Although in recent years placental pathology has been the subject of a wealth of detailed descriptions and diagnostic categorization, systematic correlation of these conditions with the pathology of stillbirth has not been attempted. We examine the relationship between specific inflammatory, maternal, and fetal vascular pathologies and the central nervous system pathology and histological indicators of fetal compromise. Our design was a retrospective case series of 37 3rd-trimester intrauterine fetal deaths. In general, mixed placental pathologies were the rule, with three quarters of the placentas demonstrating combinations of maternal vascular pathology, fetal vascular pathologies, umbilical cord abnormalities, or inflammatory lesions. The range of brain pathology was limited to acute, severe congestion, white matter edema, and neuronal karyorrhexis (pontosubicular necrosis with or without neuronal karyorrhexis at other sites). Established periventricular leukomalacia was present in only 2 cases. The presence of neuronal karyorrhexis or white matter gliosis was correlated with the presence of a high-grade inflammatory lesion and with fetal thymic involution. Neuronal karyorrhexis, but not white matter gliosis, correlated as well with histologically established fetal vascular lesions in the placenta, even once the effect of inflammation was accounted for. Gliosis also correlated with inflammation, meconium staining, and thymic involution. Central nervous system injury may be the end result of complex placental pathologies, and neuronal injury may be a consequence of the fetal inflammatory response. The correspondence between the time courses of histological features of chorioamnionitis, neuronal karyorrhexis, and thymic involution points to irreversible central nervous system injury being common 12-48 hours prior to in utero demise.

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It seems certain that blended learning will be on the rise in higher education, with in-person meetings increasingly precious time, and online synchronous and asynchronous sessions used to complement them. This paper examines Knowledge Building in two graduate courses conducted during the COVID-19 pandemic. There were no in-person sessions; rather, synchronous Zoom sessions were combined with asynchronous work in a knowledge building environment–Knowledge Forum. Knowledge Forum is designed to make transparent and accessible means by which deep understanding and sustained creative work proceed. Accordingly, for example, rise-above notes and view rearrangement support synthesis and explanatory coherence, epistemic markers support knowledge-advancing discourse, and analytics support self-and group-monitoring of progress as work proceeds. In this report, we focus on these aspects of Knowledge Building, using a subset of analytics to enhance understanding of key concepts and design of principles-based practices to advance education for knowledge creation. Overall, we aimed to have students take collective responsibility for advancing community knowledge, rather than focus exclusively on individual achievement. As we reflect on our experiences and challenges, we attempt to answer the following questions: Do courses that introduce Knowledge Building in higher education need an in-person or synchronous component? In what ways can we leverage in-class time and Knowledge Forum work to engage students in more advanced knowledge creation? We conclude that synchronous and asynchronous Knowledge Building can be combined in powerful new ways to provide students with more design time and deeper engagement with content and peers.

Her primary research interests are in Human Factors and Systems Engineering, specifically their application in Education (e.g. learning outcomes assessment, engineering problem solving). Before that, she completed her MASc. (2015) and BASc. (2012) in Electrical Engineering from University of Toronto.