External Workloads Vary by Position and Game Result in US-based Professional Soccer Players

International Journal of Exercise Science 16(6): 688-699, 2023. Professional soccer is a physically demanding sport that requires players to be highly trained. Advances using GPS allow the tracking of external workloads for individual players in practice and competition, however, there is a lack of evidence on how these measures impact match results. Therefore, we analyzed external workloads by player position and determined if they vary depending on the result of competitive matches. External workloads were analyzed in professional soccer players (n = 25) across 28 competitive games. One-way ANOVA determined if workloads varied by position (striker – ST, wide midfielder - WM, central midfielder – CM, wide defender - WD, central defender – CD) or across games won (n = 8), lost (n = 13) or tied (n = 7). Repeated-measures ANOVA assessed differences in workloads specific to each position in each of the result categories. Statistical significance was set at p \u3c 0.05. Across all games, more high-speed and very-high speed running was done by ST and WD compared to CD (p \u3c 0.001) and CM (p \u3c 0.001 - 0.02). Whole-team data showed no differences in any external workload variable with respect to match result (p \u3e 0.05), however, in games won ST did more very high-speed running than in losing games (p = 0.03) and defending players did more high and very high-speed running in games tied vs. those won or lost (p \u3c 0.05). Whole-team external workloads do not vary depending on the match result; however, high speed running may be a differentiating factor at the positional level. Coaches should consider position-specific analysis when examining player workloads

A meta-analysis of GFR slope as a surrogate endpoint for kidney failure

Glomerular filtration rate (GFR) decline is causally associated with kidney failure and is a candidate surrogate endpoint for clinical trials of chronic kidney disease (CKD) progression. Analyses across a diverse spectrum of interventions and populations is required for acceptance of GFR decline as an endpoint. In an analysis of individual participant data, for each of 66 studies (total of 186,312 participants), we estimated treatment effects on the total GFR slope, computed from baseline to 3 years, and chronic slope, starting at 3 months after randomization, and on the clinical endpoint (doubling of serum creatinine, GFR

Acute Treatment Effects on GFR in Randomized Clinical Trials of Kidney Disease Progression

Background: Acute changes in GFR can occur after initiation of interventions targeting progression of CKD. These acute changes complicate the interpretation of long-term treatment effects. Methods: To assess the magnitude and consistency of acute effects in randomized clinical trials and explore factors that might affect them, we performed a meta-analysis of 53 randomized clinical trials for CKD progression, enrolling 56,413 participants with at least one estimated GFR measurement by 6 months after randomization. We defined acute treatment effects as the mean difference in GFR slope from baseline to 3 months between randomized groups. We performed univariable and multivariable metaregression to assess the effect of intervention type, disease state, baseline GFR, and albuminuria on the magnitude of acute effects. Results: The mean acute effect across all studies was 20.21 ml/min per 1.73 m2 (95% confidence interval, 20.63 to 0.22) over 3 months, with substantial heterogeneity across interventions (95% coverage interval across studies, 22.50 to 12.08 ml/min per 1.73 m2). We observed negative average acute effects in renin angiotensin system blockade, BP lowering, and sodium-glucose cotransporter 2 inhibitor trials, and positive acute effects in trials of immunosuppressive agents. Larger negative acute effects were observed in trials with a higher mean baseline GFR. Conclusion: The magnitude and consistency of acute GFR effects vary across different interventions, and are larger at higher baseline GFR. Understanding the nature and magnitude of acute effects can help inform the optimal design of randomized clinical trials evaluating disease progression in CKD

Proceedings of the Third Annual Deep Brain Stimulation Think Tank: A Review of Emerging Issues and Technologies

The proceedings of the 3rd Annual Deep Brain Stimulation Think Tank summarize the most contemporary clinical, electrophysiological, imaging, and computational work on DBS for the treatment of neurological and neuropsychiatric disease. Significant innovations of the past year are emphasized. The Think Tank\u27s contributors represent a unique multidisciplinary ensemble of expert neurologists, neurosurgeons, neuropsychologists, psychiatrists, scientists, engineers, and members of industry. Presentations and discussions covered a broad range of topics, including policy and advocacy considerations for the future of DBS, connectomic approaches to DBS targeting, developments in electrophysiology and related strides toward responsive DBS systems, and recent developments in sensor and device technologies

