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We aim to collect the evidence of efficacy of Gentle Guman Touch (GHT) and Yakson Touch in preterm neonates as pain relief, heart rate, oxygen saturation, and urine cortisol level. We made our search through PubMed, Web of Science, Scopus, and Cochrane by the mid of March 2023. Randomized control trials (RCTs) were included, and the Cochrane risk of bias tool was utilized to assess their quality. Using Review Manager software, a meta-analysis was conducted. We computed the mean difference (MD) with a 95% confidence interval (CI) for the continuous data. During the examination, the Neonatal Infant Pain Scale (NIPS) was significantly reduced in the touch group compared to the control group (MD = -3.40, 95% CI [-4.15 to -2.64], P-value= 0.00001). After the examination, the NIPS score was also reduced by both Yakson touch and GHT compared to the control (MD = -2.14, 95% CI [-3.42 to -0.85], P-value <0.00001). Yakson touch and GHT are non-pharmacological, easy, and safe methods that can be used for painful interventions to reduce the pain experience of preterm infants from variable interventions. Both methods improved infant sleep and behavior. Preterm infants' heart rates and oxygen saturation were unaffected by Yakson touch or GHT.

We compare the hematocrit, hemoglobin, need for transfusion, recurrent phototherapy, serum bilirubin level, and serum ferritin at different time frames for the umbilical cord milking (UCM) and delayed cord clamping (DCC) in both full-term and preterm infants. A comprehensive search through various databases aimed to compare UCM and DCC studies until May 2nd, 2023. Cochrane and NIH tools assessed RCTs and cohorts, respectively. Meta-analysis employed Review Manager 5.4 software, calculating MD and RR with 95% CIs for continuous and dichotomous data. We included 20 studies with a total of 5189 infants. Regarding preterm infants, hematocrit level showed no significant difference between intact Umbilical Cord Milking (iUCM) compared to DCC (MD = −0.24, 95% CI [−1.11, 0.64]). Moreover, Neonatal death incidence was significantly higher with the UCM technique in comparison to DCC (RR = 1.28, 95% CI [1.01 to 1.62]). Regarding term and late preterm infants, Hematocrit level showed no significant difference between the iUCM or cUCM techniques compared to DCC (MD = 0.21, 95% CI [−1.28 to 1.69]), (MD = 0.96, 95% CI [−1.02 to 2.95]), respectively. UCM led to a higher risk of neonatal death in preterm infants compared to DCC. However, the incidence of polycythemia was lower in the UCM group. Additionally, UCM was associated with higher rates of severe IVH events. Based on these findings, DCC may be preferred due to its lower incidence of severe IVH and neonatal death. Nous comparons l'hématocrite, l'hémoglobine, le besoin de transfusion, la photothérapie récurrente, le taux de bilirubine sérique et la ferritine sérique à différentes périodes pour la traite du cordon ombilical (UCM) et le clampage retardé du cordon (DCC) chez les nourrissons nés à terme et prématurés. Une recherche complète dans diverses bases de données visait à comparer les études UCM et DCC jusqu'au 2 mai 2023. Les outils Cochrane et NIH ont évalué les ECR et les cohortes, respectivement. La méta-analyse a utilisé le logiciel Review Manager 5.4, calculant le MD et le RR avec des IC à 95 % pour les données continues et dichotomiques. Nous avons inclus 20 études portant sur un total de 5 189 nourrissons. Concernant les nourrissons prématurés, le niveau d'hématocrite n'a montré aucune différence significative entre la traite du cordon ombilical intact (iUCM) et la DCC (DM = −0,24, IC à 95 % [−1,11, 0,64]). De plus, l'incidence des décès néonatals était significativement plus élevée avec la technique UCM qu'avec la technique DCC (RR = 1,28, IC à 95 % [1,01 à 1,62]). Concernant les nourrissons à terme et peu prématurés, le niveau d'hématocrite n'a montré aucune différence significative entre les techniques iUCM ou cUCM par rapport à la technique DCC (DM = 0,21, IC à 95 % [−1,28 à 1,69]), (DM = 0,96, IC à 95 % [−1,02 à 2,95]), respectivement. L'UCM a entraîné un risque plus élevé de décès néonatal chez les nourrissons prématurés par rapport au DCC. Cependant, l'incidence de la polyglobulie était plus faible dans le groupe UCM. De plus, l'UCM était associée à des taux plus élevés d'événements IVH graves. Sur la base de ces résultats, le DCC peut être préféré en raison de sa plus faible incidence d'IVH grave et de décès néonatals.

