Statistical sampling in a legislative framework for peer review of medicare services

This article discusses problems addressed in developing an efficient way of identifying levels of inappropriate professional practice in delivery of Medicare services, using statistical sampling within a legislative peer-review scheme. An efficient alternative to the current sampling methodology is proposed.     

Development of a human-specific real-time PCR assay for the simultaneous quantitation of total genomic and male DNA

A duplex real-time quantitative PCR assay was developed for forensic DNA analysis, which provides simultaneous quantitation of total genomic human DNA and human male DNA. The assay utilizes two spectrally resolved fluorogenic probes in a 5' nuclease (TaqMantrade mark) assay. Within the range of organisms empirically tested and based upon theoretical specificity using National Center for Biotechnology Information GenBank sequences, primer and probe sequences were shown to be human specific, and the Y-chromosome probe, male-specific. A mixture-challenge study resulted in accurate quantitation of 25 pg male DNA in a mixture of up to 1:5000 (male:female DNA). Additional experimental results include comparisons with the slot blot method and commercial real-time PCR kits. The assay developed addresses the shortcomings of the traditional slot blot method as well as the commercial real-time PCR kits. This method is shown to be specific, relatively simple, rapid, has low limits of detection, and consumes limited sample in addition to reporting both the male and total genomic DNA concentrations present.     

Utility of the Y-STR typing systems Y-PLEX 6 and Y-PLEX 5 in forensic casework and 11 Y-STR haplotype database for three major population groups in the United States

The Y-PLEX 6 and Y-PLEX 5 systems enable analysis for 11 Y-STR loci. We present here the utility of these systems in forensic casework. A total of 188 samples, including 127 evidence samples, were analyzed using either or both of the systems. The evidence sample types included fingernail scrapings, sperm or seminal fluid, epithelial cells, blood and other tissues. The Y-STR typing systems provided useful probative results in difficult cases. A reference database for Caucasian (n = 517), African American (n = 535), and Hispanic (n = 245) population groups within the United States was generated for estimating the haplotype frequency in forensic casework. Among the individuals profiled, 311 Caucasians, 412 African Americans, and 194 Hispanics provided unique profiles in their respective population datasets. This is the first report describing the haplotype database for the set of 11 Y-STR loci recommended by the Scientific Working Group on DNA Analysis Methods (SWGDAM). Linkage analysis reveals that the frequencies from forensically important autosomal loci can be multiplied with the Y-STR haplotype frequency. The results from Y-PLEX systems have been accepted in courts in the United States.     

Lay persons' versus psychologists' judgments of psychologically aggressive actions by a husband and wife

Literature assessing knowledge of and attitudes toward social issues has demonstrated that mental health professionals and lay persons often differ greatly. To add to the normative information in the field of psychological abuse and to determine whether the differences previously found between mental health professionals and lay persons extend to this field, a sample from each group rated psychologically aggressive items by a husband toward his wife. For the 102 items, psychologists were more likely to label the behaviors as "psychological abuse," but this tendency was due to psychologists considering the behaviors as either "always" or "possibly" abusive, whereas lay persons demonstrated a bimodal response pattern of rating the behaviors as "always" or "never" psychological abuse. Lay persons were much more likely than psychologists to rate items high in terms of severity level, however. The two groups used different contextual factors for determining that a behavior was psychological abuse when they initially were uncertain that it was abusive.     

Sudden death due to atlantoaxial subluxation in marfan syndrome

Marfan syndrome is 1 of the commonest inherited connective tissue disorders. Sudden death may occur and is usually attributed to cardiovascular manifestations of the syndrome. Atlantoaxial hypermobility, increased odontoid height, and rotatory subluxation are well described in this syndrome, but this paper details what seems to be the first reported case of sudden and unexpected death due to spontaneous atlantoaxial subluxation in Marfan syndrome.