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He began going to trade shows handing out brochures about his idea and e-mailing just about anyone he could think of. Harold Rosen had set up a lunch with Musk at a seafood restaurant near the SpaceX headquarters in Los Angeles and brought Straubel along to help talk up the electric plane idea. The crazy idea struck an immediate chord with Musk, who had been thinking about electric vehicles for years. While Musk had mostly focused on using ultracapacitors for the vehicles, he was thrilled and surprised to hear how far the lithium ion battery technology had progressed. On the spot, Musk and Straubel formed a kinship that would survive more than a decade of extreme highs and lows as they set out to do nothing less than change the world. The Los Angeles­based company started in 1992 and was the bleeding edge of electric vehicles, building everything from zippy midsize passenger jobs right on up to sports cars. It was a type of kit car that had a fiberglass body sitting on top of a steel frame and went from zero to 60 miles per hour in 4. He saw its potential as a screaming-fast machine that could shift the perception of electric cars from boring and plodding to something aspirational. For months Musk offered to fund an effort to transform the kit car into a commercial vehicle but got rebuffed time and again. Martin Eberhard and Marc Tarpenning had founded NuvoMedia in 1997 to create one of the earliest electronic book readers, called the Rocket eBook. The work at NuvoMedia had given the men insight into cutting-edge consumer electronics and the hugely improved lithium ion batteries used to power laptops and other portable devices. They both lived in Woodside, one of the wealthiest towns in Silicon Valley, and chatted from time to time about what they should tackle next. When they rejected his overtures, Eberhard decided to form his own company and see what the lithium ion batteries could really do. He could adjust the weight, number of batteries, resistance of the tires and body, and then get back answers on how many batteries it would take to power the various designs. The technology seemed instead to favor a lighter-weight, high-end sports car, which would be fast, fun to drive, and have far better range than most people would expect. These technical specifications complemented the findings of Tarpenning, who had been doing research into a financial model for the car. The Toyota Prius had started to take off in California, and it was being purchased by wealthy eco-crusaders. The men figured they could build something for the $3 billion per year luxury auto market in the United States that would let rich people have fun and feel good about themselves too. While at Disneyland a few months earlier on a date with his wife, Eberhard had come up with the name Tesla Motors, both to pay homage to the inventor and electric motor pioneer Nikola Tesla and because it sounded cool. The cofounders rented an office that had three desks and two small rooms in a decrepit 1960s building located at 845 Oak Grove Avenue in Menlo Park. The third desk was occupied a few months later by Ian Wright, an engineer who grew up on a farm in New Zealand. He was a neighbor of the Tesla cofounders in Woodside, and had been working with them to hone his pitch for a networking startup. When the start-up failed to raise any money from venture capitalists, Wright joined Tesla. As the three men began to tell some of their confidants of their plans, they were confronted with universal derision. They figured that Nikola Tesla had built an electric motor a century earlier and that creating a drivetrain to take the power from the motor and send it to the wheels was doable. The really frightening part of their enterprise would be building the factory to make the car and its associated parts. The days of Henry Ford having raw materials delivered to one end of his Michigan factory and then sending cars out the other end had long passed. Lotus, the English carmaker, had released the two-door Elise in 1996, and it certainly had the sleek, ground-hugging appeal to make a statement to high-end car buyers. After talking to a number of people in the car dealership business, the Tesla team decided to avoid selling their cars through partners and sell direct. With these basics of a plan in place, the three men went hunting for some venture capital funding in January 2004.

