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BACKGROUND: Delayed cord clamping and umbilical cord milking provide placental transfusion to vigorous newborns. Delayed cord clamping in nonvigorous newborns may not be provided owing to a perceived need for immediate resuscitation. Umbilical cord milking is an alternative, as it can be performed more quickly than delayed cord clamping and may confer similar benefits. OBJECTIVE: We hypothesized that umbilical cord milking would reduce admission to the neonatal intensive care unit compared with early cord clamping in nonvigorous newborns born between 35 and 42 weeks gestation. STUDY DESIGN: This was a pragmatic cluster-randomized crossover trial of infants born at 35 to 42 weeks gestation in 10 medical centers in 3 countries between January 2019 and May 2021. The centers were randomized to umbilical cord milking or early cord clamping for approximately 1 year and then crossed over for an additional year or until the required number of consented subjects was reached. Waiver of consent as obtained in all centers to implement the intervention. Infants were eligible if nonvigorous at birth (poor tone, pale color, or lack of breathing in the first 15 seconds after birth) and were assigned to umbilical cord milking or early cord clamping according to their birth hospital randomization assignment. The baseline characteristics and outcomes were collected following deferred informed consent. The primary outcome was admission to the neonatal intensive care unit for predefined criteria. The main safety outcome was hypoxic-ischemic encephalopathy. Data were analyzed by the intention-to-treat concept. RESULTS: Among 16,234 screened newborns, 1780 were eligible (905 umbilical cord milking, 875 early cord clamping), and 1730 had primary outcome data for analysis (97% of eligible; 872 umbilical cord milking, 858 early cord clamping) either via informed consent (606 umbilical cord milking, 601 early cord clamping) or waiver of informed consent (266 umbilical cord milking, 257 early cord clamping). The difference in the frequency of neonatal intensive care unit admission using predefined criteria between the umbilical cord milking (23%) and early cord clamping (28%) groups did not reach statistical significance (modeled odds ratio, 0.69; 95% confidence interval, 0.41-1.14). Umbilical cord milking was associated with predefined secondary outcomes, including higher hemoglobin (modeled mean difference between umbilical cord milking and early cord clamping groups 0.68 g/dL, 95% confidence interval, 0.31-1.05), lower odds of abnormal 1-minute Apgar scores (Apgar ≤3, 30% vs 34%, crude odds ratio, 0.72; 95% confidence interval, 0.56-0.92); cardiorespiratory support at delivery (61% vs 71%, modeled odds ratio, 0.57; 95% confidence interval, 0.33-0.99), and therapeutic hypothermia (3% vs 4%, crude odds ratio, 0.57; 95% confidence interval, 0.33-0.99). Moderate-to-severe hypoxic-ischemic encephalopathy was significantly less common with umbilical cord milking (1% vs 3%, crude odds ratio, 0.48; 95% confidence interval, 0.24-0.96). No significant differences were observed for normal saline bolus, phototherapy, abnormal 5-minute Apgar scores (Apgar ≤6, 15.7% vs 18.8%, crude odds ratio, 0.81; 95% confidence interval, 0.62-1.06), or a serious adverse event composite of death before discharge. CONCLUSION: Among nonvigorous infants born at 35 to 42 weeks gestation, umbilical cord milking did not reduce neonatal intensive care unit admission for predefined criteria. However, infants in the umbilical cord milking arm had higher hemoglobin, received less delivery room cardiorespiratory support, had a lower incidence of moderate-to-severe hypoxic-ischemic encephalopathy, and received less therapeutic hypothermia. These data may provide the first randomized controlled trial evidence that umbilical cord milking in nonvigorous infants is feasible, safe and, superior to early cord clamping.

