Microbiological indicators of water quality in submerged karst caves of Wakulla Springs

22 slides in Powerpoint presentation

Association of race and health insurance in treatment disparities of colon cancer: A retrospective analysis utilizing a national population database in the United States

Background Both health insurance status and race independently impact colon cancer (CC) care delivery and outcomes. The relative importance of these factors in explaining racial and insurance disparities is less clear, however. This study aimed to determine the association and interaction of race and insurance with CC treatment disparities. Study setting Retrospective cohort review of a prospective hospital-based database. Methods and findings In this cross-sectional study, patients diagnosed with stage I to III CC in the United States were identified from the National Cancer Database (NCDB; 2006 to 2016). Multivariable regression with generalized estimating equations (GEEs) were performed to evaluate the association of insurance and race/ethnicity with odds of receipt of surgery (stage I to III) and adjuvant chemotherapy (stage III), with an additional 2-way interaction term to evaluate for effect modification. Confounders included sex, age, median income, rurality, comorbidity, and nodes and margin status for the model for chemotherapy. Of 353,998 patients included, 73.8% (n = 261,349) were non-Hispanic White (NHW) and 11.7% (n = 41,511) were non-Hispanic Black (NHB). NHB patients were less likely to undergo resection [odds ratio (OR) 0.66, 95% confidence interval [CI] 0.61 to 0.72, p < 0.001] or to receive adjuvant chemotherapy [OR 0.83, 95% CI 0.78 to 0.87, p < 0.001] compared to NHW patients. NHB patients with private or Medicare insurance were less likely to undergo resection [OR 0.76, 95% CI 0.63 to 0.91, p = 0.004 (private insurance); OR 0.59, 95% CI 0.53 to 0.66, p < 0.001 (Medicare)] and to receive adjuvant chemotherapy [0.77, 95% CI 0.68 to 0.87, p < 0.001 (private insurance); OR 0.86, 95% CI 0.80 to 0.91, p < 0.001 (Medicare)] compared to similarly insured NHW patients. Although Hispanic patients with private and Medicare insurance were also less likely to undergo surgical resection, this was not the case with adjuvant chemotherapy. This study is mainly limited by the retrospective nature and by the variables provided in the dataset; granular details such as continuity or disruption of insurance coverage or specific chemotherapy agents or dosing cannot be assessed within NCDB. Conclusions This study suggests that racial disparities in receipt of treatment for CC persist even among patients with similar health insurance coverage and that different disparities exist for different racial/ethnic groups. Changes in health policy must therefore recognize that provision of insurance alone may not eliminate cancer treatment racial disparities.ECU ALS PLOS Institutional Account Progra

Representing and extending ensembles of parsimonious evolutionary histories with a directed acyclic graph

In many situations, it would be useful to know not just the best phylogenetic tree for a given data set, but the collection of high-quality trees. This goal is typically addressed using Bayesian techniques, however, current Bayesian methods do not scale to large data sets. Furthermore, for large data sets with relatively low signal one cannot even store every good tree individually, especially when the trees are required to be bifurcating. In this paper, we develop a novel object called the "history subpartition directed acyclic graph" (or "history sDAG" for short) that compactly represents an ensemble of trees with labels (e.g. ancestral sequences) mapped onto the internal nodes. The history sDAG can be built efficiently and can also be efficiently trimmed to only represent maximally parsimonious trees. We show that the history sDAG allows us to find many additional equally parsimonious trees, extending combinatorially beyond the ensemble used to construct it. We argue that this object could be useful as the "skeleton" of a more complete uncertainty quantification.Comment: To appear in JM

