A quarter of these patients will be diagnosed with acute coronary syndromes, but among those, nearly half will have nondiagnostic electrocardiograms. Anterior STEMI on ElectrocardiogramĬhest pain is the second most common complaint in emergency departments, with 6.4 million visits annually in the United States. HEART Score for Suspected Acute Coronary Syndromesįigure 1. Clinical Features of Type 1 and Type 2 Myocardial Infarction American Heart Association/ American College of Cardiology Classes of Recommendation and Levels of Evidence Risk Management Pitfalls for Management of NSTEMI in the Emergency DepartmentĬlinical Pathway for Risk Stratification for STEMI and NSTEMI in the Emergency DepartmentĬlinical Pathway for Management of NSTEMI in the Emergency Department.Ischemia-Guided Strategy Versus Early-Invasive Management StrategyĬopeptin as a Biomarker for Acute Coronary Syndromes Left Bundle Branch Block and Sgarbossa Criteria What is the best ED management when you don’t know whether the patient’s further treatment strategy is going to be early-invasive or ischemia-guided? Is there new evidence on treatment strategies – analgesia, antiplatelets, anticoagulation? Risk stratification scores: HEART, GRACE, TIMI: Which is best for the ED? What is the latest evidence on the value of high-sensitivity troponin assays? How has the modified Sgarbossa criteria increased sensitivity for identifying MI? What is the sensitivity of serial ECGs in detecting an occluding lesion? What are the different causes of STEMI and NSTEMI? Type 1 MI versus type 2?īesides chest pain, what is the likelihood that other symptoms, such as nausea, dyspnea, and diaphoresis, are pointing to MI? Are these related to age, ethnicity, and sex? What are the ECG criteria that differentiate STEMI and NSTEMI? For the emergency clinician, it is critical to make the correct diagnosis, fast: STEMI, NSTEMI, unstable angina (or is it pulmonary embolism or just heartburn?). In hospitalized NSTEMI patients with high risk of clinical events, early PCI is associated with improved 28-day survival.Ĭoronary delayed early percutaneous revascularization.Up to 25% of patients who present to the ED with chest pain are diagnosed with acute coronary syndromes (ACS). By 1-year of follow up, there was no significant difference in mortality with respect to early vs. After accounting for potential confounders, early PCI was associated with a 58% reduced 28-day mortality (OR = 0.42 95% CI: 0.21-0.84) for the entire population, and 57% reduced mortality (OR = 0.43 95% CI: 0.21-0.88) for high risk patients. The 28-day and 1-year mortality were 2% and 5%, respectively. Most were white (79%), male (68%), with mean age 61 years. Associations between early versus late PCI and mortality were analyzed using multivariable logistic regression adjusted for demographics, hospitalization year, TIMI score, and comorbidities.įrom 1987 to 2012, 6,746 patients were hospitalized with NSTEMI and underwent PCI. Patients were stratified into low (TIMI score 2-4), and high risk (TIMI score 5-7, or presence of cardiogenic shock, ventricular fibrillation, or cardiac arrest). We limited our study to patients undergoing early (<24 hr of the event onset), or late (≥24 hr) percutaneous coronary intervention (PCI). NSTEMI was classified using a validated algorithm. The ARIC Study has conducted hospital surveillance of acute myocardial infarction (MI) since 1987. The real-world effectiveness of this strategy is unknown. A delayed invasive strategy (24-72 hr) is considered reasonable for low risk patients. Current guidelines recommend early invasive intervention (<24 hr) for high risk patients with non-ST-segment elevation myocardial infarction (NSTEMI).
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8/11/2023 0 Comments No 6 shion cosplayIt was finished quickly, thanks to its simple design, but Marin did not use it due to its large amount of skin exposure. For this cosplay, she wears orange-yellow color contacts and applies a foundation, so her skin tone matches Veronica's. Marin wears a platinum blonde wig with a white choker, jagged teeth, a small cloth around the chest that emphasizes her under-boob, and short pants. She wears different color contacts symbolizing Heterochromia, her left being blue and her right being red. Her accessories also include a choker and black gloves. Her dress is layered and fringed at the edges. There's also an imitating jewel on her chest. Marin wears an officer's cap with a fleur-de-lis on the cap and an officer's jacket with epaulets and fringes. Why it says 17 is unknown, it might be what Marin got in her playthrough of Saint ♡ Slippery's Academy for Girls - The Young Ladies of the Humiliation Club: Debauched Miracle Life 2. The way 17 is written is in Chinese telly marks, so another telly mark is added by each intercourse Shizuku has had. The number 17 is written on her thighs, right beneath the underwear, as a detail of how many times Shizuku had intercourse. The stockings are connected to the underwear with two strings on each leg. She wears black rose embroidered stockings. The top layer is a rose embroidered pattern with frilled at the end, then there's a black layer and