Glucocorticoids (GCs) are frequently used for treating and preventing chronic lung disease and circulatory dysfunction in premature infants. However, there is growing concern about the detrimental effects of systemic GC administration on neurodevelopment. The first choice of GCs to minimize the adverse effects on the developing brain is still under debate. We investigated the effect of commonly used GCs such as dexamethasone (DEX), betamethasone (BET) and hydrocortisone (HDC) on the proliferation of human-induced pluripotent stem cell (iPSC)-derived neuronal progenitor cells (NPCs). In this study, NPCs were treated with various concentrations of GCs and subjected to cell proliferation assays. Furthermore, we quantified the number of microtubule-associated protein 2 (MAP2) positive neurons in NPCs by immunostaining. All GCs promoted NPC proliferation in a dose-dependent manner. We also confirmed that MAP2-positive neurons in NPCs increased upon GC treatment. However, differential effects of GCs on MAP2 positive neurons were observed when we treated NPCs with H2O2. The total numbers of NPCs increased upon any GC treatment even under oxidative conditions but the numbers of MAP2 positive neurons increased only by HDC treatment. GCs promoted human iPSCs–derived NPC proliferation and the differential effects of GCs became apparent under oxidative stress. Our results may support HDC as the preferred choice over DEX and BET to prevent adverse effects on the developing human brain.Electronic supplementary materialThe online version of this article (doi:10.1186/2193-1801-3-527) contains supplementary material, which is available to authorized users.

A 78-year-old

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To clarify sta awareness and the current status of facilities regarding end-of-life care and the planning for severely disabled children and adults. Methods: A questionnaire survey on ACP was conducted on all 466 sta members of a residential facility for children with medical disabilities. Results: e response rate was 77.0%; 20.2% of direct support sta and 50.9% of indirect support sta answered that they had never heard of ACP (or life conferences). e respondents had experienced discussions with the patient and family members about medical treatment and care in the last stage of life was 27.1%. e content of the discussions was more often about the family's values and wishes than about the patient's values and intentions, and the timing of the start of the discussions was often when death was approaching .More than 70% of the direct supporters wished to participate in ACP, discussions, and they wished to receive training in advance of ACP implementation . e majority of sta agreed that surrogate decision-making in the absence of family members should be discussed by a multidisciplinary medical and care team, and that the results should be approved by an ethics committee. Conclusion:Training for sta is necessary for the promotion of ACP in medical-type residential care facilities for children with disabilities.

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