Remarkable Women of UNMC: Dr. Helen Starke

Helen Starke joined the UNMC faculty as an assistant professor in July 1969. This was before the Division of Cardiovascular Medicine was formally established in 1972. She was designated principal electrocardiographer and placed in direct charge of the cardiac elective with administrative responsibility for phonocardiography, vectorcardiography, and exercise testing. Although she joined a team of only two other full time cardiology faculty members, she helped to legitimize the specialty and grow the division. She took pleasure running the inpatient cardiology service and was reluctant to let her colleagues do morning rounds. In 1975, she was promoted to the rank of associate professor. Dr. Starke’s fellowship training emphasized physiology and focused on congenital heart disease as well as adult cardiology. Former colleagues remember her as a doctor with an encyclopedic knowledge of cardiac physiology. She was an expert on the natural history of untreated valvular and congenital heart disease, and a master at EKG interpretation

Natural resource education: Getting forest products workers into the flow

The forest products industry employs over 1.4 million people in the U.S.; it ranks among the top ten manufacturing employers in 46 states. Surprisingly, a recent survey of U.S. forest products workers revealed substantial ignorance and misperceptions about forests and forestry issues. Despite this, few educational programs are targeted at this audience. The Oregon Forest Resources Institute has teamed up with Oregon State University\u27s Forestry Media Center to fill this gap with Project FLOW (Forestry Learning Opportunities for Workers). Phase one of this project, completed in summer 1997, analyzed current status of forestry educational opportunities for forest workers in Oregon: existing educational activities, opportunities for new programs, and obstacles to implementing new programs. A mail-in survey, sent to human resource officers or chief executives of 590 forest products businesses in Oregon, indicated that it was important for forest workers to have reliable information about forestry topics. However, fewer than half those responding said that their company currently distributes educational materials or provides on-the-job learning opportunities. Principal obstacles cited were lack of time during the workday, lack of staff, and lack of relevant and effective educational materials. Phase two of this project will use the survey data, as well as information collected from focus groups, site visits, and telephone conversations with key stakeholders, to develop and pilot-test learning materials in various formats. We anticipate that materials developed through this project will have wide application throughout the United States-and that better-informed workers are likely to become better individual decision makers and more effective ambassadors for sound forest management

Crossborder Dividend Taxation and the Preferences of Taxable and Nontaxable Investors: Evidence From Canada

We consider how fund managers respond to the conflicting preferences of their investors. We focus on the conflict between the taxable and retirement accounts of international funds, which face different tradeoffs between dividends and capital gains. In principle, managers could resolve this conflict through dividend arbitrage, but a proprietary database of dividend-arbitrage transactions shows that in practice they cannot. Thus, managers must resolve it through their investment policies. We find robust evidence that managers with more retirement money favor the preferences of retirement investors and further evidence for this view in the difference between U.S. and Canadian funds’ portfolio weights

Nurses\u27 Alumnae Association Bulletin, June 1970

Alumnae President\u27s Message Congratulations Alumni Association Portrait of Samuel D. Gross Officers and Chairmen of Committees Financial Report Progress of Jefferson 1969-1970 School of Nursing Annual Report School of Practical Nursing Report Emergency Department Patient Services Department Annual Luncheon Pictures Committee Reports Progress of the Alumnae Association Crossword Puzzle Missing Graduates Resume of Alumnae Meetings Minutes Class News Student Nurses Section Crossword Puzzle Answers Notice

Chronic Migraine Epidemiology and Outcomes – International (CaMEO-I) Study: Methods and multi-country baseline findings for diagnosis rates and care

