This pilot study evaluated a brief parent journaling program in the neonatal intensive care unit (NICU).
 
  Hundred NICU parents were randomized to a control group (no journal) or an intervention group (journal provided). Parents reported pre- and post-intervention anxiety and depression symptoms using the hospital anxiety and depression scale (HADS) and qualitative journal use data. The analysis included Student's paired two-tailed t-test and two-way ANOVA. This study was registered with clinicaltrials.gov on April 1, 2020, NCT04331925.
 
  At baseline, clinically significant anxiety was more prevalent than depression (66% vs. 23%). Post-intervention scores were best predicted by baseline scores. Relative to controls, intervention group parents experienced a decrease in anxiety from baseline (t = -1.983, p = 0.056). The same effect was not seen for depression. Most intervention group parents used the journal and provided positive feedback.
 
  Journal use rates and positive feedback support the acceptability of a NICU journaling program.
 Journal use rates and positive feedback support the acceptability of a NICU journaling program.
  This study evaluates differences in child healthcare utilization by maternal fertility status in the first four years of life.
 
  The retrospective cohort evaluated Massachusetts (MA) live born infants using data linked from clinical assisted reproductive technology (ART) data, birth certificates, and hospital discharge records. Hospital records of infants born 2004-2017 to mothers of fertile (no infertility treatments or indicators of infertility), unassisted subfertile (UF, indicators of infertility but no fertility treatment), medically assisted reproduction (MAR, non-ART assistance with reproduction) and ART treatment were studied. Adjusted relative risk (aRR) was calculated using multivariable log binomial regression models.
 
  We included 339,426 singleton live-born infants discharged from birth hospitalization. Compared to children born to fertile mothers, those born to UF, MAR and ART-treated mothers were more likely to have hospital-based care (aRR 1.06-1.21) in their first 4 years.
 
  Maternal subfertility with and without treatment was associated with small increases in child healthcare utilization.
 Maternal subfertility with and without treatment was associated with small increases in child healthcare utilization.
  The influence of previous viral symptoms on the level and duration of human milk antibodies reactive to SARS-CoV-2, and common human coronaviruses (HCoVs) was investigated.
 
  Antibodies reactive to S1 and S2 subunits from SARS-CoV-2, HCoV-OC43, and HCoV-229E were measured via ELISA in human milk samples collected from March to June 2020 in mothers with and without viral symptoms.
 
  The presence of viral symptoms influenced the levels of SARS-CoV-2 S2-reactive SIgA/IgA and tended to influence SARS-CoV-2 S1 SIgA/IgA and S2-reactive SIgM/IgM in human milk but did not relate to IgG. HCoV-229E S1 + S2-reactive SIgA/IgA and SIgM/IgM, as well as HCoV-OC43 S1 + S2-reactive IgG were related to the symptoms. The duration of antibody levels in human milk in mothers with viral symptoms varied between 3 and 4 months post maternal report of viral symptoms.
 
  Previous viral symptoms and individual mothers may change the antibody cross-reactive levels to SARS-CoV-2 and HCoVs in human milk.
 Previous viral symptoms and individual mothers may change the antibody cross-reactive levels to SARS-CoV-2 and HCoVs in human milk.Neonatal-Perinatal Medicine (NPM) fellowship programs have undergone constant evolution since their first appearance in the 1960s. This article is the first in a seven-part series (Table 1) that critically evaluates the essentials of neonatology fellowship clinical and research education, performance assessment, and administrative support necessary to support NPM fellowship programs. This overview article will provide background on the history of NPM fellowship programs and provide a framework for the article series. Table 1 Essentials of NPM fellowship article series. Essentials of NPM fellowship Part 1 Overview of NPM fellowship  Description of the evolution of NPM Fellowship Part 2 Clinical education and experience  Strengths, weaknesses, opportunities, and threats of clinical education in NPM fellowship Part 3 Scholarship opportunities and threats  Scholarship requirements during NPM fellowship Part 4 Innovations in medical education  Critical analysis of current educational practices and andragogical innovations in NPM fellowship Part 5 Evaluation of competence and proficiency using milestones  Assessment of NPM fellows during training using competency-based medical education principles Part 6 Program administration  Administrative infrastructure and stakeholders necessary to run a NPM fellowship program Part 7 Careers in NPM  Career preparation and opportunities for NPM fellowship graduates.
  To derive testing and treatment thresholds for early-onset neonatal sepsis and compare them to thresholds used in the Kaiser-Permanente (KP) Sepsis Calculator.
 
  Using surveys distributed in the United States, Brazil and Italy, decision thresholds were derived via self-identified thresholds selected from structured lists (Method 1), and based on clinical vignette responses for testing and treatment with or without inclusion of associated relative risk (Methods 2 and 3).
 
  Using Method 1, both testing and treatment thresholds were higher than the KP calculator thresholds. Test thresholds were lower (Method 2) or equivalent (Method 3) to KP using clinical vignettes. No vignette reached the 50% cutoff necessary to define a treatment threshold.
 
  The test threshold used by the KP calculator is the same as the threshold chosen by clinicians given a vignette and risk estimate. The KP treatment threshold is lower than that derived using all 3 methods.
 The test threshold used by the KP calculator is the same as the threshold chosen by clinicians given a vignette and risk estimate. The KP treatment threshold is lower than that derived using all 3 methods.
  To serially assess fetal cardiac dimensions in congenital diaphragmatic hernia (CDH) and their relation to disease severity.
 
  Retrospective analysis of CDH cases and matched controls. Mitral (MVd) and tricuspid (TVd) valve diameters, left (LV) and right (RV) ventricular length and area, Z-scores, were serially assessed at 24-26, 30-32, and 35-37 weeks gestational age (GA).
 
  In CDH cases MVd, MVd Z-score, and LV area were significantly reduced at 24-26 and 35-37 weeks GA. TVd, TVd Z-score, and RV area were significantly reduced at 24-26 weeks.  https://www.selleckchem.com/Akt.html  RV area Z-score increased with advancing GA. MVd and MVd Z-score were significantly lower at 24-26 weeks GA in CDH who had a combined outcome of death and/or ECMO.
 
  LV hypoplasia in CDH is characterized by reduced MVd from 24 weeks GA. MVd, and the ratio of mitral and tricuspid valve diameters at later gestations, may be potential predictors of disease severity.
 LV hypoplasia in CDH is characterized by reduced MVd from 24 weeks GA. MVd, and the ratio of mitral and tricuspid valve diameters at later gestations, may be potential predictors of disease severity.