G96-1277 Pine Moths

Pine moths can seriously damage pine trees. This NebGuide helps you recognize damage and symptoms, identify the pest, and choose a control. Pine moths are serious pests of pines in Nebraska. Larvae (caterpillars) damage trees by tunneling just beneath the bark of the trunk and branches (Figure 1), most commonly on the trunk just below a branch. The tunnels they make can girdle the trunk or branches or physically weaken them so they are easily broken by wind or snow (Figure 2). Heavily infested trees are often deformed and are sometimes killed

G98-1349 Woody Landscape Plants: Selection and Planting

This NebGuide discusses how to select the right tree or shrub for any location and how to properly plant and care for it. Properly planted and cared for trees and shrubs add beauty, protection, diversity and value to almost any property, whether they are planted in a park, in front of your house, or along a street or highway. Planting is only the first step in the process of maintaining a well kept, desirable landscape. Proper maintenance practices need to be considered and performed on an annual basis to ensure the plant\u27s long term health and vigor. Landscape trees and shrubs are not difficult to plant, but proper species selection and planting techniques are necessary to ensure success. Successful planting also requires a knowledge of growth characteristics, site requirements and intended landscape function

Clinical judgement and therapeutic decision making

AbstractClinical decision making is under increased scrutiny due to concerns about the cost and quality of medical care. Variability in physician decision making is common, in part because of deficiencies in the knowledge base, but also due to the difference in physicians' approaches to clinical problem solving. Evaluation of patient prognosis is a critical factor in the selection of therapy, and careful attention to methodology is essential to provide reliable information.Randomized controlled clinical trials provide the most solid basis for the establishment of broad therapeutic principles. Because randomized studies cannot be performed to address every question, observational studies will continue to play a complementary role in the evaluation of therapy. Randomized studies in progress, meta analyses of existing data, and increased use of administrative and collaborative clinical data bases will improve the knowledge base for decision making in the future

Importance of clinical measures of ischemia in the prognosis of patients with documented coronary artery disease

AbstractTo examine the value of clinical measures of ischemia for stratifying prognosis, 5,886 consecutive patients who had symptomatic significant (≥75% stenosis) coronary artery disease were studied. Using the Cox regression model in a randomly selected half of the patients, the prognostically independent clinical variables were weighted and arranged into a simple angina score: angina score = angina course × (1 + daily angina frequency) + ST-T changes, where angina course was equal to 3 if unstable or variant angina was present, 2 if the patient's angina was progressive with nocturnal episodes, 1 if it was progressive without nocturnal symptoms and 0 if it was stable; 6 points were added for the presence of “ischemic” ST-T changes. This angina score was then validated in an independent patient sample.The score was a more powerful predictor of prognosis than was any individual anginal descriptor. Furthermore, the angina score added significant independent prognostic information to the patient's age, sex, coronary anatomy and left ventricular function. Patients with three vessel disease and a normal ventricle (n = 1,233) had a 2 year infarction-free survival rate of 90% with an angina score of 0 and a 68% survival rate with an angina score ≥9. With an ejection fraction <50% and three vessel disease (n = 1,116), the corresponding infarction-free survival figures were 76 and 56%. Thus, a careful summarization of clinical markers of ischemia in the form of an angina score can provide a powerful prognostic tool and may aid clinicians in identifying high risk patients who are candidates for aggressive therapeutic interventions

Outcomes Associated With Early vs Late Initiation of Exclusive Enteral Feeding Regimens Following Laparoscopic Gastrostomy Tube Placement in the Pediatric Patient

ObjectivesDespite frequent placement of pediatric laparoscopic gastrostomy tubes (GTs), no rigorous evaluation of initial feeding and advancement regimens exists. Therefore, the aim of this study was to determine whether early enteral feeding after GT placement is associated with increased symptoms, procedural complications, or length of stay (LOS).MethodsIn this retrospective cohort study, the records of all patients at a tertiary care pediatric hospital who had gastrostomy placement were reviewed. Only patients fed exclusively via gastrostomy were included. Feeding was monitored starting with the first postoperative feed and subsequently in 24- hour increments. Adverse events were recorded based on clinical documentation.ResultsA total of 480 patients met inclusion criteria. Patients who started feeds between 24 and 36 hours had a shorter LOS compared with those who started at 36- 48 hours (P = .0072) or >48 hours (P < .0001). Patients requiring - ¥60 hours to reach goal feeds had significantly longer LOS than the other groups. There was no difference in the distribution of the LOS based on percentage of goal feeds initiated. Patients who required - ¥60 hours to attain goal feeds had the most feeding complications.ConclusionsMore aggressive feeding advancement and earlier initiation of feeds were associated with decreased LOS without an associated increase in adverse clinical events.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/162797/2/ncp10503.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/162797/1/ncp10503_am.pd

