Rapid and high-throughput forensic short tandem repeat typing using a 96-lane microfabricated capillary array electrophoresis microdevice

A 96-channel microfabricated capillary array electrophoresis (muCAE) device was evaluated for forensic short tandem repeat (STR) typing using PowerPlex 16 and AmpFlSTR Profiler Plus multiplex PCR systems. The high-throughput muCAE system produced high-speed <30-min parallel sample separations with single-base resolution. Forty-eight previously analyzed single-source samples were accurately typed, as confirmed on an ABI Prism 310 and/or the Hitachi FMBIO II. Minor alleles in 3:1 mixture samples containing female and male DNA were reliably typed as well. The instrument produced full profiles from sample DNA down to 0.17 ng, a threshold similar to that found for the ABI 310. Seventeen nonprobative samples from various evidentiary biological stains were also correctly typed. The successful application of the muCAE device to actual forensic STR typing samples is a significant step toward the development of a completely integrated STR analysis microdevice.     

Acute flurazepam intoxication: a case report

A fatality due to ingestion of flurazepam is reported. Flurazepam is a benzodiazepine, a widely prescribed hypnotic drug for use in sleep disorders. There are only few documented reports of the disposition of flurazepam in deaths due to overdose. A 68-year-old woman was found deceased at home with no evidence of trauma or asphyxia. Toxicologic analyses were performed and drug levels measured by means of gas chromatography coupled to mass spectrometry. The flurazepam concentration in each specimen was as follows: heart blood 2.8 microg/mL, bile 323 microg/mL, and urine 172 microg/mL. Presence of flurazepam into gastric content was observed too. Based on the autopsy findings, patient history, and toxicologic results, the cause of death was determined to be acute intoxication of flurazepam and the manner, suicide.     

Allele frequencies for 15 autosomal STR loci and admixture estimates in Puerto Rican Americans

Allelic frequencies of 15 short tandem repeats (STR) markers (CSF1PO, FGA, THO1, TPOX, VWA, D3S11358, D5S818, D7S820, D8S1179, D13S317, D16S539, D18S51, D21S11, D19S433 and D2S1338) were determined using the AmpFl STR Identifiler PCR Amplification Kit in Puerto Rican American individuals (N=205) from Massachusetts. The FGA, D18S51 and D2S1338 loci had a high power of discrimination (PD) with values of 0.967, 0.965 and 0.961, respectively. Significant deviations from the Hardy-Weinberg (HW) equilibrium were not detected. An important genetic contribution of Caucasian European (76.4%) was detected in Puerto Rican Americans. However, comparative analysis between Puerto Rican American and other neighboring populations from United States mainly with African and Caucasian Americans, revealed significant differences in the distribution of STR markers. Our results are important for future comparative genetic studies of different American ethnic groups, in particular a cultural group called Hispanic-Americans and should be helpful for forensic and paternity testing.     

African American Oxford House residents: sources of abstinent social networks

The current study found that African American residents of Oxford House (OH) used Narcotics Anonymous (NA) at high rates, and that both OH and NA strongly contributed to abstinent social networks. Having siblings and other family members in one's network predicted substance use among network members, whereas spouses, parents, and children did not have an effect on the rate of substance use. These findings suggest that OH and NA may be effective sources of abstinent social support for African Americans recovering from substance abuse. However, family members are well represented in the support networks of African Americans in OH.     

Stress and coping: the roles of ethnicity and gender in substance abuse recovery

This study investigated ethnic and gender differences in reported resource losses and gains for recovering substance abusers living in Oxford Houses (OH). Participants (n = 829) completed a version of Hobfoll's (1998) Conservation of Resources (COR) Evaluation. Results indicated significant individual differences in resources, based on gender, ethnicity, and the length of OH residential stay. Men reported fewer resource gains and losses than women. With respect to ethnicity, African-Americans reported greater gains and losses in resources than European-Americans. Individuals with less time in an OH also reported having experienced more losses in the past 3 months.     

