3443. Short, medium, and long deferral of umbilical cord clamping compared with umbilical cord milking and immediate clamping at preterm birth: a systematic review and network meta-analysis with individual participant data.
作者: Anna Lene Seidler.;Sol Libesman.;Kylie E Hunter.;Angie Barba.;Mason Aberoumand.;Jonathan G Williams.;Nipun Shrestha.;Jannik Aagerup.;James X Sotiropoulos.;Alan A Montgomery.;Gillian M L Gyte.;Lelia Duley.;Lisa M Askie.; .
来源: Lancet. 2023年402卷10418期2223-2234页
Deferred (also known as delayed) cord clamping can improve survival of infants born preterm (before 37 weeks of gestation), but the optimal duration of deferral remains unclear. We conducted a systematic review and individual participant data network meta-analysis with the aim of comparing the effectiveness of umbilical cord clamping strategies with different timings of clamping or with cord milking for preterm infants.
3444. Deferred cord clamping, cord milking, and immediate cord clamping at preterm birth: a systematic review and individual participant data meta-analysis.
作者: Anna Lene Seidler.;Mason Aberoumand.;Kylie E Hunter.;Angie Barba.;Sol Libesman.;Jonathan G Williams.;Nipun Shrestha.;Jannik Aagerup.;James X Sotiropoulos.;Alan A Montgomery.;Gillian M L Gyte.;Lelia Duley.;Lisa M Askie.; .
来源: Lancet. 2023年402卷10418期2209-2222页
Umbilical cord clamping strategies at preterm birth have the potential to affect important health outcomes. The aim of this study was to compare the effectiveness of deferred cord clamping, umbilical cord milking, and immediate cord clamping in reducing neonatal mortality and morbidity at preterm birth.
3446. Treatment of severe symptomatic aortic valve stenosis using non-invasive ultrasound therapy: a cohort study.
作者: Emmanuel Messas.;Alexander Ijsselmuiden.;Danijela Trifunović-Zamaklar.;Bernard Cholley.;Etienne Puymirat.;Jonathan Halim.;Radmila Karan.;Menno van Gameren.;Duško Terzić.;Vladimir Milićević.;Mickael Tanter.;Mathieu Pernot.;Guillaume Goudot.
来源: Lancet. 2023年402卷10419期2317-2325页
Calcific aortic stenosis is commonly treated using surgical or transcatheter aortic valve replacement; however, many patients are not considered suitable candidates for these interventions due to severe comorbidities and limited life expectancy. As such, non-invasive therapies might offer alternative therapeutic possibilities in these patients. This study aimed to assess the safety of non-invasive ultrasound therapy and its ability to improve valvular function by softening calcified valve tissue.
3448. Rethinking how development assistance for health can catalyse progress on primary health care.
作者: Tobias Kasper.;Gavin Yamey.;Sinead Dwyer.;Kaci Kennedy McDade.;Jon Lidén.;Cora Lüdemann.;Mohamed Mustafa Diab.;Osondu Ogbuoji.;Prashant Poodla.;Christina Schrade.;Andrea Thoumi.;Armand Zimmerman.;Yibeltal Assefa.;Luke N Allen.;Paulin Basinga.;Patricia J Garcia.;Debra Jackson.;Henry Mwanyika.;Rachel Nugent.;Anthony Ofosu.;Salman Rawaf.;K Srinath Reddy.;Dykki Settle.;Beth Tritter.;Christoph Benn.
来源: Lancet. 2023年402卷10418期2253-2264页
Global campaigns to control HIV, tuberculosis, malaria, and vaccine-preventable illnesses showed that large-scale impact can be achieved by using additional international financing to support selected, evidence-based, high-impact investment areas and to catalyse domestic resource mobilisation. Building on this paradigm, we make the case for targeting additional international funding for selected high-impact investments in primary health care. We have identified and costed a set of concrete, evidence-based investments that donors could support, which would be expected to have major impacts at an affordable cost. These investments are in: (1) individuals and communities empowered to engage in health decision making, (2) a new model of people-centred primary care, and (3) next generation community health workers. These three areas would be supported by strengthening two cross-cutting elements of national systems. The first is the digital tools and data that support facility, district, and national managers to improve processes, quality of care, and accountability across primary health care. The second is the educational, training, and supervisory systems needed to improve the quality of care. We estimate that with an additional international investment of between US$1·87 billion in a low-investment scenario and $3·85 billion in a high-investment scenario annually over the next 3 years, the international community could support the scale-up of this evidence-based package of investments in the 59 low-income and middle-income countries that are eligible for external financing from the World Bank Group's International Development Association.
3452. Omicron BA.2.86 cross-neutralising activity in community sera from the UK.
作者: Brian J Willett.;Nicola Logan.;Sam Scott.;Chris Davis.;Therese McSorley.;Patawee Asamaphan.;Margaret J Hosie.;Paula Olmo.;Joe Grove.;Richard Orton.;Antonia Ho.;John Haughney.;David L Robertson.;Emma C Thomson.
来源: Lancet. 2023年402卷10417期2075-2076页 3453. Impact of discontinuing oxytocin in active labour on neonatal morbidity: an open-label, multicentre, randomised trial.
作者: Aude Girault.;Loïc Sentilhes.;Raoul Desbrière.;Paul Berveiller.;Diane Korb.;Charline Bertholdt.;Julie Carrara.;Norbert Winer.;Eric Verspyck.;Eric Boudier.;Tiphaine Barjat.;Gilles Levy.;Georges Emmanuel Roth.;Gilles Kayem.;Mona Massoud.;Caroline Bohec.;Paul Guerby.;Elie Azria.;Julie Blanc.;Hélène Heckenroth.;Jessica Rousseau.;Charles Garabedian.;Camille Le Ray.; .
来源: Lancet. 2023年402卷10417期2091-2100页
Oxytocin is effective in reducing labour duration but can be associated with fetal and maternal complications that could potentially be reduced by discontinuing the treatment during labour. We aimed to assess the impact of discontinuing oxytocin during active labour on neonatal morbidity.
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