Sterling: A New Orchardgrass

Sterling orchardgrass is suitable for inclusion in grass-legume mixtures for use as pasture, hay, grass silage or green chop. It has been superior in winterhardiness, stand establishment and yield of forage and seed

Findings From a National Survey of Older US Adults on Patient Willingness to Use Telehealth Services: Cross-Sectional Survey

BACKGROUND: Telehealth (telemedicine and telepharmacy) services increase access to patient services and ensure continuity of care. However, few studies have assessed factors that influence patients' willingness to use telehealth services, and we sought to investigate this. OBJECTIVE: This study aims to examine respondents' (aged between 45 and 75 years) willingness to use telehealth services (telepharmacy and telemedicine) and the correlates of the willingness to use telehealth services. METHODS: We administered a cross-sectional national survey of 1045 noninstitutionalized US adults aged between 45 and 75 years in March and April 2021. Multiple logistic regression analyses were used to identify demographic and health service use correlates of self-reported willingness to use telehealth services. RESULTS: Overall willingness to use telemedicine was high (674/1045, 64.5%). Adults aged 55 years and older were less willing to use telemedicine (aged between 55 and 64 years: odds ratio [OR] 0.61, 95% CI 0.42-0.86; aged 65 years or older: OR 0.33, 95% CI 0.22-0.49) than those younger than 55 years. Those with a regular provider (OR 1.01, 95% CI 1-1.02) and long travel times (OR 1.75, 95% CI 1.03-2.98) were more willing to use telemedicine compared to those without a regular provider and had shorter travel times, respectively. Willingness to use telemedicine services increased from 64.5% (674/1045) to 83% (867/1045) if the service was low-cost or insurance-covered, was with their existing health care provider, or was easy-to-use. Overall willingness to use telepharmacy was 76.7% (801/1045). Adults aged older than 55 years were less willing to use telepharmacy (aged between 55 and 64 years: OR 0.57, 95% CI 0.38-0.86; aged 65 years or older: OR 0.24, 95% CI 0.15-0.37) than those younger than 55 years. Those who rated pharmacy service quality higher were more willing to use telepharmacy (OR 1.06, 95% CI 1.03-1.09) than those who did not. CONCLUSIONS: Respondents were generally willing to use telehealth (telemedicine and telepharmacy) services, but the likelihood of their being willing to use telehealth decreased as they were older. For those initially unwilling (aged 55 years or older) to use telemedicine services, inexpensive or insurance-covered services were acceptable

Safety and efficacy of tenecteplase in patients with wake-up stroke assessed by non-contrast CT (TWIST): a multicentre, open-label, randomised controlled trial