BACKGROUND: The Chronic Migraine Epidemiology and Outcomes-International study provides insight into people with migraine in multiple countries. METHODS: This cross-sectional, observational, web-based cohort study was conducted in Canada, France, Germany, Japan, United Kingdom, and United States. An initial Screening Module survey solicited general healthcare information from a representative sample and identified participants with migraine based on modified International Classification of Headache Disorders-3 criteria; those with migraine completed a detailed survey based on validated migraine-specific assessments. RESULTS: Among 90,613 people who correctly completed the screening surveys, 76,121 respondents did not meet the criteria for migraine, while 14,492 did. Among respondents with migraine, mean age ranged from 40 to 42 years. The median number of monthly headache days ranged from 2.33 to 3.33 across countries, while the proportion of respondents with moderate-to-severe disability (measured by Migraine Disability Assessment) ranged from 30% (Japan) to 52% (Germany). The proportion of respondents with ≥15 monthly headache days ranged from 5.4% (France) to 9.5% (Japan). Fewer than half of respondents with migraine in each country reported having received a migraine diagnosis. CONCLUSION: These results demonstrated high rates of migraine-related disability and underdiagnosis of migraine across six countries. This study will characterize country-level burden, treatment patterns, and geographical differences in care

Pharmacologic and Clinical Considerations of Nalmefene, a Long Duration Opioid Antagonist, in Opioid Overdose

Opioid use disorder is a well-established and growing problem in the United States. It is responsible for both psychosocial and physical damage to the affected individuals with a significant mortality rate. Given both the medical and non-medical consequences of this epidemic, it is important to understand the current treatments and approaches to opioid use disorder and acute opioid overdose. Naloxone is a competitive mu-opioid receptor antagonist that is used for the reversal of opioid intoxication. When given intravenously, naloxone has an onset of action of approximately 2 min with a duration of action of 60–90 min. Related to its empirical dosing and short duration of action, frequent monitoring of the patient is required so that the effects of opioid toxicity, namely respiratory depression, do not return to wreak havoc. Nalmefene is a pure opioid antagonist structurally similar to naltrexone that can serve as an alternative antidote for reversing respiratory depression associated with acute opioid overdose. Nalmefene is also known as 6-methylene naltrexone. Its main features of interest are its prolonged duration of action that surpasses most opioids and its ability to serve as an antidote for acute opioid overdose. This can be pivotal in reducing healthcare costs, increasing patient satisfaction, and redistributing the time that healthcare staff spend monitoring opioid overdose patients given naloxone

Cost-effectiveness of a two-layer compression bandage versus standard bandage following total knee arthroplasty

AIMS: To assess the cost-effectiveness of a two-layer compression bandage versus a standard wool and crepe bandage following total knee arthroplasty, using patient-level data from the Knee Replacement Bandage Study (KReBS). METHODS: A cost-utility analysis was undertaken alongside KReBS, a pragmatic, two-arm, open label, parallel-group, randomized controlled trial, in terms of the cost per quality-adjusted life year (QALY). Overall, 2,330 participants scheduled for total knee arthroplasty (TKA) were randomized to either a two-layer compression bandage or a standard wool and crepe bandage. Costs were estimated over a 12-month period from the UK NHS perspective, and health outcomes were reported as QALYs based on participants' EuroQol five-dimesion five-level questionnaire responses. Multiple imputation was used to deal with missing data and sensitivity analyses included a complete case analysis and testing of costing assumptions, with a secondary analysis exploring the inclusion of productivity losses. RESULTS: The base case analysis found participants in the compression bandage group accrued marginally fewer QALYs, on average, compared with those in the standard bandage group (reduction of 0.0050 QALYs (95% confidence interval (CI) -0.0051 to -0.0049)), and accumulated additional mean costs (incremental cost of £52.68 per participant (95% CI 50.56 to 54.80)). Findings remained robust to assumptions tested in sensitivity analyses, although considerable uncertainty surrounded the outcome estimates. CONCLUSION: Use of a two-layer compression bandage is marginally less effective in terms of health-related quality of life, and more expensive when compared with a standard bandage following TKA, so therefore is unlikely to provide a cost-effective option

