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Optimized extrusion melt-blending of polylactic acid (PLA) polymer with a minor biopolymeric phase, polybutylene adipate terephthalate (PBAT), and compatibilized with random ethylene-methyl acrylate-glycidyl methacrylate terpolymer (EMA-GMA, Trademark: Lotader AX-8900) led to an outstanding improvement in mechanical properties. At the noncompatibilized PLA–PBAT (80–20) blend point, significant enhancement (∼4500%) in toughness and elongation-at-break was already obtained without compromising any elastic properties. The effect of the compatibilizer content on the mechanical properties of the PLA–PBAT (80–20) blend was investigated by an optimal custom response surface methodology. Thus, 2 wt % Lotader content was determined to be optimal by a numerical optimization methodology with a desirability value, D, of 0.882 to maximize toughness and elongation-at-break. The compatibilization and thermal behavior of the Lotader-modified blends were analyzed by scanning electron microscopy (SEM), differential scanning calorimetry (DSC), and thermogravimetric analysis (TGA). Upon adding the compatibilizer, the original phase-separated morphology of the blends changed from PBAT quasi-spherical domains to nearly elongated elliptical ones. It was also found that the interfacial boundary line of the domains faded away, which revealed that interfacial compatibility was achieved. The thermostability of the blends remained largely unaltered following the incorporation of PBAT and Lotader. Moreover, while PBAT exhibited a minor influence on the crystallinity of PLA, Lotader had no discernible impact on crystallinity, as evidenced by the DSC thermograms. Thus, the compatibilizer at the optimal point in the optimized blend ratio led to the formation of a phase-separated morphology that combined internal cavitation, interfacial cavitation, and strong adhesion features at the right proportions in the microstructure which underlies the micromechanisms driving the remarkable enhancement of as much as 7100% in toughness and ductility.

Importance: Hepatitis C virus (HCV) care cascade data by race/ethnicity for US correctional populations are sparse. Objective: To evaluate the HCV care cascade by race/ethnicity for a state correctional population. Design, Setting, and Participants: This retrospective cohort study used Connecticut Department of Correction data for incarcerated individuals tested, diagnosed, and treated for chronic HCV infection with direct-acting antivirals (DAAs) from 2019 to 2023. Main Outcomes and Measures: HCV care cascade outcomes, including testing, treatment, and cure rates, were compared by race/ethnicity. Poisson regression was used to estimate prevalence ratios (PRs), with adjustment for demographic and legal status factors. Results: A total of 24,867 patients tested for HCV (88.9% men, mean (SD) age 35.6 (11.8), 32.7% White, 37.9% Black, 28.4% Hispanic, 0.6% Asian, 0.4% American Indian/Alaska Native (AIAN), 34.7% sentenced ≥ 1 year). Both HCV exposure and chronic HCV were highest for White (27.1% and 15.2%) and lowest for Black individuals (4.6% and 2.6%) (P< 0.01, for both outcomes). While incarcerated, 63.2% of chronic HCV patients started DAAs, and treatment rates did not significantly differ by race/ethnicity (P> 0.05). For those treated and having post-treatment lab data available, cure rates were 98.8% or better for all racial/ethnic groups (P> 0.05). In the adjusted regression analyses, HCV treatment initiation was lower for those sentenced < 1 year (PR, 0.76; 95% CI, 0.67–0.87) and unsentenced (PR, 0.85; 95% CI, 0.80–0.91) than those sentenced ≥ 1 year. The adjusted prevalence of advanced fibrosis stage/activity grade was not significantly associated with race/ethnicity. Conclusions: In this cohort study, less than two-thirds of chronic HCV patients initiated DAA treatment during their incarceration, and for those with available data, nearly all were cured. While there were disparities in HCV exposure and chronic HCV infection, significant racial/ethnic differences were not observed for treatment initiation or cure rates. Further efforts are needed to increase HCV treatment, especially for patients with shorter incarceration periods.

Opposing a great power is a means of asserting one's own power, and several countries aspire to be great powers regionally if not globally. One expression of power is the [...]