Background: Current evidence supports the use of intravenous thrombolysis with alteplase in patients with wake-up stroke selected with MRI or perfusion imaging and is recommended in clinical guidelines. However, access to advanced imaging techniques is often scarce. We aimed to determine whether thrombolytic treatment with intravenous tenecteplase given within 4·5 h of awakening improves functional outcome in patients with ischaemic wake-up stroke selected using non-contrast CT. Methods: TWIST was an investigator-initiated, multicentre, open-label, randomised controlled trial with blinded endpoint assessment, conducted at 77 hospitals in ten countries. We included patients aged 18 years or older with acute ischaemic stroke symptoms upon awakening, limb weakness, a National Institutes of Health Stroke Scale (NIHSS) score of 3 or higher or aphasia, a non-contrast CT examination of the head, and the ability to receive tenecteplase within 4·5 h of awakening. Patients were randomly assigned (1:1) to either a single intravenous bolus of tenecteplase 0·25 mg per kg of bodyweight (maximum 25 mg) or control (no thrombolysis) using a central, web-based, computer-generated randomisation schedule. Trained research personnel, who conducted telephone interviews at 90 days (follow-up), were masked to treatment allocation. Clinical assessments were performed on day 1 (at baseline) and day 7 of hospital admission (or at discharge, whichever occurred first). The primary outcome was functional outcome assessed by the modified Rankin Scale (mRS) at 90 days and analysed using ordinal logistic regression in the intention-to-treat population. This trial is registered with EudraCT (2014–000096–80), ClinicalTrials.gov (NCT03181360), and ISRCTN (10601890). Findings: From June 12, 2017, to Sept 30, 2021, 578 of the required 600 patients were enrolled (288 randomly assigned to the tenecteplase group and 290 to the control group [intention-to-treat population]). The median age of participants was 73·7 years (IQR 65·9–81·1). 332 (57%) of 578 participants were male and 246 (43%) were female. Treatment with tenecteplase was not associated with better functional outcome, according to mRS score at 90 days (adjusted OR 1·18, 95% CI 0·88–1·58; p=0·27). Mortality at 90 days did not significantly differ between treatment groups (28 [10%] patients in the tenecteplase group and 23 [8%] in the control group; adjusted HR 1·29, 95% CI 0·74–2·26; p=0·37). Symptomatic intracranial haemorrhage occurred in six (2%) patients in the tenecteplase group versus three (1%) in the control group (adjusted OR 2·17, 95% CI 0·53–8·87; p=0·28), whereas any intracranial haemorrhage occurred in 33 (11%) versus 30 (10%) patients (adjusted OR 1·14, 0·67–1·94; p=0·64). Interpretation: In patients with wake-up stroke selected with non-contrast CT, treatment with tenecteplase was not associated with better functional outcome at 90 days. The number of symptomatic haemorrhages and any intracranial haemorrhages in both treatment groups was similar to findings from previous trials of wake-up stroke patients selected using advanced imaging. Current evidence does not support treatment with tenecteplase in patients selected with non-contrast CT. Funding: Norwegian Clinical Research Therapy in the Specialist Health Services Programme, the Swiss Heart Foundation, the British Heart Foundation, and the Norwegian National Association for Public Health

Evaluating Forage Quality as Animal Production Per Unit of Forage and Land Area

The need to more adequately express feed value in forages and, that will communicate this value among agricultural scien­tists, agri-business clientele and producers has long been recognized world wide. Modern dairy, beef and sheep producers are becoming increasingly concerned about forage quality ; its translation into animal products per unit land area ; and its effect along with forage yield on enterprise profits. The Hay Marketing Task Force-Forage Analysis Subcom­mittee organized by the American Forage and Grassland Council in 1975 proposed hay standards based on in vivo digestible dry matter or energy availability (DDM) and dry matter intake (DMI) predicated from acid detergent fiber (ADF) and neutral detergent fiber (NDF), respectively. Dry matter intake was expressed as grams per kilogram metabolic weight (g/w kg 0-75) in early papers (Rohweder et al, 1978). Recent studies show the use of actual body weight to be a better predictor of forage intake than the traditionnal metabolic weight (Rohweder et al, 1987a). Mertens (1985) stated that differences in intake typically account for 50 to 70 percent of the variation in nutrient intake. It is a critical component in most ration balancing systems. Mertens (1982) also summarized data from many experiments and subsequently proposed that NDF be used as a common dietary characteristic which can be related to fill and energy intake. He estimated that at minimum fat corrected milk (FCM) production, daily NDF intake was 1.2 kg ± 0.1 % for each 100 kg of body weight. This small variation in NDF intake suggests that it can be a constant for predicting intake

Yellow-bellied gliders use glide poles to cross the Pacific Highway at Halfway Creek, north-east New South Wales

The installation of glide poles to enable gliding mammals to cross wide road corridors has become a common feature of highway upgrades in eastern Australia. While frequent use by small species has been well documented, records of use by large glider species are scant. During 15 months of camera monitoring of two glide poles in the median of the Pacific Highway at Halfway Creek, north-east New South Wales, yellow-bellied gliders (Petaurus australis) were detected on nine occasions. On three of these occasions, video footage captured glide launches across the northbound carriageway. Our study provides the first definitive evidence of repeated use of wooden glide poles by the yellow-bellied glider to cross a highway corridor. Glide poles, therefore, have the potential to restore functional connectivity for yellow-bellied gliders at locations where major roads bisect forest habitat. </jats:p