a frilled layer beneath. There are at least three layers to the dress, including a crinoline to make the dress look fluffy. She is slimmest directly beneath the breasts, where the dress starts. A few NuBra's are stacked beneath the breast pockets to make them look bigger. Her breast pockets cover the breasts, with two strings tied in a loop-back pattern going from frill to frill. There is a brown leather choker attached to a metal ring with a chain extending from it. The cuffs are extended to cover the hand and widen towards the end like a cone and the end is ruffled. She dons a black maid gown with frills where the arm meets the torso. She wears a black mob cap with three red artificial roses on top, the mob cap having an embroidered rose pattern. Her eyebrows are shaved and new eyebrows are drawn to best mimic the expression. She wears purple color contacts and her eye shadow is red. The eyelashes are moderately long but only on the outer corners of the eye to create a droopy eye impression. Marin wears a black shoulder-length wig with a violet tint, her bangs slightly spread out and covering her forehead, extending just above the fake eyelashes. When she is going somewhere casual, she tends to wear various outfits that fit her liking. She also tends to wear a stretchy black choker, two bracelets on her left arm, and a ring on both her right pinkie and left index finger. At school, she wears a white button shirt with one chest pocket on her left, a navy blue tie, a plaid skirt, black socks, and brown shoes. Her fashion sense varies according to where she is. In the manga, she can be seen with a tongue piercing, but this was not included in the anime. Marin typically wears multiple silver ear piercings which include a captive bead ring through each earlobe as well as two round studs in her right ear, three round studs in her left ear, and a barbell in an industrial piercing through her left ear. Her hairstyles include long straight hair, a single ponytail, a double ponytail, a double knot on top, a bun, and a single top ponytail. She has smooth blonde hair with an ombré transition to pinkish-red or citrus orange at the tips and reaching down to her waist in the rear her bangs cover a majority of her forehead and eyebrows, reaching to her eyelashes two locks of hair flow over her shoulders and end around chest height. She has long, glittery-pink acrylic nails. Her eyes are naturally a dark brown, though she is almost always seen with dark pink color contacts when she isn't cosplaying. Marin Kitagawa is an above-average height girl with a slim waistline and light skin tone. 8/11/2023 0 Comments Usmc mos list 1985They command and/or lead CI/HUMINT units in tactical information gathering operations and activities in support of identified collection requirements. Read more about becoming a Ground Intelligence Officer Counterintelligence and Human Source Intelligence Officer – 0204Ĭounterintelligence/Human Intelligence (CI/HUMINT) Officers serve in both counterintelligence and human intelligence billets. Ground Intelligence Officers serve as commanders and staff officers in the operating forces and are responsible for tactical planning and employment of ground surveillance and reconnaissance units as well as the coordination of a unit’s overall intelligence effort. After three years of experience and completion of MIOC (MAGTF Intelligence Officer Course), you will be designated as a MAGTF Intelligence Officer, with leadership opportunities in both joint and Marine Corps billets.įollowing career designation and four or more years of intelligence experience (usually around rank of Captain), all Marine Corps intelligence officers from the four specialty intelligence MOSs (0203, 0204, 0206, and 0207) merge into the 0202 MAGTF Intelligence Officer PMOS. Once the rank of Major is attained, all of the disciplines merge together as the officer becomes a Marine Air Ground Task Force (MAGTF) Intelligence Officer. These officers will gain unique opportunities for leadership, deployment and training. Duty assignments vary widely from all levels of the Operating Forces, Supporting Establishment, and Joint Commands.Įntry-level Marine Intelligence Officers will be given specific training within one of the following disciplines: Ground, Human Source, Signals or Air Intelligence. The specialties within the Intelligence 02 community are analysis, counterintelligence, imagery interpretation, geographic intelligence and human intelligence. The Intelligence occupational fields conducts the collection, processing, and dissemination of intelligence. Read more about becoming a Marine Manpower Officer Intelligence Officer – 02 The Manpower and Personnel Administration occupational field, which includes several hundred Staff Noncommissioned Officers and Noncommissioned Officers (PMOS 0111 Administrative Specialists) and hundreds of restricted officers, (PMOS 0170 Personnel Officers), provides manpower and administrative support to commanders at all echelons, enhancing the readiness and operational capabilities of the total force. Manpower Officers have oversight and management responsibilities for the Marine Corps’ most important resource – our Marines. Those MOS’s with links to more information have been updated. This page is currently being updated to align with the “Marine Officer MOS Assignment Handbook”. For example, as a Communications Officer you will be an 0601 (Basic Communications Officer) until you finish the course at which point you will be an 0602. In some cases, your designator may be slightly different until you finish your MOS school. The following list focuses mainly on the designators you can receive coming out of The Basic School. 