Malpractice claims can result from accepting cases in which the lawyer has little knowledge or experience, failing to screen clients and cases to identify the ones with problems that could lead to malpractice claims, or from breakdowns in the administration of cases. Other frequent sources of malpractice claims are lawyers' failing to identify potential conflicts in representing multiple clients on the same matter, and fee disputes with clients. Ways to prevent malpractice are detailed.

PRACTICE RECOMMENDATIONS Consider mobile phone texting as a possible cause of tendinitis in the hand. (B) * Advise mobile phone users to text with both hands, take frequent breaks, and [...]

Litigation services is a complex specialty, requiring expert knowledge in diverse fields. In this article, Byron S. Cherkas, CPA, a partner of Byron Cherkas & Company, Miami, describes the software [...]

Aerosolized pentamidine administration may pose potential risks to health care workers exposed to fugitive drug and to infectious respiratory pathogens (eg, tuberculosis) generated by pentamidine-induced cough. Classic infection control methods may be applied to this problem, although the effectiveness of these measures in mitigating environmental pentamidine exposure is unknown. Lack of data fully characterizing pentamidine's mechanism of action or potential mutagenicity, carcinogenicity, or teratogenicity raises concern and suggests worker exposure and environmental contamination be minimized. We report herein on the efficacy of an aerosol containment hood in containing fugitive pentamidine aerosol during administration. (Chest 1992; 102:1764-66), AP=aerolized pentamidine; HEPA=high-efficiency particulate air Administration of aerosolized pentamidine (AP) in health care settings may result in exposure of health care workers to environmental drug and infectious respiratory pathogens generated [...]

Infection with human immunodeficiency virus (HIV) is often complicated by skin disorders, such as Kaposi's sarcoma. Recent reports have identified a microorganism in HIV-related skin and blood vessel lesions that resembles the bacillus-type organism that causes cat scratch disease. In cat scratch disease, the bacteria Pasteurella multocida are usually transmitted by the bite or scratch of a cat. The cat scratch bacillus or a similar organism was shown to cause the widespread development of node-like skin lesions in HIV-infected patients. This HIV-related skin disease has been referred to as epithelioid angiomatosis, bacillary angiomatosis, and disseminated cat scratch disease. Epithelioid or bacillary angiomatosis has been treated with a combination of antibiotics, although it remains unclear which antibiotic is most effective. A case is described of a 48-year-old homosexual man with acquired immunodeficiency syndrome (AIDS) and advanced cat scratch disease who responded to treatment with the antibiotic doxycycline. (Consumer Summary produced by Reliance Medical Information, Inc.)

IMPORTANCE: Therapy-related myelodysplastic syndrome or acute myeloid leukemia (tMDS/AML) is a rare, usually fatal complication of chemotherapy, including certain alkylating agents, topoisomerase II inhibitors, and platinum compounds. With the introduction of new chemotherapeutic agents, expanded indications for established agents, and increased neoadjuvant and adjuvant chemotherapy, tMDS/AML risks in the modern age are poorly understood. OBJECTIVES: To quantify tMDS/AML risk after chemotherapy for solid cancer among United States adults since 2000 and correlate tMDS/AML risk patterns with chemotherapy treatment practices. DESIGN, SETTING, AND PARTICIPANTS: A population-based cohort study was conducted using cancer registries from the Surveillance, Epidemiology, and End Results (SEER) Program and Medicare claims. Risk analyses included 1619 tMDS/AML cases among 700 612 adults (age, 20-84 years) who were diagnosed with first primary solid cancer during 2000 to 2013 (followed up through 2014), received initial chemotherapy, and survived 1 year or longer, as reported to SEER. Descriptive analyses were conducted of SEER records linked with Medicare claims for chemotherapy in 165 820 older adults (age, 66-84 years) receiving initial chemotherapy for a first primary solid cancer in 2000-2013. Data analysis was conducted from October 2017 to April 2018. EXPOSURES: Receipt of initial chemotherapy for solid cancer. MAIN OUTCOMES AND MEASURES: Second primary tMDS/AML. RESULTS: Based on 1619 tMDS/AML cases in the SEER database (mean [SD] age, 64.3 [12.2] years; 1148 [70.9%] female), tMDS/AML risks were statistically significantly elevated after chemotherapy for 22 of 23 solid cancers (all except colon). Relative risks ranged from 1.5 to greater than 10 and excess absolute risks from 1.4 to greater than 15 cases per 10 000 person-years compared with the general population. Overall survival following tMDS/AML diagnosis was poor (1270 of 1619 patients [78.4%] died; median overall survival, 7 months). For patients treated with chemotherapy at the present time, approximately three-quarters of tMDS/AML cases expected to occur within the next 5 years will be attributable to chemotherapy. In the SEER-Medicare database, use of known leukemogenic agents, particularly platinum compounds, in initial chemotherapy increased substantially since 2000, most notably for gastrointestinal tract cancers (esophagus, stomach, colon, and rectum; 10% in 2000-2001 to 81% during 2012-2013). CONCLUSIONS AND RELEVANCE: Large-scale, United States population-based data demonstrate excess tMDS/AML risks following chemotherapy for nearly all solid tumor types, consistent with expanded use of known leukemogenic agents in the 21st century. Continued efforts to reduce treatment-related adverse events, particularly for solid cancer patients with favorable prognosis, are needed.

