Introduction The study objectives are to describe the national health and safety standards in family child care homes (FCCHs) and child care centers and compare them by child care type. Method Child care health consultants and research assistants completed the standardized Health and Safety Checklist, which comprised key national health and safety standards, in a convenience sample of 21 FCCHs and 31 child care centers enrolled in two larger studies conducted in CA. Results The checklist was completed in 1 or 2 hours in FCCHs and centers, respectively. The internal consistency of the overall checklist subscales was moderate to strong. Eight of 10 checklist subscales were not significantly different in FCCHs and centers, but outdoor facilities (p less then .05) and supervision, interaction, and physical activity (p less then .05) were different. Discussion The Health and Safety Checklist is valid in FCCHs and centers and identifies targeted interventions for nurses to improve child care quality.Objective To determine whether the population level outcomes of pediatric acute promyelocytic leukemia have improved over time. Study design We conducted a retrospective analysis of the Surveillance Epidemiology and End Results database for patients with acute promyelocytic leukemia, up to 20 years of age, diagnosed between 1976 and 2016 and actively followed. Patients were stratified based on their period of diagnosis (1976-1989, 1990-1999, 2000-2009, 2010-2016) to assess the temporal trends in overall survival and early mortality. Results A total of 553 patients with a median age of 15 years (range, 0-20 years) were included. The 5-year overall survival increased significantly over time (by 22.6% from 1976 to 1989; by 59.2% from 1990 to 1999; by 77.7% from 2000 to 2009; and by 88.9% from 2010 to 2016; P less then .001). Early mortality showed an improvement over time in the most recent cohort (by 14% from 1976 to 1989; by 13.5% from1990 to 1999; by 13.3% 2000 to 2009; and by 7.2% from 2010 to 2016) after adjusting for other demographic characteristics in a logistic regression model. On multivariate analysis of overall survival, diagnosis in the earlier time periods was associated with higher mortality as compared with the 2010-2016 period. Age, sex, and race/ethnicity were not significant predictors of overall survival. Conclusions Outcomes of pediatric acute promyelocytic leukemia have continued to improve over time at the population level.Objective To evaluate changes in cerebral oxygenation, peripheral arterial oxygenation, respiratory status, and administered fraction of inspired oxygen during the first 10 minutes of life in premature infants receiving umbilical cord milking compared with delayed cord clamping (DCC). Study design Premature infants born at 230/7 to 276/7 weeks of gestation were randomized to umbilical cord milking or DCC. A near infrared spectroscopy sensor, pulse oximeter, and electrocardiogram electrodes were placed. Pulse rate, cerebral tissue oxygenation, peripheral oxygen saturation, airway pressure, and fraction of inspired oxygen were collected for 10 minutes in the delivery room. Longitudinal models were used to compare effects of umbilical cord milking and DCC. Results Fifty-six infants had cerebral oximetry and advanced monitoring at birth. There was an increased incidence of severe intraventricular hemorrhage in infants who received umbilical cord milking compared with DCC (P = .0211). Longitudinal models suggested that peripheral oxygen saturation was higher in the umbilical cord milking group in the first 4 minutes (P = .0221) and that mean airway pressures were lower in the umbilical cord milking group after the first 7 minutes (P = .0072). No statistical differences were observed for fraction of inspired oxygen, cerebral tissue oxygenation, or heart rates. Conclusions The data suggest that the rapid transfer of blood during umbilical cord milking may facilitate lung expansion with improved pulmonary blood flow, but may also increase cerebral blood flow, resulting in severe intraventricular hemorrhage. Trial registration ClinicalTrials.gov NCT03145142.Objectives To describe patterns of primary and specialty care delivery in pediatric patients with inflammatory bowel diseases (IBD), delineate which members of the healthcare team provided services, and identify gaps in care. Study design Cross-sectional survey of parents of children (2-17 years) with IBD and adolescents with IBD (13-17 years) at a free-standing, quaternary children's hospital regarding healthcare receipt. Results There were 161 parents and 84 adolescents who responded to the survey (75% and 60% response, respectively). The mean patient age was 14 ± 3 years, 51% were male, 80% had Crohn's disease, 16% ulcerative colitis, and 4% IBD-unspecified. Most parents were white (94%), living in a suburban setting (57%). Sixty-nine percent of households had ≥1 parent with a bachelor's degree or higher. Most had private insurance (43%) or private primary with public secondary insurance (34%). Most patients received annual check-ups (70%), vaccinations (78%), and care for minor illnesses (74%) from their primary care provider. Check-ups for gastrointestinal symptoms, IBD monitoring, and changes in type/dosing of IBD treatment were provided by their gastroenterology provider (77%, 93%, and 86% of patients, respectively). Discussions about family/peer relationships, school/extracurricular activities, and mood were not addressed in 30%-40% of participants. Adolescents frequently reported that no one had talked to them about substance use (40%), sexual health (50%), or body image (60%); 75% of adolescents and 76% of their parents reported that no one had discussed transitioning to an adult provider. Conclusions There were gaps in the psychosocial care of pediatric patients with IBD. Coordinated, comprehensive care delivery models are needed.Aim Oxytocin, a peptide hormone synthesized in the hypothalamic paraventricular nucleus, has been reported to participate in the regulation of learning and memory performance. However, no report has demonstrated the effect of oxytocin on the amyloid-beta (Aβ)-induced impairment of synaptic plasticity. In this study, we examined the effects of oxytocin on the Aβ-induced impairment of synaptic plasticity in mice. selleck compound Methods To investigate the effect of oxytocin on synaptic plasticity, we prepared acute hippocampal slices for extracellular recording and assessed long-term potentiation (LTP) with perfusion of the Aβ active fragment (Aβ25-35) in the absence and presence of oxytocin. Results We found that oxytocin reversed the impairment of LTP induced by Aβ25-35 perfusion in the mouse hippocampus. These effects were blocked by pretreatment with the selective oxytocin receptor antagonist L-368,899. Furthermore, the treatment with the ERK inhibitor U0126 and selective Ca2+-permeable AMPA receptor antagonist NASPM completely antagonized the effects of oxytocin.