8/11/2023 0 Comments Dave ramsey budget appThe service also presents several categories that you might overlook. When making a budget, you assign a specific dollar amount to each spending category. Through these ideals, you learn how to use zero-sum budgeting to pay your current bills with last month’s paycheck. YNAB promotes four ideals to manage your money. Read our guide on ways to save $500 per month if you don’t believe the claims made by YNAB. Read our guide on how to stop living paycheck-to-paycheck to achieve financial stability.Īccording to the YNAB site, the average user identifies at least $600 in savings within the first two months of using the service. They do allow you to test the service for free for 34 days.ĭespite the cost, this is a powerful budget planner offering hands-on help so that you can pay off debt and go beyond trying to make ends meet. If that doesn’t describe you, the service costs $14.99 per month or $98.99 if you sign up for the annual plan. Luckily, college students can access a free one-year subscription. It belongs higher on our list, but the cost holds it back. You Need A Budget (YNAB) is a terrific resource to manage your budget. You can get 50% off the PocketSmith Premium Monthly plan for the first two months if you use the code: 50OFFPREMIUM-F4RG. This plan has everything in the Premium plan plus unlimited accounts and 30 years of budget projections.īetter yet, if you deal with multiple currencies, this app has automatic currency conversion based on daily rates. You also get up to ten years of projections, can manage ten accounts, and can create unlimited budgets.Īlternately, you can upgrade to the Super plan for $19.95 or $14.16 per month if paid annually. Only the two paid plans offer automatic account tracking.įor example, the Premium plan costs $7.50 per month when paid annually ($90 total) or $9.95 month-to-month. However, you must manually import your banking transactions with the free Basic version of this budgeting app. At the same time, you can manage two different bank accounts and project your budget up to six months in advance. PocketSmith is a free personal budget software option that allows you to create up to 12 budgets. Personal Capital - track your net worth for free!Įxcellent free budgeting software and one of the top alternatives to Mint. Read our guide on the top alternatives to Empower if the app isn’t for you. You can also access the platform on desktop or mobile via their Android or iOS-based app. Like all the other options on our list, it offers bank-level security. This service offers many investing tools if you’re new to investing. You will need to invest at least $100,000 to be eligible for the managed portfolios. The only time you pay is if you utilize their optional wealth management service. You can also manually enter transactions and account balances when you can’t link accounts.Įmpower is free to use. The platform syncs with your bank, investment, and other financial accounts to help you monitor all your finances in one spot. However, this service takes budgeting to the next level by allowing you to do the following: Many online budgeting tools only allow you to monitor your bills and bank account balances. EmpowerĮmpower(formerly known as Personal Capital) is one of the top personal finance software options on the market. Here are the top budgeting tools you can use to help accomplish your goalsĮach one uses different strategies and features, but they all aim to help you improve your finances. If you find it difficult to manage your finances, money management apps can be a great choice to simplify the process. 8/11/2023 0 Comments Elta md tinted sunscreen cvsZinc oxide is an effective physical sunscreen ingredient, which means it sits atop the skin and reflects or absorbs UV rays. Elta MD Tinted Sunscreen ReviewĮlta MD sells a tinted sunscreen called "Elta MD UV Clear Tinted Broad - Spectrum SPF 46." Tinted sunscreens have two main benefits according to Elta MD’s site: to reduce white residue from standard sunscreen and to reflect more light. In this review we’ll answer these questions and more as we review every ingredient in two of Elta MD's most popular sunscreens: Elta MD Tinted Sunscreen and Elta MD UV Clear. The brand claims to be the "#1 Dermatologist - Recommended Sunscreen Brand."