We report high-surface area, hierarchical pore structured, and robust activated carbon discs (ACDs) prepared via the assembly of micron-sized carbon spheres with mesophase pitch in a low-pressure foaming and carbonization process. The carbon disc ACDCS75 with the largest specific surface area (1338 m2·g–1) was obtained from a blend of 75 wt % carbon spheres and 25 wt % mesophase pitch, and this ACD had a bulk density of 0.62 g·cm–3and a high compressive strength of 26.3 MPa. A nitrogen-doped ACDCS75 disc was prepared by postcarbonization ammonia treatment to study the effect of nitrogen-containing surface functional groups on the uptake of CO2on ACDs. The adsorption of pure fluids CO2, CH4, and N2were measured at temperatures of 298, 308, and 318 K at pressures from 6 to 3496 kPa for CO2, pressures from 9 to 3996 kPa for CH4, and pressures from 7 to 3994 kPa for N2using a high-pressure gravimetric apparatus (Belsorp-BG). The equilibrium adsorption capacities of ACDCS75 measured at 298 K and pressure close to 1000 kPa were 5.67 mmol·g–1CO2, 3.60 mmol·g–1CH4, and 2.09 mmol·g–1N2, and at 3500 kPa were 6.16 mmol·g–1CO2, 4.42 mmol·g–1CH4, and 3.18 mmol·g–1N2. After ammonia treatment the capacities of N-ACDCS75 at 298 K and 1000 kPa were 6.22 mmol·g–1CO2, 3.70 mmol·g–1CH4, and 1.98 mmol·g–1N2, and at 3500 kPa were 7.16 mmol·g–1CO2, 4.87 mmol·g–1CH4, and 3.32 mmol·g–1N2. The pure gas equilibrium adsorption capacities were regressed to Toth and Langmuir models, and the uptake of components from gas mixtures was predicted using an ideal selectivity to make a preliminary evaluation of the potential to use these ACDs for gas separation. After N-doping the predicted changes in selectivities at 298 K and 100 kPa were from 6.0 to 7.2 for CO2over N2and 2.8 to 3.3 for CH4over N2on ACDCS75 compared to on N-ACDCS75.

History CB, a 32-year-old woman, was diagnosed with Multiple Sclerosis in January 2004, initially presenting with optical manifestations. Her symptoms began as a central smudging effect, which evolved into complete [...]

The article focuses on the ugly mob action reigned in a Chicago suburb called Cicero recently. Its impetus was fear of acquiring Negro neighbors. The Negro question is closely related to the absence of a good government in Cicero. Three years ago a reform movement to reorganize the municipal structure made strong headway until the night before the election. Police failure to disperse crowd of white people led to increasing violence. On each occasion, effective police action in preventing the crowds from growing and in arresting recalcitrant ended the violence. The record is clear that proper police action can prevent mob violence, whatever the mob's motivation.

