Pulmonary vascular changes associated with hypoplastic left ventricle syndrome

The lungs of ten newborn infants who died of hypoplastic left ventricle syndrome were studied by a morphometric technique that (1) determined the percentage wall thickness of injected pulmonary arteries, (2) determined the ratio between the number of alveoli per high-power field and the number of corresponding arteries, and (3) examined in detail the extension of medial smooth muscle to the vessels at the periphery of the acinus. The findings in the lung were related to the gross cardiac morphological changes and to echocardiographic and hemodynamic findings. The echocardiograms of eight neonates demonstrated small left ventricles. The aortic root was hypoplastic in seven and the left atrium was small in three of the eight. Pulmonary artery hypertension and elevation of the left atrial pressure were present in all infants in whom measurements were obtained. The mean percentage wall thickness of all vessels was greater in afflicted infants than in normal age-matched control subjects. There was a normal ratio between the number of alveoli per high-power field and the number of corresponding arteries, and all infants had extension of muscle to the peripheral vessels at the alveolar duct and alveolar wall levels. The pulmonary vascular abnormalities observed in the neonate with hypoplastic left ventricle syndrome may represent persistence of fetal vascular abnormalities associated with the abnormal fetal circulatory hemodynamics resulting from the malformation. These abnormalities may influence the success of surgery proposed for hypoplastic left ventricle syndrome.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/48096/1/246_2006_Article_BF02336435.pd

Process studies of organizational space

The past decade has experienced an increase in the number of studies on organizational space or where work occurs. A number of these studies challenge traditional views of organizational space as a fixed, physical workspace because researchers fail to account for the spatial dynamics that they observe. New technologies, shifting employee-employer relations, and burgeoning expectations of the contemporary workforce blur boundaries between home and work, connect people and things that historically could not be linked, and extend workspaces to nearly everywhere, not just office buildings. Research on these transformations calls for incorporating movement into the physicality of work. Thus, organizational scholars have turned to process studies as ways to examine the dynamic features that create and alter spatial arrangements. However, the rapidly growing work in this area lacks integration and theoretical development. To address these concerns, we review and classify the organizational literature that casts space as a process, that is, dynamically as movements, performances, flows, and changing routines. This review yields five orientations of organizational space scholarship that we label as: developing, transitioning, imbricating, becoming, and constituting. We discuss these orientations, examine how they relate to key constructs of organizational space, and show how this work offers opportunities to theorizing about organizations.peerReviewe

Management of oral and maxillofacial trauma during the first wave of the COVID-19 pandemic in the United Kingdom

We assess the effect of coronavirus disease 2019 (COVID-19) on UK oral and maxillofacial (OMF) trauma services and patient treatment during the first wave of the pandemic. From 1 April 2020 until 31 July 2020, OMF surgery units in the UK were invited to prospectively record all patients presenting with OMF trauma. Information included clinical presentation, mechanism of injury, how it was managed, and whether or not treatment included surgery. Participants were also asked to compare the patient’s care with the treatment that would normally have been given before the crisis. Twenty-nine units across the UK contributed with 2,229 entries. The most common aetiology was mechanical fall (39%). The most common injuries were soft tissue wounds (52%) and, for hard tissues, mandibular fractures (13%). Of 876 facial fractures, 79 patients’ treatment differed from what would have been normal pre-COVID, and 33 had their treatment deferred. Therefore the care of 112 (14%) patients was at variance with normal practice because of COVID restrictions. The pattern of OMFS injuries changed during the first COVID-19 lockdown. For the majority, best practice and delivery of quality trauma care continued despite the on-going operational challenges, and only a small proportion of patients had changes to their treatment. The lessons learnt from the first wave, combined with adequate resources and preoperative testing of patients, should allow those facial injuries in the second wave to receive best-practice care