Attitudes of a community members as a function of participatory research with Oxford Houses

Citizen participation in research may include involvement in generating original ideas, planning appropriate designs, collecting data, and helping to implement interventions. Unfortunately, little is known about the attitudes of the community members who participate in such research processes. In the present exploratory study, a team of community members (4 men, 3 women; age > 30 years old) who were employed as investigator research associates to evaluate an innovative substance abuse recovery home were asked for their perspectives about their involvement in the research effort. Findings indicated that these community members felt their participation was a positive experience. Moreover, while their understanding and sense of participation in the research process increased, their identification and affiliation with their support organization was not reduced. Results imply that there is a need to better understand how citizen members of community organizations are affected by their involvement in the research process.     

Creating a home to promote recovery: the physical environments of Oxford House

The interior and exterior physical characteristics of substance abuse recovery program dwellings (11 woman, 44 men) from three geographic sections of the United States were assessed at creating a "house-as-home" for residents. Although each house was independently governed and operated by residents, results indicated vast similarities among the interior characteristics, amenities, and structural aspects. These rented dwellings also had similar well-maintained exterior characteristics, despite their geographic locations. Follow-up interviews of former residents indicated that these house characteristics and amenities helped create a sense of home not found in traditional institutional facilities. Results suggested that residents of self-governed independently operated recovery houses may create and maintain safe and sober settings that elicit a sense of home among residents.     

Medicolegal aspects of an unusual uterine perforation with multiload-Cu 375R

Perforation of the uterus is one of the most serious complications associated with insertion of intrauterine contraceptive devices (IUD). According to recent studies, this lesion occurs in 0.87 per 1000 cases, but statistics generally fluctuate between 0.05 and 13 per 1000 insertions. "Primary" perforations occur at the time of IUD insertion, and "secondary," or delayed, perforations are usually assumed to be caused by reactive uterine contractions. We report an unusual case of uterine perforation, which occurred 9 days after the insertion of a Multiload-Cu 375 IUD. The criteria for differential diagnosis between primary and secondary complications are discussed, particularly from the perspective of medical malpractice cases.     

Health care joint ventures between tax-exempt organizations and for-profit entities

Health care exempt organizations have many options regarding their structure and affiliations with for-profit entities. As long as any joint ventures are carefully structured and the nonprofit retains control over the exempt health care activities, the Internal Revenue Service should not question the structure. However, as outlined above, if the for-profit entity effectively gains control over the activities of the venture, the structure is not likely to be upheld by the IRS or the courts, and either the exempt status of the nonprofit will be denied or revoked, or health care income will be subject to the unrelated business income tax. In summary, the health care industry has been severely impacted by many economic forces, including uncertainty in the area of joint ventures between nonprofits and for-profit health care systems. The uncertainty as to whether the joint venture would negatively impact the nonprofit's tax-exempt status undoubtedly caused many nonprofits to form for-profit subsidiaries and otherwise expanded operations in a for-profit marketplace. Fortunately, with the guidance that is currently available in the form of Revenue Ruling 98-15, Redlands, St. David's, and now Revenue Ruling 2004-51, health care institutions can move forward with properly structured joint ventures with greater confidence that the joint venture will not endanger the tax-exempt status of the nonprofit.     

Postbariatric surgery deaths, which fall under the jurisdiction of the coroner

Obesity has attained epidemic proportions in the United States, with more than 50% of adults classified as overweight or obese. If untreated, morbidly obese patients have a 1 in 7 chance of reaching normal life expectancy. The surgical treatment of obesity has emerged as the most effective treatment modality in long-term weight control and has become increasingly popular, with attendant postoperative complications and death. We performed a cross-sectional, coroner based, 2-year retrospective review of archival case records for decedents who died following bariatric surgery for the treatment of obesity to identify underlying causes of death and forensic characteristics of this cohort. Fifteen (0.5%) out of 3097 archival cases died following bariatric surgery, with approximately 73% of decedents dying within 6 months of surgery. The underlying causes of death in 80% of decedents were natural comorbidities of obesity, with cardiovascular diseases (33%) being the most frequent causes of death, followed by gastrointestinal diseases (20%), acute pulmonary thromboembolism (13%), and acute bacterial pneumonia (13%). The majority of decedents were white females who remained morbidly obese after bariatric surgery. Only 2 decedents died of direct inadvertent/accidental surgical complications.