Objective To compare quantified terminal ileal (TI) motility during MR enterography (MRE) with histopathological severity of acute inflammation in Crohn’s disease. Methods A total of 28 Crohn’s patients underwent MRE and endoscopic TI biopsy. Axial and coronal TrueFISP, HASTE and post-gadolinium VIBE images were supplemented by multiple coronal TrueFISP cine motility sequences through the small bowel volume. TI motility index (MI) was quantified using validated software; an acute inflammation score (eAIS; 0–6) was assigned to the biopsy. Two observers qualitatively scored mural thickness, T2 signal, contrast enhancement and perimural oedema (0–3) to produce an activity score (aMRIs) based on anatomical MRI. The association among the MI, eAIS and aMRIs was tested using Spearman’s rank correlation. Wilcoxon rank sum test compared motility in subjects with and without histopathological inflammation. Results Mean MI and mean eAIS were 0.27 (range 0.06–0.55) and 1.5 (range 0–5), respectively. There was a significant difference in MI between non-inflamed (mean 0.37, range 0.13–0.55) and inflamed (mean 0.19, range 0.06–0.44) TI, P  = 0.002, and a significant negative correlation between MI and both eAIS (Rho = −0.52, P  = 0.005) and aMRIs (R = −0.7, P  < 0.001). Conclusion Quantified TI motility negatively correlates with histopathological measures of disease activity and existing anatomical MRI activity biomarkers. Key Points • Magnetic resonance imaging is increasingly used to assess Crohn’s disease. • MRI measurements can provide a quantitative assessment of small bowel motility. • MR enterography can grade Crohn’s disease. • Small bowel motility can be used as a marker of inflammatory activity.

Breast cancer is the most common cancer among women worldwide. It is a major cause of cancer death, and its incidence rate has been gradually increasing in the Arab world, Saudi Arabia has a higher proportion of young females getting breast cancer than other countries. This study was conducted to investigate the knowledge, attitude, and practice regarding breast self-examination among females from 20 to 60 years old in Jazan Region, Saudi Arabia. Using A Community-based descriptive cross-sectional approach, data were gathered from 567 Saudi and non-Saudi women using structured interviews and then analyzed using the Statistical Package for Social Sciences (IBM) version 21.0 software program. Where the study indicated that around half of the participants (55.7%) had good total knowledge scores regarding breast self-examination, and most had positive attitudes. However, only 205 (36.2%) respondents practice it regularly. Moreover, the study reveals a significant association between respondents' knowledge and attitudes toward breast self-examination (P = 0.05). These findings indicate moderate knowledge, poor breast self-examination practices, and a significant association between knowledge and attitudes. Therefore, conducting health education programs is necessary to raise awareness about breast self-examination (BSE) among Jazan women. Le cancer du sein est le cancer le plus répandu chez les femmes dans le monde. Il s'agit d'une cause majeure de décès par cancer et son taux d'incidence augmente progressivement dans le monde arabe. L'Arabie saoudite compte une proportion plus élevée de jeunes femmes atteintes d'un cancer du sein que les autres pays. Cette étude a été menée pour étudier les connaissances, l'attitude et la pratique concernant l'auto-examen des seins chez les femmes de 20 à 60 ans dans la région de Jazan, en Arabie Saoudite. À l'aide d'une approche transversale descriptive communautaire, les données ont été recueillies auprès de 567 femmes saoudiennes et non saoudiennes à l'aide d'entretiens structurés, puis analysées à l'aide du logiciel Statistical Package for Social Sciences (IBM) version 21.0. L'étude a indiqué qu'environ la moitié des participantes (55,7 %) avaient de bons scores totaux de connaissances concernant l'auto-examen des seins et que la plupart avaient des attitudes positives. Cependant, seuls 205 (36,2%) répondants le pratiquent régulièrement. De plus, l'étude révèle une association significative entre les connaissances et les attitudes des répondants à l'égard de l'auto-examen des seins (P = 0,05). Ces résultats indiquent des connaissances modérées, de mauvaises pratiques d'auto-examen des seins et une association significative entre les connaissances et les attitudes. Par conséquent, il est nécessaire de mener des programmes d'éducation sanitaire pour sensibiliser les femmes de Jazan à l'auto-examen des seins (ESB).

Background Soil-transmitted helminth (STH) infections during pregnancy pose a significant threat to maternal health and perinatal outcomes. The low uptake of preventive deworming in high-burden settings, such as Somaliland, suggests systemic gaps in service delivery that require urgent attention. This study aims to identify the determinants of deworming among pregnant women in Somaliland to inform targeted public health strategies. Methods This cross-sectional study analyzed data from 3038 women who had a pregnancy in the five years preceding the 2020 Somaliland Demographic and Health Survey (DHS). The DHS employs a two-stage stratified sampling design to ensure a nationally representative sample. Our analysis accounted for this complex survey design by applying the provided sampling weights. We used multivariate logistic regression to identify factors associated with receiving deworming medication during a past pregnancy. Results The overall prevalence of deworming was critically low at 1.9%, a stark contrast to the 75% WHO global coverage target. After adjusting for confounders, the analysis revealed that ‘structural barriers’—physical and financial obstacles to healthcare access—were the primary determinants. Women in rural (Adjusted Odds Ratio [AOR] = 0.35; 95% CI 0.15–0.82) and nomadic (AOR = 0.12; 95% CI 0.03–0.51) areas had significantly lower odds of being dewormed compared to urban women. Conversely, women in the highest wealth quintile had nearly six times the odds of receiving treatment compared to those in the lowest (AOR = 5.85; 95% CI 1.28–26.7). Conclusion The alarmingly low deworming coverage in Somaliland appears to be driven by geographic and socioeconomic inequities. Our findings suggest that in this setting, structural factors have a stronger association with service uptake than individual-level characteristics. By prioritizing outreach services and addressing barriers to access, public health strategies can significantly improve the uptake of this essential care, improving maternal and child health outcomes.