Video: Board Certification: Reaching the Pinnacle of Practice

Course Outline & Timeline Registration & Continental Breakfast: 7:30 to 7:55 am Atrium & Lecture Room Welcome & Introduction: 7:55 to 8:00 am Elena Rose Minicucci, J.D., Director of Alumni Relations, NSU Shepard Broad Law Center Welcome Introduce Professor Donna Carol Litman, and attorneys Sheryl Moore, Steven Farbman, Todd Weicholz, and William Snyder, LL.M. Seminar Presentation 8:00 am to 9:15 am Professor Donna Carol Litman - Moderator Nova Southeastern University Shepard Broad Law Center Fort Lauderdale, FL Florida Bar Board Certified in Tax Law Professor Litman will lead the discussion among the other Board Certified attorneys listed above. The Discussion will cover the following: Overview of Board Certification – Requirements Rules Regulating Board Certification – in general Handout: Rule 6-3.5 “Standards for Certification” (general) Handout: Rule 6-3.6 “Recertification” (general) Revocation of Certification – Once Certified, lawyer may lose Certification for certain reasons such as: if the area of practice ceases to be certified; if disciplinary action is taken against the lawyer pursuant to Rules Regulating The Florida Bar; if the lawyer commits a crime; misrepresentation by the lawyer; failure to abide by the rules and regulations governing the program; other lawyer misconduct. Handout: Rule 6-3.8 “Revocation of Certification” 6 Ethics – Rules Regulating The Florida Bar Rule 6-3.9 “Manner of Certification” attorney and law firm must comply with this rule for all advertising, website, business cards, office sign; limitation on use of terms: “Specialist” or “Board Certified” or “Expert” or “B.C.S.” Handout: Rule 6-3.9 “Manner of Certification” & 4-7.14(a)(4) “Potentially Misleading Advertisements” Practice Areas – Board Certification in Florida offers twenty-four practice areas in which to become Board Certified Handout: “Florida’s 24 Legal Specialty Areas” from The Florida Bar Five Specific Board Certification Practice areas discussed below by speakers who are Board Certified in their practice areas: Tax Law Certification: Donna Carol Litman, Esq. Requirements as set forth in Rule 6-5 “Standards for Certification of a Board Certified Tax Lawyer” Handout: Rule 6-5 (including 6-5.1 through 6-5.4) Discussion of Article: Board Certification: The View From the Bench…and Beyond” by George W. Maxwell, III, 77 APR Fla. B.J. 34 (April 2003) – how Judges view Board Certified attorneys Marital & Family Law Certification: Sheryl Moore, Esq. Requirements as set forth in Rule 6-6 “Standards for Board Certification in Marital & Family Law” Handout: Rule 6-6 (including 6-6.1 through 6-6.5) – lawyers and judicial officers included Case Law and/or Ethical Considerations – The Florida Bar v. Morse 784 So. 2d 414 (Fla. 2001) dealing with revocation of Board Certification in Marital & Family Law for failure to provide diligent and competent representation to client Civil Trial Certification: Steven S. Farbman, Esq. Requirements as set forth in Rule 6-4 “Standards for Certification of a Board Certified Civil Trial Lawyer” Handout: Rule 6-4 (including 6-4.1 through 6-4.4) Case Law and/or Ethical Considerations – Rules Regulating The Florida Bar, Chapter 4 – 1.5 Fees and Costs for Legal Services (including Contingency Fee Agreements) and Art. 1 Sec. 26 The Florida Constitution, “Claimant’s Right to Fair Compensation” Criminal Trial Certification: Todd Weicholz, Esq. Requirements as set forth in Rule 6-8 “Standards for Certification of a Board Certified Criminal Lawyer” Handout: Rule 6-8 (including 6-8.1 through 6-8.4) Case Law and/or Ethical Considerations – 4-7.18 “Direct Contact with Prospective Clients” especially relevant to criminal defense matters Wills, Trusts & Estates Certification: William Snyder, LL.M, Esq. Requirements as set forth in Rule 6-7 “Standards For Certification of a Board Certified Wills, Trusts, and Estates Lawyer” 7 Handout: Rule 6-7 (including 6-7.1 through 6-7.4) Case Law & Ethical Considerations - Rules Regulating the Florida Bar – Chapter 4 – 7.13 “Deceptive and Inherently Misleading Advertisements” especially regarding experience and special expertise Professor Donna Carol Litman, Esq. 9:15 to 9:30 am General Question & Answer Session with Seminar Attendees & Board Certified Speakers: Sheryl Moore, Esq., Steven S. Farbman, Esq., Todd Weicholz, Esq., and William Snyder, LL.M., Esq. Seminar ends at 9:30 a

