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Aims To evaluate the efficacy and safety of two insulin intensification strategies for patients with type 2 diabetes previously treated with basal insulin - insulin degludec ( IDeg) and insulin aspart ( IAsp) - administered as a co-formulation ( IDegAsp) or as a basal-bolus regimen ( IDeg and IAsp in separate injections). Methods This 26-week, open-label, treat-to-target, phase IIIb, non-inferiority trial randomized patients (1 : 1) to IDegAsp twice daily with main meals (n = 138; IDegAsp group) or IDeg once daily and IAsp 2-4 times daily (n = 136; IDeg+ IAsp group). Results After 26 weeks, the mean glycated haemoglobin ( HbA1c) level was 7.0% (53 mmol/mol) for the IDegAsp group and 6.8% (51 mmol/mol) for the IDeg+ IAsp group (Δ% HbA1c from baseline −1.31 and −1.50%, respectively). The non-inferiority of IDegAsp versus IDeg+ IAsp was not confirmed for mean change in HbA1c [estimated treatment difference ( ETD) 0.18, 95% confidence interval ( CI) −0.04, 0.41; p = non-significant]. No significant differences were observed in the proportion of patients achieving HbA1c <7.0% (56.5 and 59.6%, respectively). IDegAsp treatment resulted in a significantly lower total daily insulin dose, a smaller change in body weight, numerically lower rates of confirmed hypoglycaemia (self-reported plasma glucose <3.1 mmol/l; rate ratio 0.81; p = non-significant), and nocturnal confirmed hypoglycaemic episodes (rate ratio 0.80; p = non-significant) versus IDeg+ IAsp. Patient-reported outcome scores for social functioning were significantly higher for IDegAsp versus IDeg+ IAsp ( ETD 2.2; 95% CI 0.3, 4.1; p < 0.05). Conclusions Both intensification strategies effectively improved glycaemic control. Although non-inferiority was not confirmed, there were no significant differences between the groups that could affect clinical utility. [ABSTRACT FROM AUTHOR]

Background: Long-term treatment with supplemental oxygen has unknown efficacy in patients with stable chronic obstructive pulmonary disease (COPD) and resting or exercise-induced moderate desaturation.Methods: We originally designed the trial to test whether long-term treatment with supplemental oxygen would result in a longer time to death than no use of supplemental oxygen among patients who had stable COPD with moderate resting desaturation (oxyhemoglobin saturation as measured by pulse oximetry [Spo2], 89 to 93%). After 7 months and the randomization of 34 patients, the trial was redesigned to also include patients who had stable COPD with moderate exercise-induced desaturation (during the 6-minute walk test, Spo2 ≥80% for ≥5 minutes and <90% for ≥10 seconds) and to incorporate the time to the first hospitalization for any cause into the new composite primary outcome. Patients were randomly assigned, in a 1:1 ratio, to receive long-term supplemental oxygen (supplemental-oxygen group) or no long-term supplemental oxygen (no-supplemental-oxygen group). In the supplemental-oxygen group, patients with resting desaturation were prescribed 24-hour oxygen, and those with desaturation only during exercise were prescribed oxygen during exercise and sleep. The trial-group assignment was not masked.Results: A total of 738 patients at 42 centers were followed for 1 to 6 years. In a time-to-event analysis, we found no significant difference between the supplemental-oxygen group and the no-supplemental-oxygen group in the time to death or first hospitalization (hazard ratio, 0.94; 95% confidence interval [CI], 0.79 to 1.12; P=0.52), nor in the rates of all hospitalizations (rate ratio, 1.01; 95% CI, 0.91 to 1.13), COPD exacerbations (rate ratio, 1.08; 95% CI, 0.98 to 1.19), and COPD-related hospitalizations (rate ratio, 0.99; 95% CI, 0.83 to 1.17). We found no consistent between-group differences in measures of quality of life, lung function, and the distance walked in 6 minutes.Conclusions: In patients with stable COPD and resting or exercise-induced moderate desaturation, the prescription of long-term supplemental oxygen did not result in a longer time to death or first hospitalization than no long-term supplemental oxygen, nor did it provide sustained benefit with regard to any of the other measured outcomes. (Funded by the National Heart, Lung, and Blood Institute and the Centers for Medicare and Medicaid Services; LOTT ClinicalTrials.gov number, NCT00692198 .). [ABSTRACT FROM AUTHOR]

• Virtual Reality is one of the emerging technologies with a potential to improve well-being, quality of life and fitness. • Older adults showed significant improvements in quality of life, happiness and some functional fitness components, among those who experienced virtual reality sessions. • The research supports future considerations to use specific VR apps to assist active ageing. Ageing is a complex process with physical, psychological, and social changes, which can lead to diseases and disability, and further reduce happiness levels. Virtual reality (VR) is an emerging technology with the potential to improve overall well-being, quality of life (QoL), muscle activity and balance. Our study aimed to determine the influence of VR sessions on the QoL, happiness, and functional fitness components of an elderly cohort. A non-blinded randomized controlled trial was conducted. Sixty participants, who visited the active ageing center at the university were randomized into two groups- intervention and control. The intervention group received VR experience sessions for 15 min twice a week for a duration of 6 weeks, while the control group received no sessions. Participants filled out a questionnaire for QoL assessment and happiness assessment. They were also tested for several functional fitness components. Both questionnaires and fitness tests were conducted at the beginning and at the end of study. QoL improved by some metrics assessed (Pain/Discomfort and Anxiety/Depression). Happiness significantly improved in the intervention group relative to the control group. Among the functional fitness tests, the back scratch test 1st and back scratch test 2nd were measured to be significantly improved in the intervention group in comparison to control group. VR sessions have potential to influence the well-being and functional fitness of older adults and further support the process of healthy and active ageing. Future considerations could focus on supporting more physical and psychological aspects of the older people through VR content. NCT04166747. [ABSTRACT FROM AUTHOR]