Characterizing cellular diversity at different levels of biological organization and across data modalities is a prerequisite to understanding the function of cell types in the brain. Classification of neurons is also essential to manipulate cell types in controlled ways and to understand their variation and vulnerability in brain disorders. The BRAIN Initiative Cell Census Network (BICCN) is an integrated network of data-generating centers, data archives, and data standards developers, with the goal of systematic multimodal brain cell type profiling and characterization. Emphasis of the BICCN is on the whole mouse brain with demonstration of prototype feasibility for human and nonhuman primate (NHP) brains. Here, we provide a guide to the cellular and spatial approaches employed by the BICCN, and to accessing and using these data and extensive resources, including the BRAIN Cell Data Center (BCDC), which serves to manage and integrate data across the ecosystem. We illustrate the power of the BICCN data ecosystem through vignettes highlighting several BICCN analysis and visualization tools. Finally, we present emerging standards that have been developed or adopted toward Findable, Accessible, Interoperable, and Reusable (FAIR) neuroscience. The combined BICCN ecosystem provides a comprehensive resource for the exploration and analysis of cell types in the brain.

Being outdoors encourages content creativity, inclusion of new ideas and perspectives, student voice and agency, authentic contextualization, and connection to nature. In this article, the authors share why integrating mathematics and nature is beneficial for both students and teachers, provide an example of a middle-grades lesson taught outside, and highlight the five core routines that can be used to plan any lesson beyond the classroom.

This case study was structured around the experiences of five dual major Special Education and Elementary Education teacher candidates completing the Special Education edTPA, with a focus on K-5 mathematics. Community of practice provided a lens for study design and data analysis. Findings revealed that the teacher candidates adopted shared concerns and passions about the edTPA and their mathematics teaching and how they embody their views of Special Educators and/or Elementary Educators.

"Nature-based learning" is learning through exposure to nature and nature-based activities (Jordan and Chawla 2019). Nature and mathematics can be connected through teaching and learning with natural materials (objects from nature) or teaching and learning in outside spaces. In this article, the authors elaborate on the rationale for nature-based integration in mathematics, and share two lessons from a third-grade multiplication exploration as examples of nature-based learning, which benefit students' mathematical, interpersonal, and natural connections.

The Mathematics Enthusiast Special Issue (2014) presented an extensive review of the literature around the content knowledge of prospective elementary teachers (PTs). The issue excluded articles around PTs' beliefs. Understanding research around PTs' beliefs is important to understanding how to design and support their teaching preparation. Attending to PTs' beliefs helps to ensure their content knowledge and instructional methods are aligned with reform-based mathematics. This article highlights a literature review that addressed the omission of beliefs and explored how teacher preparation might address PTs' held beliefs.

Productive struggle is an essential part of mathematics instruction that promotes learning with deep understanding. A video scenario is used to provide a glimpse of productive struggle in action and to showcase its characteristics for both students and teachers. Suggestions for supporting productive struggle are provided.

It is well documented that engagement in arts and cultural activities contributes to improving and maintaining the health and well-being of older people. Despite this, many health and social care professionals do not recognize or accept arts and cultural activities as relevant to their care remit. To address this, a team of 17 individuals comprising older service users, and staff from a range of health and social care, arts, and museum and archive services in North East England worked collaboratively to design and develop the Museum Health and Social Care Service (MHSCS). MHSCS is a resource and training package that reinforces the care and clinical benefits of arts and cultural activities to older people's health and wellbeing, aimed at supporting health and social care professionals to acknowledge and use these activities as integral to care delivery.

The research is clear on the importance of student connectedness to school. Adolescents who feel connected to school and perceive the adults there to be caring are more likely to be academically and socially engaged. Middle school is a critical time for students to feel connected to school, but these grade levels present greater challenges to those who are working to foster student connectedness. In this article, the authors identify three focus areas that are critical to fostering student connectedness to school: (1) transitions to middle school; (2) student support systems; and (3) program elements that include an effective anti-bullying effort.

Copay accumulator programs, which exclude the benefit of manufacturer patient assistance from annual maximum out‐of‐pocket costs, shift costs for expensive oncology drugs from plans to patients. Legislation is ongoing to protect patients from these potentially harmful redefinitions of cost‐sharing. [ABSTRACT FROM AUTHOR]