As companies try to implement newly relevant human resource policies for managerial organization and practices through strategic planning and to fit structure, culture, and process with ...externalities, they need a well-educated, effective, and committed workforce to draw on. New paradigm companies recognize that external business strategies require counterparts for human resources often involving significantly changed roles for the HR function. The new paradigm organization model also recognizes interdependencies between life and work. Hewlett Packard became the metaphor for new paradigm organizations some 30 years ago. The paradox of the high-achievement organization, the strategic choice between improved management of people versus a broad human resource philosophy, is not a simple matter. Among other things, new paradigm approaches require strategies to assist in power shaping and new communication patterns. The main tasks that top management faces today emphasize learning/adaptation, strategic culture management, and human resources as a strategic partner.
Four hundred twenty-six patients with esophageal atresia with or without tracheoesophageal fistula have been primarily cared for at the University of Michigan Medical Center since Cameron Haight's ...initial experience with this entity. Over the period of observation, the incidence of new cases as well as the number of associated anomalies has remained constant. The long-term survival of these patients has steadily improved over the past half-century from 36% in the pre-1950 era to 84% during the most recent 20 years. Conversely, operative mortality has shown a progressive decline from 56% early in the authors' series to 6.9% more recently, despite a steady increase in the proportion of high-risk neonates seen at the University of Michigan Medical Center during this time span. In the last 9 years, there have been no postoperative deaths in group A or B risk infants (36 patients), while the rate has been 18.2% in group C risk babies (27 patients); almost all of these deaths were due to severe associated anomalies. During the last 10 years, the authors have changed their technique of anastomosis from a two- to a one-layer method while still advocating a primary repair via an extrapleural approach. Although this change has resulted in a modest increase in the rate of anastomotic leak (17% vs. 6.2%, p less than 0.03), the leaks have been small and asymptomatic because of the extrapleural approach and, as a result, have been managed conservatively without any untoward sequelae. Conversely, there has been a significant decrease in the rate of stricture formation with the one-layer anastomosis (4.3% vs. 23.3%, p less than 0.002). While this may in part be explained by the change in anastomotic technique, it is felt that the more aggressive diagnosis and surgical management of gastroesophageal reflux (seen in 37.9% of our recent group) have contributed greatly to this decrease. The steady improvement in survival over this 50-year period, in spite of the increasing number of high-risk infants, is attributable to major improvements in neonatal care before, during, and after operation.
Ultrafast X-ray imaging provides high resolution information on individual fragile specimens such as aerosols, metastable particles, superfluid quantum systems and live biospecimen, which is ...inaccessible with conventional imaging techniques. Coherent X-ray diffractive imaging, however, suffers from intrinsic loss of phase, and therefore structure recovery is often complicated and not always uniquely-defined. Here, we introduce the method of in-flight holography, where we use nanoclusters as reference X-ray scatterers in order to encode relative phase information into diffraction patterns of a virus. The resulting hologram contains an unambiguous three-dimensional map of a virus and two nanoclusters with the highest lat- eral resolution so far achieved via single shot X-ray holography. Our approach unlocks the benefits of holography for ultrafast X-ray imaging of nanoscale, non-periodic systems and paves the way to direct observation of complex electron dynamics down to the attosecond time scale.
A phase III open-label clinical trial was conducted at 11 institutions to determine the safety and efficacy of gadoteridol in children suspected of having neurologic disease. One hundred three ...children were included in the safety analysis; 92 were evaluated for efficacy (76 intracranial and 16 spinal examinations). Three adverse events were reported in two children. All adverse events were considered minor and resolved spontaneously without treatment or sequelae. In a comparison of enhanced T1-weighted magnetic resonance images with unenhanced T1- and T2-weighted images, enhancement of disease was noted in 70% of the intracranial and 38% of the spinal examinations. Additional diagnostic information was reported in 82% of the postcontrast intracranial examinations and 62% of the spinal examinations. Use of this additional information contributed to a potential modification of patient diagnosis in 48% of intracranial and 20% of spinal cases with additional information. These results indicate excellent safety and efficacy for use of gadoteridol in children with suspected intracranial or spinal disease.
Relationship of muscle capillary basement membrane thickness and diabetic retinopathy.
R F Klein ,
K R Feingold ,
C Morgan ,
W H Stern and
M D Siperstein
Abstract
We examined the relationship between ...the thickness of the quadriceps muscle capillary basement membrane and diabetic retinopathy.
Basement membrane thickness was measured in two groups of patients with long-standing type II diabetes mellitus. One group
of patients (N = 13) had no evidence of diabetic retinopathy on fluorescein angiography, whereas the other (N = 12) had proliferative
microvascular disease. All the patients were male, and both groups were of similar ages, duration of diabetes, serum creatinines,
and glycemic control as reflected by HbA1 levels. Mean muscle capillary basement membrane width (+/- SE) of the patients with
proliferative retinopathy (3346 +/- 262) was significantly greater (P less than .05) than that observed in the patients without
retinopathy (2660 +/- 177). The results of this study suggest that there is a relationship between capillary basement membrane
thickness in skeletal muscle and the severity of microangiopathy in the eye. However, there was a substantial overlap between
the two groups, indicating that for any individual patient the measurement of muscle capillary basement width will probably
not be useful in identifying the presence or absence of retinopathy.
The capsid structures of the 7 serotypes of foot-and-mouth disease virus have been compared utilizing a series of neutralizing monoclonal antibodies which were previously shown to recognize at least ...4 distinct epitopes on type A12 virus. A radioimmune binding assay using radioactively labeled antigens and the monoclonal antibodies revealed that certain conformation dependent epitopes are conserved among A subtypes, while some continuous epitopes are conserved among A subtypes as well as other FMDV serotypes. On the basis of differential reactivity among other FMDV subtypes and serotypes two additional epitopes have been defined on the A12 particle. Binding and neutralization assays revealed that the presence and function of an epitope are not necessarily correlated.
Abstract
The effects of irrigation water high in soluble salts on the establishment of three species of maple trees in a Southwestern landscape were determined. Thirty Drummond red maple, Caddo sugar ...maple and bigtooth maple trees were irrigated during a 15-month period with either municipal water (pH 7.9, EC=952–1197 mg/l) or rainwater (pH 6.0, EC = 8.4 mg/l) after planting in containers of sandy clay loam soil. Trees of all species irrigated with rainwater had greater height and caliper increases, and better visual appearances than did those watered with municipal water. The Caddo and bigtooth maples were visually superior to the Drummond red maples. Frequency of irrigation had no effect on any measured plant responses, and no differences in leaf areas due to irrigation source or frequency were found.
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