The Antiferromagnetic Band Structure of La2CuO4 Revisited

Using the Becke-3-LYP functional, we have performed band structure calculations on the high temperature superconductor parent compound, La2CuO4. Under the restricted spin formalism (rho(alpha) equal to rho(beta)), the R-B3LYP band structure agrees well with the standard LDA band structure. It is metallic with a single Cu x2-y2/O p(sigma) band crossing the Fermi level. Under the unrestricted spin formalism (rho(alpha) not equal to rho(beta)), the UB3LYP band structure has a spin polarized antiferromagnetic solution with a band gap of 2.0 eV, agreeing well with experiment. This state is 1.0 eV (per formula unit) lower than that calculated from the R-B3LYP. The apparent high energy of the spin restricted state is attributed to an overestimate of on-site Coulomb repulsion which is corrected in the unrestricted spin calculations. The stabilization of the total energy with spin polarization arises primarily from the stabilization of the x2-y2 band, such that the character of the eigenstates at the top of the valence band in the antiferromagnetic state becomes a strong mixture of Cu x2-y2/O p(sigma) and Cu z2/O' p(z). Since the Hohenberg-Kohn theorem requires the spin restricted and spin unrestricted calculations give exactly the same ground state energy and total density for the exact functionals, this large disparity in energy reflects the inadequacy of current functionals for describing the cuprates. This calls into question the use of band structures based on current restricted spin density functionals (including LDA) as a basis for single band theories of superconductivity in these materials.Comment: 13 pages, 8 figures, to appear in Phys. Rev. B, for more information see http://www.firstprinciples.co

Characterization of Actions Taken During the Delivery of Medication Therapy Management: A Time-and-Motion Approach

OBJECTIVES: To characterize actions performed by pharmacists and support staff during provision of medication therapy management (MTM) and to compare actions performed according to practice characteristics. METHODS: A purposeful sample of 7 MTM practices (2 call centers and 5 community practices) was identified and visited by investigators. Pharmacists and support staff were observed during their routine provision of MTM. Investigators characterized "major" (e.g., preparation for a comprehensive medication review) and "minor" (i.e., specific steps in overarching major action) actions with the use of a time-and-motion approach. RESULTS: A total of 32 major and 469 minor actions were observed. Practices were characterized as Later Maturity Level or Early Maturity Level on the basis of their self-reported MTM appointment volume, self-assessment of the extent of integration of chronic care model principles, and payer mix. Later Maturity Level practices were more likely to deliver follow-up medication therapy reviews and comprehensive medication reviews (CMRs) as opposed to targeted medication reviews (TMRs) and to receive physician referrals for MTM. Later Maturity Level practices were also more likely to use paid interns than pharmacy rotation students. CMR activities observed at Later Maturity Level practices lasted a median of 30.8 minutes versus 20.3 minutes for CMR activities at Early Maturity Level practices. Similarly, TMR activities observed at Later Maturity Level practices were longer: a median of 31.0 minutes versus 12.3 minutes. At Later Maturity Level practices, pharmacists spent a greater proportion of time providing patient education, while support staff spent a greater proportion of time on tasks such as capturing demographics and introducing or explaining MTM. CONCLUSION: MTM activities were longer at Later Maturity Level practices, and these practices were more likely to use paid pharmacy interns and to receive physician referrals for MTM. This work provides a foundation for future research