īut is there really a difference between expensive and cheaper sunscreen brands? Are the ingredients used by Elta MD backed by clinical research? Do their products contain any harmful additives? And how do real users rate their products? See full bio., Medical Reviewer Last updated: Oct 12, 2022Įlta MD is a cosmetics company that sells a wide variety of skincare products, but they're known for their sunscreen. See full bio., Co-authorīrian Moore is a board-certified dermatologist who has authored three clinical trials and completed a research fellowship at the Cleveland Clinic. See full bio., Co-author Calloway CookĬalloway Cook is the President of Illuminate Labs and has reviewed over 1,000 clinical trials. He's also an entrepreneur who runs a health and wellness startup. Taylor Graber is a Medical Doctor (MD) and a practicing anaesthesiologist. See full bio., Co-author | Brian Moore MD, FAADīrian Moore is a board-certified dermatologist who has authored three clinical trials and completed a research fellowship at the Cleveland Clinic. See full bio., Co-author,Ĭalloway Cook is the President of Illuminate Labs and has reviewed over 1,000 clinical trials. Elta MD Sunscreen Review: Better Than Cheaper Options? Elta MD Sunscreen Review: Better Than Cheaper Options? 8/11/2023 0 Comments 15 min timer downloadThink of it like pouring water into a beaker. Uploading and downloading data can take a while, depending on the file's size and transfer rate. Then, to access our file, people have to download it to their devices. All we need to do is upload our file to the internet. With the internet, we can now easily send any file to our loved ones, even if they are a thousand miles away from us, as long as they also have access to the internet. The internet is a series of computer networks running all across the world. We can now also upload or transfer data to the internet so that other people can access it. Nowadays, we can also transfer data wirelessly through radio frequencies like Bluetooth or Wi-Fi. The simplest way to transfer a file is through a data cable specifically made to transmit data. With that said, several ways have been developed for us to be able to transfer digital files from one device to another. When we take a picture using a digital camera, we need to have a way to transfer the picture file to a computer and then to a printer to end up with the image printed on a piece of paper. In file sizes, we also use a set of prefixes to express large amounts of data, and you can see these prefixes in the table below (or try the byte conversion calculator).įiles cannot always be in just one computer or machine. This is much better than using a huge number and the same unit of measurement. Like any other unit of measurement, when we talk about large amounts of something, we can use prefixes to quickly show the scale we are dealing with. A single symbol or letter in a text file takes up approximately 1 byte of computer storage. Grouping 8 bits together forms what is called a byte. Storing more bits together means that more information is present in the file. Data stored in bits are represented by 1's and 0's and can be combined with other bits to form useful files like texts, images, audio, or videos. When storing data, computers use what is called bits, an abbreviation of "binary digits." A bit can save either a yes or a no, black or white, and so on. Computer file sizes vary depending on the amount of data or information a computer file stores. 8/11/2023 0 Comments Budget car rental airportThe Rental Car Shuttle runs 24 hours a day and departs every 10-15 minutes from the facility. Both times Ive stepped to Budget and they had a car available and. For transportation from the facility to your terminal, board the Rental Car Shuttle. Payless is a favorite on Expedia but the staff working at airport location is terrible. Buses run 24 hours a day, depart every 10-15 minutes and reach the Rental Car Center in approximately 10 minutes.ĭeparting Passengers: Before your departing flight, follow signs to return your vehicle at the Rental Car Center. Specialties: Step onto the rich and lush grounds of Maui, and feel like youre meeting an old friend when one of our staff members greet you. From there, board the Rental Car shuttle bus. Welcome to Kansas Flying into Wichita Mid-Continent Airport Need a rental car Budget Car and Truck Rental of Wichita has the best value in car rental with great rates on a wide variety of popular new cars, trucks, and vans. The savings of up to 35 applies to Budget Pay Now rates and is applicable only to the time and mileage charges of the rental. Budget and Dollar are the only car-rental agencies at the Molokai Airport. 38th Street, DFW Airport, TX, near the south entrance of the Airport.Īrriving Passengers: After collecting your baggage, follow the Rental Car signs to the designated pick-up area on the lower level of the terminal. Prepay terms and conditions will be presented on the checkout page of the reservation process. Contacting Hawaii's Car-rental Agencies ALAMO RENT-A-CAR Toll-free. The Rental Car Center is located at 2424 E. Our on-site rental car facility makes picking up or dropping off your car and getting where you’re going quick and easy. Do you want to travel the Dallas Fort Worth area on your own time? Visit DFW’s 24-hour Rental Car Center and conveniently choose from 11 companies. 