The Corporatization of Communication

Our next panel discusses the corporatization of communication

Dear Wife : the Civil War letters of Chester K. Leach

Occasional paper (University of Vermont. Center for Research on Vermont) ; no. 20

Congenital acute myeloid leukemia with unique translocation t(11;19)(q23;p13.3)

Congenital leukemia is rarely encountered in clinical practice, even in tertiary children's hospitals. Leukemia may cause significant coagulopathy, putting the patient at risk of intracranial hemorrhage. In this case, the authors present a female infant with a unique mixed phenotypic congenital acute myeloid leukemia showing mixed-lineage leukemia (MLL) rearrangement and severe coagulopathy resulting in a large subdural hematoma. Despite the fatal outcome in this case, neurosurgical treatment of patients with acute myeloid leukemia should be considered if coagulopathy and the clinical scenario allow

Endothelin-1 Predicts Hemodynamically Assessed Pulmonary Arterial Hypertension in HIV Infection.

BackgroundHIV infection is an independent risk factor for PAH, but the underlying pathogenesis remains unclear. ET-1 is a robust vasoconstrictor and key mediator of pulmonary vascular homeostasis. Higher levels of ET-1 predict disease severity and mortality in other forms of PAH, and endothelin receptor antagonists are central to treatment, including in HIV-associated PAH. The direct relationship between ET-1 and PAH in HIV-infected individuals is not well described.MethodsWe measured ET-1 and estimated pulmonary artery systolic pressure (PASP) with transthoracic echocardiography (TTE) in 106 HIV-infected individuals. Participants with a PASP ≥ 30 mmHg (n = 65) underwent right heart catheterization (RHC) to definitively diagnose PAH. We conducted multivariable analysis to identify factors associated with PAH.ResultsAmong 106 HIV-infected participants, 80% were male, the median age was 52 years and 77% were on antiretroviral therapy. ET-1 was significantly associated with higher values of PASP [14% per 0.1 pg/mL increase in ET-1, p = 0.05] and PASP ≥ 30 mmHg [PR (prevalence ratio) = 1.24, p = 0.012] on TTE after multivariable adjustment for PAH risk factors. Similarly, among the 65 individuals who underwent RHC, ET-1 was significantly associated with higher values of mean pulmonary artery pressure and PAH (34%, p = 0.003 and PR = 2.43, p = 0.032, respectively) in the multivariable analyses.ConclusionsHigher levels of ET-1 are independently associated with HIV-associated PAH as hemodynamically assessed by RHC. Our findings suggest that excessive ET-1 production in the setting of HIV infection impairs pulmonary endothelial function and contributes to the development of PAH

Revisiting the design intent concept in the context of mechanical CAD education

[EN] Design intent is generally understood simply as a CAD model¿s anticipated behavior when altered. However, this representation provides a simplified view of the model¿s construction and purpose, which may hinder its general understanding and future reusability. Our vision is that design intent communication may be improved by recognizing the multifaceted nature of design intent, and by instructing users to convey each facet of design intent through the better-fitted CAD resource. This paper reviews the current understanding of design intent and its relationship to design rationale and builds on the idea that communication of design intent conveyed via CAD models can be satisfied at three levels provided that specialized instruction is used to instruct users in selection of the most suitable level for each intent.Otey, J.; Company, P.; Contero, M.; Camba, J. (2018). Revisiting the design intent concept in the context of mechanical CAD education. Computer-Aided Design and Applications. 15(1):47-60. https://doi.org/10.1080/16864360.2017.1353733S476015