In patients with herpes zoster ophthalmicus who have stromal keratitis and anterior uveitis, topical corticosteroids to reduce inflammation may be necessary. Throughout the table, three recommendations are commonly used when concomitant administration of two drugs may lead to untoward consequences. The rationale for these recommendations are summarized below: Do not coadminister. There is either strong evidence or strong likelihood that the drug-drug interaction cannot be managed with a dose modification of one or both drugs, and will or may result in either: · · Increase in concentrations of one or both drugs, which may lead to excessive risk of toxicity; or Decrease in concentrations of one or both drugs, which may render one or both drugs ineffective. If other more favorable options exist, clinicians are advised to consider changing components of the regimen to accommodate a safer or more effective regimen. However, coadministration of the drugs may be necessary when there are no other acceptable therapeutic options that provide a more favorable benefit-to-risk ratio. Rifamycin Antibiotics-Related Interactions Rifamycin antibiotics are potent inducers of Phase 1 and Phase 2 drug metabolizing reactions. Studies have demonstrated that with daily doses of rifampin, enzyme induction increases over a week or more. When using a rifamycin antibiotic with a potential interacting drug is necessary, close monitoring for clinical efficacy of the coadministered agent is advised. Note: To avoid redundancy, drug-drug interactions are listed only once by primary drug (listed alphabetically). Subsequently, when an interacting agent becomes the primary drug, guideline users are referred to the entry for the initial primary drug. Significant Pharmacokinetic Interactions between Drugs Used to Treat or Prevent Opportunistic Infections (page 2 of 15) Primary Drug Artemether/ Lumefantrine Interacting Agent Clarithromycin Effect on Primary and/ or Concomitant Drug Concentrations lumefantrine expected Recommendations Coadministration should be avoided, if possible. If mefloquine is administered immediately before artemether/lumefantrine, monitor for decreased efficacy of artemether/lumefantrine and encourage food intake. Dose adjustment not established; if coadministered, instruct patient to take atovaquone with fatty meal and monitor for decreased atovaquone efficacy. If coadministration is required for >14 days, weigh the benefits of therapy against the risks of bedaquiline toxicities. Consider increasing caspofungin dose to 70 mg/day or switch to another echinocandin. Significant Pharmacokinetic Interactions between Drugs Used to Treat or Prevent Opportunistic Infections (page 4 of 15) Primary Drug Chloroquine Interacting Agent Clarithromycin Erythromycin Fluconazole Effect on Primary and/ or Concomitant Drug Concentrations chloroquine expected chloroquine possible chloroquine possible Recommendations Do not coadminister. See Artemether/Lumefantrine See Bedaquiline See Chloroquine Decrease daclatasvir dose to 30 mg once daily. If coadministered, monitor for toxicities of both isavuconazole and clarithromycin. Significant Pharmacokinetic Interactions between Drugs Used to Treat or Prevent Opportunistic Infections (page 5 of 15) Primary Drug Clarithromycin, continued Interacting Agent Itraconazole Effect on Primary and/ or Concomitant Drug Concentrations itraconazole and clarithromycin expected Recommendations Coadministration should be avoided, if possible. If coadministered, monitor for toxicities of both itraconazole and clarithromycin); consider monitoring itraconazole concentration and adjust dose accordingly. If coadministered, consider reducing rifabutin dose, monitoring clarithromycin and rifabutin concentrations, and monitoring for rifabutin toxicities. If coadministered, monitor for rifapentine toxicities; consider monitoring clarithromycin and rifapentine concentrations and adjusting doses accordingly. Consider increasing daclatasvir dose to 90 mg once daily and monitor for therapeutic efficacy. See Artemether/Lumefantrine See Atovaquone (oral solution) See Atovaquone/Proguanil See Bedaquiline See Clarithromycin Coadministration should be avoided, if possible. Itraconazole doses >200 mg/day are not recommended unless dosing is guided by itraconazole concentration. With coadministration, decrease rifabutin dose to 150 mg/day and monitor rifabutin concentration. See Artemether/Lumefantrine See Bedaquiline See Chloroquine See Daclatasvir See Dasabuvir/Ombitasvir/Paritaprevir/ Ritonavir See Elbasvir/Grazoprevir Do not coadminister.

Although some pesticides are more toxic than others, the purpose of these chemicals is to kill pests, so even low levels of exposure can be toxic to humans. The effects caused by exposure to pesticides range from skin rashes, burning eyes, and cough to acute illness with nausea, vomiting, diarrhea, sweating, twitching, and difficulty breathing. Women who work with pesticides may be at higher risk of experiencing a miscarriage or having a child with a birth defect. They are exposed to toxic pesticides at work, either when they spray fields or when they cultivate and harvest crops in recently sprayed fields. They-and their families-are exposed to pesticides off the job from pesticides drifting through the air and from pesticide residues on their clothes and on the food they eat and in the well or irrigation water they use to drink and bathe. Moreover, although data on particular incidents is limited, there are many stories about crop-dusting planes accidentally spraying migrants with pesticides. Indeed, children of farmworkers are likely to be the most pesticide-exposed subgroup in the United States. One recent study examined the neurological function of children living in a heavily agricultural area of Mexico. Researchers compared children living in two communities: a heavily agricultural community where children were regularly exposed to pesticides, and a community where nonchemical pest control methods were used in agriculture. In the community where pesticides were heavily used, researchers detected a variety of highly toxic organochlorine pesticides in the umbilical cord blood and breast milk of women. Children in the exposed community showed significantly diminished stamina and coordination when performing a number of tasks (catching a ball, jumping in place, dropping raisins into a bottle cap). The