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Polypropylene (PP)/acrylonitrile butadiene rubber (NBR) composite plates reinforced with halloysite nanotubes (HNTs) were manufactured in the presence of dual compatibilizers: PP-grafted maleic anhydride (PP-g-MA) and styrene ethylene butylene styrene-grafted maleic anhydride (SEBS-g-MA). The mechanical characteristics and microstructure of the PP/NBR/HNT nanocomposites were investigated as a function of NBR content (10, 20, and 30 wt.%) and HNTs content (3, 5, and 7 wt.%). The results demonstrated that the rubber particles were well dispersed over the PP matrix and that the HNTs were partly agglomerated at contents above 5%. Friction stir welding (FSW) was used to join the nanocomposite plates. A significant reduction in scattered NBR droplet size was seen in the FS-welded specimens containing 80/20 (wt/wt) PP/NBR composites in the presence of a dual compatibilizer. Considerable improvement in particle dispersion was observed in the case of PP/NBR blends filled 80/20 (wt/wt) with HNTs joined using FSW, leading to enhanced mechanical properties in the joints. This was due to the stirring action of the FSW tool. Suitable agreement between anticipated and confirmed values was observed in experiments.

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OBJECTIVES: The aim of this study was to identify the incidence of upper gastrointestinal bleeding (UGIB) in the postprocedural period following transcatheter aortic valve replacement (TAVR). BACKGROUND: As TAVR moves into intermediate- and low-risk patients, it has become increasingly important to understand its extracardiac complications. The patient population undergoing TAVR have clinical and demographic characteristics that place them at significant risk of UGIB. Practical aspects of TAVR, including use of antithrombotic therapy, further increase risk of UGIB. METHODS: A retrospective single-center evaluation of 841 patients who underwent TAVR between January 2005 and August 2014 was performed in conjunction with analysis of referral patterns to the gastroenterology service for UGIB at the same site. RESULTS: The overall risk of UGIB following TAVR was found to be 2.0% (n = 17/841). Additionally, the risk of UGIB in patients receiving triple antithrombotic therapy was found to be 10-fold greater than patients not receiving triple antithrombotic therapy (11.8% vs 1.0%). Endoscopy findings demonstrated five high-risk esophageal lesions including erosive esophageal ulcers, visible vessels at the GE junction, erosions at distal esophagus, and an actively bleeding esophageal ring that had been intubated through by the transesophageal echocardiography (TEE) probe. CONCLUSIONS: This large cohort study demonstrates that TAVR is associated with a moderate risk of severe UGIB. The results of this study suggest that patients on triple antithrombotic therapy are at highest risk for severe UGIB. © 2016 Wiley Periodicals, Inc.

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BACKGROUND: Our study aims were to measure the associations between body mass index (BMI) and body surface area (BSA) with outcomes for stage II and III colon cancer and to evaluate if the effect of obesity is modified by disease stage and receipt of adjuvant therapy. METHODS: Using a prospective cohort of stage II and III colon cancer patients who were referred between 2001 and 2005, we compared 3-year relapse-free survival (3-year RFS), 5-year cancer-specific survival (5-year CSS), and 5-year overall survival (5-year OS) rates among different BMI and BSA categories. Cox proportional-hazards models were constructed to explore the relationships between different body compositions and outcomes while adjusting for confounders. RESULTS: Postoperative height and weight were used to classify 913 patients as normal weight (n = 424, BMI <25 kg/m(2)), overweight (n = 319, BMI 25-30 kg/m(2)), and obese (n = 170, BMI >30 kg/m(2)). Using Mosteller formula, 684 subjects had normal BSA (≤ 2.0 m(2)) and 229 had high BSA (>2.0 m(2)). Obese subjects experienced similar 3-year RFS (61.9 vs. 66.5 vs. 63.6 %, p = 0.51), 5-year CSS (65.6 vs. 72.4 vs. 68.0 %, p = 0.22), and 5-year OS (60.8 vs. 64.0 vs. 62.2 %, p = 0.69) when compared to overweight subjects and those with normal BMIs, respectively. Likewise, individuals with high BSA had similar outcomes as those with normal BSA (66.2 vs. 63.6 %, p = 0.64 for 3-year RFS, 70.3 vs. 68.6 %, p = 0.62 for 5-year CSS, and 64.5 vs. 61.9 %, p = 0.48 for 5-year OS). In Cox models, advanced age, male gender, stage III disease, and poor performance status correlated with inferior RFS, CSS, and OS, but BMI and BSA did not. CONCLUSIONS: Obesity as measured by either BMI or BSA was not associated with differences in outcomes in stage II and III colon cancer.

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BACKGROUND: Patients with cognitive impairment no dementia (CIND) are at an increased risk of progression to Alzheimer's disease (AD). Whether subtle impairments in functional or social abilities at the CIND stage can predict progression to AD is not yet fully determined. We evaluated whether impairments on the Disability Assessment for Dementia (DAD) and Functional Rating Scale (FRS) can predict progression to AD. METHODS: We examined 70 patients with CIND from the ACCORD cohort having complete DAD and FRS baseline and 2-year follow-up data. MANCOVA adjusted for age, sex, education and baseline MMSE score compared the baseline and 2-year change in DAD and FRS scores in CIND patients who progressed to AD versus non-progressors. RESULTS: There were no significant differences between CIND progressors and non-progressors in baseline total DAD or FRS scores. FRS domain analysis revealed that greater impairment in social/occupational functioning significantly predicted progression, while there were no predictive DAD domains. In progressors, both DAD and FRS scores significantly declined over time with the largest changes in instrumental activities of daily living (IADL). CONCLUSION: While changes in IADL characterize the progression from CIND to AD, impairment in complex social-cognitive competency significantly predicts risk of progression and may mark early AD.

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