Aspects of hairy black holes in spontaneously-broken Einstein-Yang-Mills systems: Stability analysis and Entropy considerations

We analyze (3+1)-dimensional black-hole space-times in spontaneously broken Yang-Mills gauge theories that have been recently presented as candidates for an evasion of the scalar-no-hair theorem. Although we show that in principle the conditions for the no-hair theorem do not apply to this case, however we prove that the `spirit' of the theorem is not violated, in the sense that there exist instabilities, in both the sphaleron and gravitational sectors. The instability analysis of the sphaleron sector, which was expected to be unstable for topological reasons, is performed by means of a variational method. As shown, there exist modes in this sector that are unstable against linear perturbations. Instabilities exist also in the gravitational sector. A method for counting the gravitational unstable modes, which utilizes a catastrophe-theoretic approach is presented. The r\^ole of the catastrophe functional is played by the mass functional of the black hole. The Higgs vacuum expectation value (v.e.v.) is used as a control parameter, having a critical value beyond which instabilities are turned on. The (stable) Schwarzschild solution is then understood from this point of view. The catastrophe-theory appproach facilitates enormously a universal stability study of non-Abelian black holes, which goes beyond linearized perturbations. Some elementary entropy considerations are also presented...Comment: Latex file, 50 pages, 2 figures (included as PS files at the end: plot1.ps, plot2.ps

Virus Infection of Plants Alters Pollinator Preference: A Payback for Susceptible Hosts?

Plant volatiles play important roles in attraction of certain pollinators and in host location by herbivorous insects. Virus infection induces changes in plant volatile emission profiles, and this can make plants more attractive to insect herbivores, such as aphids, that act as viral vectors. However, it is unknown if virus-induced alterations in volatile production affect plant-pollinator interactions. We found that volatiles emitted by cucumber mosaic virus (CMV)-infected tomato (Solanum lycopersicum) and Arabidopsis thaliana plants altered the foraging behaviour of bumblebees (Bombus terrestris). Virus-induced quantitative and qualitative changes in blends of volatile organic compounds emitted by tomato plants were identified by gas chromatography-coupled mass spectrometry. Experiments with a CMV mutant unable to express the 2b RNA silencing suppressor protein and with Arabidopsis silencing mutants implicate microRNAs in regulating emission of pollinator-perceivable volatiles. In tomato, CMV infection made plants emit volatiles attractive to bumblebees. Bumblebees pollinate tomato by 'buzzing' (sonicating) the flowers, which releases pollen and enhances self-fertilization and seed production as well as pollen export. Without buzz-pollination, CMV infection decreased seed yield, but when flowers of mock-inoculated and CMV-infected plants were buzz-pollinated, the increased seed yield for CMV-infected plants was similar to that for mock-inoculated plants. Increased pollinator preference can potentially increase plant reproductive success in two ways: i) as female parents, by increasing the probability that ovules are fertilized; ii) as male parents, by increasing pollen export. Mathematical modeling suggested that over a wide range of conditions in the wild, these increases to the number of offspring of infected susceptible plants resulting from increased pollinator preference could outweigh underlying strong selection pressures favoring pathogen resistance, allowing genes for disease susceptibility to persist in plant populations. We speculate that enhanced pollinator service for infected individuals in wild plant populations might provide mutual benefits to the virus and its susceptible hosts.Major funding for this project was provided to JPC by the Leverhulme Trust (Grant numbers RPG-2012-667 and F/09741/F: https://www. leverhulme.ac.uk/). Additional funding to JPC and studentships to support JHW and SCG came from the Biotechnological and Biological Sciences Research Council (Grant number BB/J011762/1: http://www.bbsrc.ac.uk/). Other additional funding was obtained from the Isaac Newton Trust (http://www. newtontrust.cam.ac.uk/: grant number 12.07/I to AMM).This is the final version of the article. It first appeared from the Public Library of Science via http://dx.doi.org/:10.1371/journal.ppat.100579