < 0.001 , low-volume: 37 N (13%), 95% CI: 18–55 N, p = 0.001 ), but there were no between-group differences ( p = 0.38 ). Maximal eccentric torque, jump height, and sprint performance did not change. Maximal eccentric force increased from the pretest to week 6 (20 N (7%), 95% CI: 8 to 31 N, p < 0.001 ), but not week 4 (8 N (3%), 95% CI: −2 to 18 N, p = 0.22 ). High training volume with the Nordic hamstrings exercise did not lead to greater adaptations in strength, jump height, or speed than a low-volume programme. Players in both groups had to train for at least 6 weeks to improve maximal eccentric force significantly.

the injury and illness patterns in women's premier league football. Materials and Methods During the 2020 and 2021 seasons players in the women's premier football league in Norway reported all health problems (acute injuries, overuse injuries and illnesses) weekly, using the Oslo Sports Trauma Research Centre Questionnaire on Health Problems. We calculated incidence, average weekly prevalence, and burden (the crossproduct of incidence and severity) of all health problems reported. ResultsWe included 294 female football players (22±4 years, range: 16-37) in the study. The average response rate to the weekly questionnaire was 79% (SD: ±9%). On average, 32% (95% CI, 31% to 33%) of the players reported at least one health problem at any time and 22% (95% CI, 21% to 23%) reported a health problem negatively affecting their training volume or performance. Acute injuries caused the greatest burden of all health problems (68% of the total burden), followed by overuse injuries (25%) and illness (8%). Thigh was the most common injury location (n=143, 26% of all cases), but knee injuries caused the greatest time-loss (42% of total time-loss). Conclusion One in five players in the women's premier league in Norway had a health problem negatively affecting their training volume or performance at any time. Acute injuries represented the most burdensome health problem. Thigh injuries were most frequent while knee injuries caused the greatest time-loss.