Prospectus, May 10, 1983

s fashions; Lack of experience causes motorcycle accidents; Park District kicks off summer season; Park Districts begin new Life campaign; Summer brings quality; Graduation 1983 -- Tears and Laughter!; When were The Good Old Days?; Gayle Wright: Parkland\u27s early morning fisherman; Classified; D.J.\u27s honored; Return of the Jedi worth standing in line for; Blue Thunder: the ultimate weapon; MTD announces Roadeo winnerhttps://spark.parkland.edu/prospectus_1983/1016/thumbnail.jp

Cost effectiveness of thrombolytic therapy with tissue plasminogen activator as compared with streptokinase for acute myocardial infarction

BACKGROUND. Patients with acute myocardial infarction who were treated with accelerated tissue plasminogen activator (t-PA) (given over a period of 1 1/2 hours rather than the conventional 3 hours, and with two thirds of the dose given in the first 30 minutes) had a 30-day mortality that was 15 percent lower than that of pati

A risk prediction model for the assessment and triage of women with hypertensive disorders of pregnancy in low-resourced settings: the miniPIERS (Pre-eclampsia Integrated Estimate of RiSk) multi-country prospective cohort study.

BACKGROUND: Pre-eclampsia/eclampsia are leading causes of maternal mortality and morbidity, particularly in low- and middle- income countries (LMICs). We developed the miniPIERS risk prediction model to provide a simple, evidence-based tool to identify pregnant women in LMICs at increased risk of death or major hypertensive-related complications. METHODS AND FINDINGS: From 1 July 2008 to 31 March 2012, in five LMICs, data were collected prospectively on 2,081 women with any hypertensive disorder of pregnancy admitted to a participating centre. Candidate predictors collected within 24 hours of admission were entered into a step-wise backward elimination logistic regression model to predict a composite adverse maternal outcome within 48 hours of admission. Model internal validation was accomplished by bootstrapping and external validation was completed using data from 1,300 women in the Pre-eclampsia Integrated Estimate of RiSk (fullPIERS) dataset. Predictive performance was assessed for calibration, discrimination, and stratification capacity. The final miniPIERS model included: parity (nulliparous versus multiparous); gestational age on admission; headache/visual disturbances; chest pain/dyspnoea; vaginal bleeding with abdominal pain; systolic blood pressure; and dipstick proteinuria. The miniPIERS model was well-calibrated and had an area under the receiver operating characteristic curve (AUC ROC) of 0.768 (95% CI 0.735-0.801) with an average optimism of 0.037. External validation AUC ROC was 0.713 (95% CI 0.658-0.768). A predicted probability ≥25% to define a positive test classified women with 85.5% accuracy. Limitations of this study include the composite outcome and the broad inclusion criteria of any hypertensive disorder of pregnancy. This broad approach was used to optimize model generalizability. CONCLUSIONS: The miniPIERS model shows reasonable ability to identify women at increased risk of adverse maternal outcomes associated with the hypertensive disorders of pregnancy. It could be used in LMICs to identify women who would benefit most from interventions such as magnesium sulphate, antihypertensives, or transportation to a higher level of care

Prospectus, October 6, 1982

PROSPECTUS FOCUS ON VILLA GROVE; News Digest; Villa Grove looks ahead to future; Voter turnout appreciated; What\u27s your opinion on draft revitalization?: Draft dialogue wanted by student; Listeners available for PC students; Christian humorist appears; Guides needed; Addition bids out, construction to begin this fall; C-U Happenings...; Voter turnout doubled since last election; Loan funding may increase; Can you picture this?; Winter is comin, are you ready?; Three-year restoration project for historic \u27Sunnyside\u27; Growth and tradition mark Villa Grove\u27s 150 years; Classified; Places and Faces in Villa Grove; \u27Wouldn\u27t trade my life for the world,\u27 says bear trainer; Newton-John gives \u27love-filled performace\u27; Live sound makes for smokin\u27 rock; \u27Playboy\u27 sued over photo; Students, instructors cast in fall play; Security does more than give tickets; New seminar offers transfer; Community Calendar; Voices join in \u27Messiah\u27; Convocations sponsors films; Cougar has two in top ten; Are the NFL players holding fans for ransom?; Area seniors to visit PC Campus; Reps to appear at PC; Women\u27s team looking good, may reach finals; Fast Freddy Contest; More participation expected; Golf Scores; Cross Countryhttps://spark.parkland.edu/prospectus_1982/1009/thumbnail.jp

Tripodal transmembrane transporters for bicarbonate

Easy-to-make tripodal tris-thiourea receptors based upon tris(2-aminoethyl)amine are capable of chloride/bicarbonate transport and as such represent a new class of bicarbonate transport agent.<br/