Objectives. Smartphone applications (apps) are increasingly used to facilitate casual sexual relationships, increasing the risk of sexually transmitted diseases (STDs). In STD investigations, traditional contact elicitation methods can be enhanced with smartphone technology during field interviews.Methods. In 2013, the Monroe County Department of Public Health conducted a large, multi-infection STD investigation among men who have sex with men (MSM) using both index case and cluster interviews. When patients indicated meeting sexual partners online, disease intervention specialists (DISs) had access to smartphone apps and were able to elicit partners through access to inboxes and profiles where traditional contact information was lacking. Social network mapping was used to display the extent of the investigation and the impact of access to smartphones on the investigation.Results. A total of 14 index patient interviews and two cluster interviews were conducted; 97 individuals were identified among 117 sexual dyads. On average, eight partners were elicited per interview (range: 1–31). The seven individuals who used apps to find partners had an average of three Internet partners (range: 1–5). Thirty-six individuals either had a new STD (n=7) or were previously known to be HIV-positive (n=29). Of the 117 sexual dyads, 21 (18%) originated either online (n=8) or with a smartphone app (n=13). Of those originating online or with a smartphone app, six (29%) partners were located using the smartphone and two (10%) were notified of their exposure via a website. Three of the new STD/HIV cases were among partners who met online.Conclusion. Smartphone technology used by DISs in the field improved contact elicitation and resulted in successful partner notification and case finding.

The article focuses on how lawyers can benefit from applying legal project management (LPM) to mergers and acquisitions (M&A) transactions. It discusses the reasons the classic approach to these transactions no longer works including heightened sensitivity to the size and variability of legal fees as well as the advantages of LPM including error reduction. It also provides information on the deal phases of LPM and the billing tools developed by an LPM Task Force.

Few studies have examined treatment rates in patients with multiple cardiovascular risk factors. This study assessed outpatient visit and treatment patterns among patients having ≥1 cardiovascular conditions.

Letters to the editor are presented in response to articles in previous issues, including "Who Shot Mohammed al-Dura?," by James Fallows, "The Logic of Suicide Terrorism," by Bruce Hoffman and the excerpt "JFK's Second Term," by Robert Dallek, in the June 2003 issue.

AbstractBackground:Racial differences in stroke mortality are widely recognized, but it is unclear whether or not these differences are due mainly to blacks having a greater stroke incidence or higher case fatality rates compared to those of whites. Objectives:The aim of this study was to describe the race-specific US trends in hospital discharge rates and in-hospital mortality among stroke patients for the period 1980–1999. It was hypothesized that the hospital discharge rates and in-hospital mortality among stroke patients would be greater for blacks than for whites. Methods:Data from the National Hospital Discharge Survey for the period 1980–1999 were used to identify stroke subjects according to the codes of the International Classification of Diseases, ninth revision (codes 430–434 and 436). Direct standardization and Poisson regression were used to compare hospitalized stroke morbidity and mortality rates between blacks and whites. The main outcome measures were the number of stroke discharges and in-hospital deaths for black and white stroke patients. Results:Between the years 1980 and 1999, the hospital discharge rates for stroke increased for blacks (n = 8,700) and decreased for whites (n = 46,154); the in-hospital mortality rates decreased for both black and white stroke patients. Generally, the risk of a stroke hospitalization was greater for blacks than for whites by more than 70%, whereas both groups were similar in terms of in-hospital mortality rates among stroke patients. Conclusions:Differences between blacks and whites in terms of stroke mortality are more likely due to differences in stroke incidence rather than case fatality. These data imply that greater attention should be given to primary/secondary prevention and that additional research is needed to understand the reasons for these patterns.Copyright © 2002 S. Karger AG, Basel

The article reports on the low percentage of African American representation in the U.S. Army in 2015. According to Army Chief of Staff General Raymond T. Odierno, they have worked hard at Reserve Officers' Training Corps (ROTC) and the U.S. Military Academy in how to improve interest in the combat arms. Secretary of the Army John M. McHugh and Odierno released the "2014 Action Plan to Address Disparate Trends in Officer Talent Management" that signalled commitment for a diverse officer corps.

Conley (1985) uses a modified Monte Carlo method to solve sys tems of simultaneous linear algebraic equations and linear pro gramming problems. We have used Conley's two sample prob lems to compare his proposed method with the classical methods of Gauss-Jordan elimination and the revised simplex algorithm. The classical methods are about three orders of magnitude faster; therefore, Conley's proposed method does not warrant serious consideration as a viable solution procedure.

