To describe the normal heart rate (HR) of healthy newborns ≥35+0 weeks’ gestation in the first 10 min after caesarean delivery (CD) with extrauterine placental transfusion, using dry-electrode ECG (NeoBeat).

Single-centre, prospective observational study.

Norwegian County Hospital.

Newborns ≥35+0 weeks’ gestation delivered by CD under regional anaesthesia were eligible for inclusion. Newborns delivered by CD under general anaesthesia, or who needed medical intervention, were excluded.

NeoBeat was attached to the newborn’s chest immediately following delivery. The placenta was delivered without cord clamping after 60–90 s and transferred with the newborn to a resuscitation table. Modified physiology-based cord clamping (PBCC) was performed.

HR was recorded every second for 10 min. HR quartiles were calculated. Events possibly influencing HR were annotated using Liveborn Observation App.

89 newborns with a mean (SD) gestational age of 39+3 weeks (10 days) and birth weight of 3649 (536) g were included. Median (IQR) HR was 164 (117–176) and 169 (145–186) beats per minute at 20 s and 30 s, respectively, peaking at 169 (152–183) beats per minute at 4 min and then slowly decreasing to 157 (146–167) beats per minute at 10 min. HR was not significantly affected by intact-cord blood sampling (mean difference=5.4 (95% CI –1.4 to 12.1)), placental delivery (mean difference=0.7 (95% CI –3.5 to 4.9)) or cord clamping (mean difference =–0.6 (95% CI –2.1 to 0.9)).

This report describes, for the first time, HR quartiles for healthy newborns ≥35⁰ weeks’ gestation from 15 s to 20 s and up to 10 min after CD with extrauterine placental transfusion and PBCC.

Glucocorticoid therapy is prescribed for a variety of inflammatory conditions and is associated with severe adverse effects. A glucocorticoid withdrawal syndrome (GWS) may occur after prolonged glucocorticoid treatment—with or without biochemical glucocorticoid-induced adrenal insufficiency (GIAI). Previously, GWS was not considered an entity, probably due to the overlap between symptoms of GWS and GIAI. The Addison’s disease-specific quality of life questionnaire (AddiQoL-30) is a validated tool for quantifying symptoms of adrenal insufficiency resembling GWS. In the present study, we test the hypothesis that patients with a low AddiQoL-30 score and/or low cortisol response to a short Synacthen test (SST), after cessation of prednisolone treatment, may benefit from low-dose hydrocortisone therapy without increasing the risk of metabolic and cardiovascular disease during prolonged cortisol exposure.

REPLACE is a multi-centre, double-blinded, placebo-controlled randomised controlled trial in patients with polymyalgia rheumatica or giant cell arteritis after cessation of prednisolone treatment. Criteria for randomisation are an AddiQoL-30 score ≤85 and/or plasma cortisol response to SST, 30-min p-cortisol >100 and 85; and (2) patients with a SST-stimulated cortisol ≤100 nmol/L.

The study is conducted in accordance with the Declaration of Helsinki, registered at the Clinical Trials Information System (CTIS: 2024-513822-53-00) and Clinicaltrials.gov (NCT05193396), and publications will be in accordance with the recommendations of the International Committee of Medical Journal Editors. The trial is monitored by local independent Good Clinical Practice units and overseen by the Danish Data Protection Agency (journal no. 21/27119), the Regional Committees on Health Research Ethics for Southern Denmark (project ID: S-20210076), the Danish Patient Safety Authority and the Danish Medicines Agency.

NCT05193396.

During 2009–2018, the Emory Global Health Institute conducted the Tobacco-Free Cities (TFC) programme in 22 cities in mainland China. This study aims to assess the sustained impact of the TFC programme.

A qualitative study using semi-structured interviews was adopted, which focused on the leadership and capacity building, city-level smoke-free policies, tobacco control activities, outcomes of tobacco control, sustainability post TFC programme and the accomplishments of tobacco control. The thematic analysis was employed for qualitative data analysis.

Online in-depth personal interviews.

This qualitative study recruited 17 participants from 10 cities which participated in the TFC programme (five with comprehensive and five with partial smoke-free policies). Interview participants included TFC programme leaders, TFC staff and current tobacco control staff.

First, TFC members reported enhanced competencies in smoke-free policy effort and leadership. Five cities with comprehensive smoke-free policies had a high degree of public support, while cities with partial bans faced barriers such as lack of leadership support and experiencing tobacco industry influence. Tobacco control activities, including media campaigns, policy enforcement, cessation programmes and monitoring activities, were sustained in almost all cities. Enhancement in smoke-free social norms, decrease in smoking rate and second-hand smoking exposure were perceived. Challenges to sustainability included reduced financial and personnel resources and weakened policy enforcement.

The TFC programme was regarded by participants as an effective model that provided the necessary training and technical support to develop and enforce effective and sustainable tobacco control policies and initiatives at the city level in China. Future tobacco control training should focus more on developing concrete solutions for sustainability challenges.