8/11/2023 0 Comments Celtics hawks score“He wanted it,” said Don Chaney, an assistant coach with the Hawks at the time but a former teammate of Bird’s. John Schuhmann Archive Updated on Ap9:03 AM Trae. But it was the Celtics who were left standing at the end thanks to Bird, who finished with 34 points on 15-for-24 from the field, 20 of those points coming in the fourth quarter. The Hawks score 23 points on their final 12 possessions, and they did it by giving the Celtics a taste of their own spacing. Wilkins ended up with a game-high 47 points, shooting a brilliant 19-for-23 from the floor. With his team down by two points with one second left, Wilkins intentionally missed the second of two free throws, but Boston’s Robert Parish tipped the rebound to teammate Dennis Johnson as the buzzer sounded and the Celtics had a 118-116 victory. Wilkins matched Bird’s 11 points during that stretch, but it was not enough. But Atlanta stayed close and drew even again at 99-99 on a basket by Wilkins with 5:57 left.īird scored 11 points after that, including the go-ahead basket with 3:34 to play and a stunning three-pointer over Wilkins with 1:43 left. “They each put their team on their back and said, ‘Let’s go,'” said Hawks coach Mike Fratello.īird fired the first shot, a jumper with 10:03 to play, and went on to score nine points in a span of 1:58. Boston outscored its opponents by 13.2 points per game, the league’s biggest differential, from 3-point range in the regular season. The game was tied 86-86 with 10:26 to play when the teams’ respective stars took over. JUNE 10 WEMBY, METS 92 DROP FINALS GAME 1 Future San Antonio Spurs center Victor Wembanyama didnt put his best foot forward in Game 1 of the LNB Pro A Finals against Monaco. The second-seeded Celtics took down the seventh-seeded Atlanta Hawks, racing out to a 30-point halftime lead before holding on for a 112-99 win. “There was one stretch that was as pure a form of basketball as you’re ever going to see.” “It was like two gunfighters waiting to blink,” recalled Celtics forward Kevin McHale. And while basketball is a team game, this one came down to an old-fashioned shootout between Atlanta’s Dominique Wilkins and Boston’s Larry Bird. On May 22, 1988, the Eastern Conference Semifinals between the Atlanta Hawks and Boston Celtics came down to a seventh game at Boston Garden. Kentavious Caldwell Pope, Michael Porter Jr., and Aaron Gordon Reaction After Winning the 2023 NBA Finals If you are having difficulty accessing any content on this website, please visit our. Celtics Hawks are 3-2 in their last 5 games. Hawks: Live score, analysis from Game 6 of NBA playoffs. 8/11/2023 0 Comments Final draft free for a semesterMany writers tend to overwrite their first drafts. Specifically, let’s answer two frequently asked questions about what to include in a rough draft: How long should a rough draft be?Ī rough draft should be about as long as the final version. Of course, the rough draft is only for the writer, so no one will stop you if you need to skip some sections or gloss over others-but you’ll have to address any shortcuts leading up to the final draft. So, everything you’d include in the final draft should go into the first draft. What to include in a rough draft?Ī rough draft is essentially a raw version of the complete assignment. Certain flaws like organizational issues or plot holes aren’t evident until after you see them laid out in writing. Finding the perfect word and arranging elements in the best order are much easier after you have a first draft, whereas they can be quite troublesome and time-consuming without one.Ī rough draft also helps you identify problematic areas you can’t see with outlining and brainstorming alone. The ultimate goals of your rough draft are to get your ideas down and give yourself something to start with. Remind yourself: It doesn’t have to be good, it just has to be. When embraced with the right mindset, the rough draft helps cut through these obstacles by taking the pressure off. Even if you have a talent for putting words together, you’re not immune to the concerns that beset any writer, such as deadline dread, creative blocks, or any number of personal insecurities. Often, it’s the longest and most effortful phase, involving most of the actual “writing.” What’s the purpose of a rough draft? The rough draft is part of the recommended writing process, step three of five to be exact. The idea is to get a large portion of your project actually written, and worry about fixing the problems later. A rough draft is never intended to be perfect it’s full of grammatical mistakes, poor word choices, and structural issues. It acts as the framework for the final version. Grammarly helps you communicate confidently Write with Grammarly What is a rough draft?Ī rough draft or first draft (or, according to my second-grade teacher, a “sloppy copy”) is an initial, incomplete piece of writing that is the first attempt at getting all your ideas on paper. If you wish to be unblocked, you must agree that you will take immediate steps to rectify this issue. If you do not understand what is causing this behavior, please contact us here. If you promise to stop (by clicking the Agree button below), we'll unblock your connection for now, but we will immediately re-block it if we detect additional bad behavior.
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