Caudal autotomy is an effective anti-predator mechanism used by many lizard species. Fitness benefits of surviving a predatory attack are obvious, although lizards that autotomize their tails may be at greater risk during subsequent encounters with predators than lizards with complete tails. In previous laboratory studies, tail-less lizards were more vulnerable to capture by predators, but little is known about the relative survival of tailed versus tail-less lizards in nature. This study reports on significant associations between naturally incurred tail injuries and the subsequent risk of mortality in 7 populations of the lizard Uta stansburiana. I used standard mark-recapture techniques to document survival and quantified tail injuries by estimating tail completeness. I then used sampled randomization tests to compare intitial tail completeness values of surviving versus non-surviving lizards. I evaluated overall patterns by comparising the means of tail completeness values of survivors versus non-survivors among mark-recapture sequences. Lizards with incomplete tails suffered higher mortality in the field, although this was not true for every comparison considered (i.e., for every mark-recapture sequence analyzed), and the overall trend was much stronger for adult males than for either adult females or juveniles. Higher mortality among lizards with incomplete tails is presumably a consequence of increased vulnerability to capture by predators. Vulnerability to predation of tail-injured lizards may be confounded by reduced social status in this species, because social subordination can result in the occupation of an inferior home range.

This paper describes the manner in which a windows-oriented, graphical user interface can facilitate the fitting of statistical distribution functions to data representing random events. A multi featured program that can display data in the form of histo grams, fit specified distribution functions to the data and determine a distribution function that best fits the data is described and illustrated with graphical examples. The results are displayed both graphically and in tabular form. Additional features are also described. The program has been written to be compatible with the SIMAN graphical user interface, though the results are general and can be applied within any particular graphical environment.

Coal preparation is a process for removing physical impurities from coal. The process is carried out in large plants whose capa cities range from 500 to 20,000 tons of coal per day. There are about 500 such plants within the United States.A coal preparation plant simulator was developed under the sponsorship of the U.S. Department of Energy for simulating coal preparation plant performance. The simulator contains mathe matical models describing all the major components of an actual coal preparation plant. Moreover, it utilizes a network-type struc ture, thus permitting the simulator to be used for a wide variety of different plant configurations. Both the models and the net work structure are described in this paper. Results are shown for a sample problem, which is representative of an actual coal preparation plant configuration.

We examine seasonal and interpopulational variation in field levels of corticosterone (B) in the lizard Uta stansburiana. Corticosterone is the primary reptilian glucocorticosteroid, and elevated levels of this hormone have been correlated with physiological stress under both field and laboratory conditions. Patterns of seasonal variation in plasma B were generally similar in males and females, with peaks coinciding with periods of peak reproductive activity (males) or peak reproductive condition (females). Levels of circulating B usually declined as the activity season progressed and were lowest in late summer, especially among males at desert sites-including our southernmost site, where lizards exhibited poor body condition as a result of drought. Variation in B levels among populations was probably attributable to variation in the timing of seasonal samples (e.g., in relation to peaks in reproductive activity). Apparently, these populations did not experience serious (i.e., debilitating) physiological stress, as the highest recorded levels were lower than those of captive-stressed U. stansburiana. This suggests that corticosterone levels simply parallel annual patterns of activity, especially reproduction. These findings agree with other studies that have indicated a positive, rather than a negative, association between glucocorticosteroid secretion and reproductive activity. These results also suggest that basal (baseline) levels of B in free-living animals may not be indicative of the degree of "stress."

This study examined the effect of gravity correction on concentric and eccentric average force of the right and left side shoulder rotator muscles and on the external/internal rotation reciprocal muscle group ratios. Thirty-three males were tested on a Kinetic Communicator dynamometer at 150 deg/sec from a seated position with the shoulder abducted to 90 deg and positioned along the frontal plane. Gravity correction procedures were followed prior to testing, and both the gravity-uncorrected (GU) and gravity-corrected (GC) values were obtained from the dynamometer's software. Paired t-tests indicated the gravity correction procedure increased every value obtained during external rotation and decreased all values obtained during internal rotation. Also, the concentric and eccentric external/internal rotation reciprocal muscle group ratios were all higher as a result of the gravity correction procedure. These findings were consistent with previous reports on the effect of gravity correction on lower extremity muscle groups. In particular, gravity correction significantly added to the muscle group opposed by gravity (external rotators) and detracted from the muscle group assisted by gravity (internal rotators). Therefore correction for the effects of gravity is recommended during isokinetic assessment of the shoulder internal and external rotator muscle groups.