children also showed memory impairment in that they were less able to recall what they had been promised as a reward before starting. Most remarkably, however, were the differences between the ability of children in the exposed community to draw recognizable representations of people and objects (see Figure 4-1). One California study found that children with leukemia were three to nine times as likely to have a parent who reported using pesticides in the home or garden during pregnancy or lactation. Maternal occupational exposure to pesticides has also been associated with birth defects, including abnormalities of the lungs, heart, musculoskeletal system, and urogenital system and an increased risk of stillbirth. More than half of all farmworker poisonings from 1998 to 2000 occurred because of pesticide drift. The greatest number of worker poisonings were reported in Tulare, Fresno, Monterey, and Kern counties, which are 38 to 51 percent Latino and have a total Latino population of 980,000. Moreover, many health care providers fail to correctly identify cases of pesticide poisoning. Geological Survey study of rural drinking water wells between 1992 and 1999 found that 38 percent were contaminated with at least one of a group of 83 pesticides. In this study, the government took blood and urine samples from more than 1,000 people of all ages and ethnicities in the United States to test for patterns of exposure to hazardous pollutants such as pesticides. The most exposed Mexican-Americans had 5 times the exposure to a pesticide called parathion, and 2. Department of Labor, water for washing is unavailable in 16 percent of the fields in the United States. In November 1999, 150 people (mostly farmworkers) in the California town of Earlimart had to evacuate their homes after a sprinkler application of the soil fumigant metam sodium exposed them to toxic fumes. At least 24 were taken to the hospital with nausea, vomiting, headaches, burning eyes, and shortness of breath. These chemicals drifted from a potato field that was being sprayed by a crop duster to the peach orchard where the workers were laboring. Workers who apply pesticides in the field often do not have or use safety equipment such as respirators, gloves, boots, and coveralls. According to a recent study, approximately 23 percent of farmworkers reported not using any safety equipment while mixing or applying chemicals in their most recent farm job. Language and educational barriers contribute to the problem: Approximately 53 percent of all farmworkers in this country cannot read English at all, and 58 percent read Spanish at or below a seventh-grade level and would have trouble understanding technical language. Another study found that the amount of exposed skin was directly related to the concentration of pesticides found in the blood.

Pasteurized eggs come in many forms: intact shell eggs, liquid eggs, frozen eggs, or in powdered form. Even though these have been pasteurized, they still require refrigeration to slow down growth of spoilage microorganisms to extend the shelf life. As a general rule of thumb, only accept those that do not show any signs of spoilage. Reject any produce that shows signs of decay, mold, mushiness, discoloration, wilting, and bad odors. The first step is to ensure that home canned foods are not used in a food service establishment. A good can is free from rust and dents, properly sealed and labeled and slightly concave at both ends. A can with a dent on any of the three seams (top, bottom or side) must be removed from circulation. The same requirement is true for severely rusted, severely dented, leaking and cans with swollen ends. Bad cans may be rejected at delivery or segregated and clearly labeled for return to the supplier. Because of the absence of air, foods packaged in this manner provide ideal conditions for the growth of the clostridium botulinum micro-organism, unless they are refrigerated at temperatures recommended by the manufacturer. These products must be provided by approved sources and care taken to preserve the packaging during handling and when taking the temperature. Modified Atmosphere Packaged Foods Dry Foods Various food items are packaged under special conditions to prolong their shelf life. These conditions include the following: Food is placed in a package and all the air is withdrawn: vacuum packaging. Food is placed in a package, all the air is withdrawn and gases are added to preserve the contents ­ modified atmosphere packaging. Food is placed in a package, all the air is withdrawn and the food Dry foods such as grains, peas, beans, flour and sugar are to be dry at the time of receiving. Broken and defective packages will indicate contamination; as will the evidence of rodent teeth marks. Whenever these products are removed from their original containers, they must be stored in tightly covered, rodent-proof containers with proper labels. The term "potentially hazardous food" refers to foods which do not support rapid growth of microorganisms. Within the Temperature Danger Zone, most harmful microorganisms reproduce rapidly. Shellfish tags must be filed in order of delivery date and kept for a period of days. Foods in Modified Atmosphere Packages provide ideal conditions for the growth of: 8. Safe temperatures for holding potentially hazardous foods are: °F or below and °F or above 13. What are the four types of defective canned products that must be removed from circulation? These routinely include deli and luncheon meats, refrigerated or frozen entrees, etc. Care should be taken when receiving these products to ensure quality as well as safety. Following are some guidelines: Ensure that refrigerated foods are delivered at 41°F or below. Any frozen food packaging that shows signs of thawing and refreezing should be rejected. Signs include liquid or frozen liquids on the outside packaging, formation of ice crystals on the packaging or on the product, and water stains. The most common types of food storage include: Refrigeration storage Freezer storage Dry storage Storage in Ice We will discuss each of these individually; however, certain aspects are common for all types of storage and are described below. Marking the products with a date allows food workers to know which product was received first. This way, the older stock is moved to the front, and the newly received stock is placed in the back.