BACKGROUND AND OBJECTIVES: Available data on survival rates and outcomes of extremely low gestational age (GA) infants (22-25 weeks' gestation) display wide variation by country. Whether similar variation is found in statements by national professional bodies is unknown. The objectives were to perform a systematic review of management from scientific and professional organizations for delivery room care of extremely low GA infants.

Adult-onset primary torsion dystonia (PTD) may spread to multiple body parts, but the relative risk of spread by site of onset of dystonia has not been well characterized. We retrospectively identified 602 patients with PTD out of 1,500 dystonia patients in our electronic database and extracted age at onset, site of onset, family history, and spread. Survival analyses were performed for groups based on site of onset, and hazard ratios compared relative risk of spread across groups. Patients with adult-onset blepharospasm were more likely to spread (31% past the head) than those with dystonia starting in the neck (9%), larynx (12%), or upper extremities (16%). Hazard ratios proved that the blepharospasm group had the greatest relative risk of spread. The rate of spread after onset varied significantly between the different groups. Most spread occurred in the first 1 to 2 years after onset of blepharospasm, whereas the risk of spread was relatively constant over time in cervical and laryngeal dystonia. Different sites of onset of PTD confer different risks of spread, important for clinical prognosis. Different risks of spread may provide clues about underlying pathogenesis of adult-onset primary dystonias.

An accurate description of metal nanoparticle (NP)−support interactions is required for designing and optimizing NP catalytic systems because NP−support interactions may significantly impact NP stability and properties, such as catalytic activity. The ability to calculate NP interactions with amorphous supports, which are commonly used in industrial practice, is hampered because of a general lack of accurate atomically detailed model structures of amorphous surfaces. We have systematically studied relaxation processes of Pt 13 NPs on amorphous silica using recently developed realistic model amorphous silica surfaces. We have modeled the NP relaxation process in multiple steps: hard-sphere interactions were first used to generate initial placement of NPs on amorphous surfaces, then Pt−silica bonds were allowed to form, and finally both the NP and substrate were relaxed with density functional theory calculations. We find that the amorphous silica surface significantly impacts the morphology and electronic structure of the Pt clusters. Both NP energetics and charge transfer from NP to the support depend linearly on the number of Pt−silica bonds. Moreover, we find that the number of Pt−silica bonds is determined by the silica silanol number, which is a function of the silica pretreatment temperature. We predict that catalyst stability and electronic charge can be tuned via the pretreatment temperature of the support materials. The extent of support effects suggests that experiments aiming to measure the intrinsic catalytic properties of very small NPs on amorphous supports will fail because the measurable catalytic properties will depend critically on metal−support interactions. The magnitude of support effects highlights the need for explicitly including amorphous supports in atomistic studies.

Characteristics of decisions influence preferences for control over medical decisions among parents of patients in the NICU. These insights may guide improvements in physician-parent communication and consent.