Active laser diode interferometers in which the interference signal is fed back to the diode current are investigated for Twyman-Green and self-coupling interferometers. The Twyman-Green interferometer is stabilized with a stabilization factor of more than 100. By using the feedback signal of either type of interferometer, displacement is measured in a linear scale over a dynamic range of 8–9 μm with a precision of 10–60 nm. The feedback signal vs displacement shows hysteresis and multistable behavior, in accordance with theoretical results.

ABSTRACT: A review of the records of Granada Hills Hospital revealed 4 documented cases of paraesophageal hiatus hernia. One of these geriatric patients presented with incarceration of the gastric fundus, and required an emergency thoracotomy for relief. Paraesophageal hiatus hernia, unlike sliding hiatal hernia, often gives rise to acute surgical problems secondary to incarceration, obstruction, gangrene, perforation or hemorrhage. The approach to the repair operation may be either abdominal or thoracic, dependent upon the need to correct other associated gastrointestinal pathologic lesions. Unless severe debilitating medical diseases are present, operative intervention is recommended.

A sensitive and nondestructive radiometric method has been applied to the detection of metabolism of Mycobacterium lepraemurium, as a model for the study of the metabolism and substrate requirements of M. leprae. The method is based on the measurement of the 14CO2produced through the bacterial conversion of [U-14C]acetate or [U-14C]glycerol by 7 � 109bacteria suspended in 10 ml of either a simple buffer system (K-36) or a complex medium (NC-5). Metabolism of the bacilli was easily detected within 3 days after inoculation and was measured daily. NC-5 medium supported metabolism of M. lepraemuriumfor several weeks longer than the simple K-36 buffer. The radiometric technique shows promise as a rapid and efficient system for evaluating the metabolism of mycobacteria without introducing any changes in the physiologic state of the organisms, studying their metabolic pathways, determining conditions potentially favorable for multiplication of these organisms in vitro, and studying their susceptibility to inhibition by drugs.

Coherence scanning microscopy is a new technique in high resolution imaging. It shares many of the features of confocal microscopy but uses coherence effects to enhance the lateral and longitudinal resolution rather than physical apertures. This approach has two significant implications for profilometry: the longitudinal resolution is decoupled from the lateral resolution, and interference effects can be used to further enhance the longitudinal resolution. We detail the features of coherence scanning profilometry and give some examples.

Fatty acid oxidation rates tend to increase with age in most developing tissues. In skeletal muscle, heart, and liver of developing rats, we measured activities of three acyl-CoA dehydrogenase enzymes, which constitute the first step in the mitochondrial β-oxidation sequence. In skeletal muscle, activities of all three enzymes increased with age. In heart muscle, palmityl-CoA dehydrogenase increased, while the other two enzymes changed only minimally. In liver, palmityl-CoA dehydrogenase activity steadily increased with age. Decanoyl- and butyryl-CoA dehydrogenase also increased with age, but much more irregularly. We also examined the electrophoretic characteristics of these enzyme proteins in the three tissues. There were no changes in their electrophoretic patterns during development.

Laser action has been observed at 11.5 and 12.2 μm in electron‐beam‐stabilized electric discharges using He/CO/CS2 and He/N2/CS2 gas mixtures. Laser operation at 1 atm pressure was possible using He/CO/CS2 mixtures. Laser assignments, aided by the use of 13C‐enriched samples, indicate that the 001 to 100 and 0111 to 1110 transitions of CS2 both contribute to the lines observed. Line coincidences, which are very likely for several bands of CS2, may be the cause of the anomalous laser intensity distribution among the rotational states observed at low pressures.

Although dentistry in the United States has a relatively high standing, it could be improved in several ways. The quality of students entering dental schools should be raised; the curriculum should be more flexible; the differences in interests and abilities among students should be more fully recognized; students should be motivated by good examples of the relation of theory and practice; more stress should be put on pedodontics and periodontics. The dental profession should improve its teaching of dental health care to school children. Any young man or woman entering dentistry can be sure of a bright future with ample material rewards and an interesting professional life.