Cardiorespiratory hysteresis during incremental high altitude ascent-descent quantifies the magnitude of ventilatory acclimatization

Maintenance of arterial blood gases is achieved through sophisticated regulation of ventilation, mediated by central and peripheral chemoreflexes. Respiratory chemoreflexes are important during exposure to high altitude due to the competing influence of hypoxia and hypoxic hyperventilation‐mediated hypocapnia on steady‐state ventilatory drive. Inter‐individual variability exists in ventilatory acclimatization to high altitude, potentially affecting the development of acute mountain sickness (AMS). We aimed to quantify ventilatory acclimatization to high altitude by comparing differential ascent and descent values (i.e. hysteresis) in steady‐state cardiorespiratory variables. We hypothesized that (a) the hysteresis area formed by cardiorespiratory variables during ascent and descent would quantify the magnitude of ventilatory acclimatization, and (b) larger hysteresis areas would be associated with lower AMS symptom scores during ascent. In 25 healthy, Diamox‐free trekkers ascending to and descending from 5160 m, cardiorespiratory hysteresis was measured in the pressure of end‐tidal (PET)CO2, peripheral oxygen saturation (SpO2), minute ventilation (V̇E), chemoreceptor stimulus index (SI; PETCO2/SpO2) and the calculated steady‐state chemoreflex drive (SS‐CD; V̇E/SI) using portable devices (capnograph, peripheral pulse oximeter and respirometer, respectively). AMS symptoms were assessed daily using the Lake Louise Questionnaire. We found that (a) ascent‐descent hysteresis was present in all cardiorespiratory variables, (b) SS‐CD is a valid metric for tracking ventilatory acclimatization to high altitude and (c) highest AMS scores during ascent were significantly, moderately and inversely‐correlated to SS‐CD hysteresis magnitude (rs = ‐0.408, P = 0.043). We propose that ascent‐descent hysteresis is a novel and feasible way to quantify ventilatory acclimatization in trekkers during high altitude exposure

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

The Influence of Metabolic Activity on Water and Electrolyte Distribution: The Effect of Thyroidectomy

Within the past decade considerable clinical and experimental work has been done concerning the physiological importance ow water and electrolyte distribution. There is little doubt at the present time that Na, K, Mg, Ca, and Cl exercise fundamental roles in maintaining the integrity of cellular function. An interesting characteristic of most mammalian cells is their ability to maintain high K and low Na concentrations in the presence of an environment containing large amount of Na and small amounts of K. Most investigators agree that the basis for this phenomenon is related to an active metabolic process. Conway (25, 26), a leader in this area, has implicated a cytochrome-like system, not only as the active carrier , but also as the energy source in the cellular extrusion of the Na ion. In view of the basic physiological importance of these considerations, it would appear valuable to study water and electrolyte distribution while manipulating tissue metabolism experimentally. Ablation of the thyroid gland offers a controlled method of lowering tissue metabolism. The the author\u27s knowledge, there is little or no tissue electrolyte data in this area. Therefore, the present study was undertaken with the following objectives: (1) to delineate quantitative alterations in tissue water, Na, K, and Mg following thyroidectomy; (2) to develop a better understanding of the physiological basis of Na and K distribution between cells and their immediate environment. Although the term thyroidectomy will be used thoughout this paper, it should be emphasized that the operative procedure employed was a thyroparathyroidectomy. The justification for this terminology rests in the author\u27s interest and conceptual thinking in hypometabolism as an experimental variable. In addition, the animals used in this investigation were maintained on Ca water as compensation for the development of possible hypoparathyroidism. It must, however, be kept in mind that thyroidectomy implies thyroparathyroidectomy. The burden of proof rests in further and more explicity designed research