Large numbers of people are being discharged from hospital following COVID-19 without assessment of recovery. In 384 patients (mean age 59.9 years; 62% male) followed a median 54 days post discharge, 53% reported persistent breathlessness, 34% cough and 69% fatigue. 14.6% had depression. In those discharged with elevated biomarkers, 30.1% and 9.5% had persistently elevated d-dimer and C reactive protein, respectively. 38% of chest radiographs remained abnormal with 9% deteriorating. Systematic follow-up after hospitalisation with COVID-19 identifies the trajectory of physical and psychological symptom burden, recovery of blood biomarkers and imaging which could be used to inform the need for rehabilitation and/or further investigation.

The interplay between an evolving cancer and a dynamic immune microenvironment remains unclear. Here we analyse 258 regions from 88 early-stage, untreated non-small-cell lung cancers using RNA sequencing and histopathology-assessed tumour-infiltrating lymphocyte estimates. Immune infiltration varied both between and within tumours, with different mechanisms of neoantigen presentation dysfunction enriched in distinct immune microenvironments. Sparsely infiltrated tumours exhibited a waning of neoantigen editing during tumour evolution, indicative of historical immune editing, or copy-number loss of previously clonal neoantigens. Immune-infiltrated tumour regions exhibited ongoing immunoediting, with either loss of heterozygosity in human leukocyte antigens or depletion of expressed neoantigens. We identified promoter hypermethylation of genes that contain neoantigenic mutations as an epigenetic mechanism of immunoediting. Our results suggest that the immune microenvironment exerts a strong selection pressure in early-stage, untreated non-small-cell lung cancers that produces multiple routes to immune evasion, which are clinically relevant and forecast poor disease-free survival. RNA sequencing data and tumour pathology observations of non-small-cell lung cancers indicate that the immune cell microenvironment exerts strong evolutionary selection pressures that shape the immune-evasion capacity of tumours.

IntroductionLung cancer screening (LCS) by low-dose computed tomography (LDCT) offers an opportunity to impact both lung cancer and coronary heart disease mortality through detection of coronary artery calcification (CAC). Here, we explore the value of CAC and cardiovascular disease (CVD) risk assessment in LCS participants in the Lung Screen Uptake Trial (LSUT).MethodsIn this cross-sectional study, current and ex-smokers aged 60–75 were invited to a ‘lung health check’. Data collection included a CVD risk assessment enabling estimation of 10 year CVD risk using the QRISK2 score. Participants meeting the required lung cancer risk underwent an ungated, non-contrast LDCT. Descriptive data, bivariate associations and a multivariate analysis of predictors of statin use are presented.ResultsOf 1005 individuals enrolled, 680 were included in the final analysis. 421 (61.9%) had CAC present and in 49 (7.2%), this was heavy. 668 (98%) of participants had a QRISK2≥10% and QRISK2 was positively associated with increasing CAC grade (OR 4.29 (CI 0.93 to 19.88) for QRISK2=10%–20% and 12.29 (CI 2.68 to 56.1) for QRISK2≥20% respectively). Of those who qualified for statin primary prevention (QRISK2≥10%), 56.8% did not report a history of statin use. In the multivariate analysis statin use was associated with age, body mass index and history of hypertension and diabetes.ConclusionsLCS offers an important opportunity for instituting CVD risk assessment in all LCS participants irrespective of the presence of LDCT-detected CAC. Further studies are needed to determine whether CAC could enhance uptake and adherence to primary preventative strategies.

The Lung Screen Uptake Trial tested a novel invitation strategy to improve uptake and reduce socioeconomic and smoking-related inequalities in lung cancer screening (LCS) participation. It provides one of the first UK-based ‘real-world’ LCS cohorts. Of 2012 invited, 1058 (52.6%) attended a ‘lung health check’. 768/996 (77.1%) in the present analysis underwent a low-dose CT scan. 92 (11.9%) and 33 (4.3%) participants had indeterminate pulmonary nodules requiring 3-month and 12-month surveillance, respectively; 36 lung cancers (4.7%) were diagnosed (median follow-up: 1044 days). 72.2% of lung cancers were stage I/II and 79.4% of non-small cell lung cancer had curative-intent treatment.