Variability in cancer death certificate accuracy by characteristics of death certifiers

Death certificates are the source for mortality statistics and are used to set public health goals. Accurate death certificates are vital in tracking outcomes of cancer. Deaths may be certified by physicians or other medical professionals, coroners, or medical examiners. Idaho is one of 3 states that participated in a Centers for Disease Control and Prevention-funded study to assess the concordance between cancer-specific causes of death and primary cancer site among linked cancer registry/death certificate data. We investigated variability in the accuracy of cancer death certificates by characteristics of death certifiers, including certifier type (physician vs coroner), physician specialty, years of experience as death certifier, and number of deaths certified. This study showed significant differences by certifier type/physician specialty in the accuracy of cancer mortality measured by death certificates. Nonphysician coroners had lower accuracy rates compared with physicians. Although nonphysician coroners certified less than 5% of cancer deaths in Idaho, they were significantly less likely to match the primary site from the cancer registry. Results from this study may be useful in the future training of death certifiers to improve the accuracy of death certificates and cancer mortality statistics.     

Blowfly Larval Tissues as a Secondary Detector for Determining Paraquat-Related Death in Rabbit Carcass

Paraquat poisoning is commonly associated with suicide or homicide in Malaysia. In a case involving advanced body decomposition, pathological analysis regarding the cause of death may become difficult or almost impossible. Insects serve as common alternative matrix for poison detection in forensic analysis. Paraquat detection via secondary bioaccumulation in fly larvae tissue has never been reported. In this study, tissues from blowfly larvae collected from a rabbit carcass with paraquat poisoning were analyzed for secondary bioaccumulation. Larvae samples were collected and analyzed using liquid–liquid extraction. The detection was performed via reduction of quaternary ammonium presence in paraquat and analyzed using gas chromatography–mass spectrometry (GC-MS) with selected ion monitoring mode (SIM mode). GC-MS showed the elution of reduced paraquat was at retention time 12.8 min. Blowfly larvae tissue has proven useful as a secondary detector in paraquat-related deaths.     

Can the descriptive-substantive link survive beyond democracy? The policy impact of women representatives

ABSTRACT

That women offer substantive representation in democratic systems is well established. However, can they do so in partial or non-democracies? As less than half of the women in the world live in democracies, analysing female representation outside of the democratic context is crucial. We hypothesize that even in non- and partial-democracies, women exercise substantive representation. Neutralizing the confounding effects of international constraints or a general positive approach towards gender equality, we create a framework that observes the relationship, proposing and testing several scenarios to identify substantive representation. We observe correlations over time between the share of women representatives and policies female representation typically influence: reproductive rights, health spending and education spending. Our evidence shows that substantive representation appears in non- and partial democracies, and not just in democracies.     

Discordance at D3S1358 locus involving SGM Plus™ and the European new generation multiplex kits

During the course of routine database sample analysis in the Israel Police DNA database, an off-ladder D3S1358 allele, calculated to be >22.1, extending into the adjacent vWA locus was observed using Applied Biosystems SGM Plus™ kit.To verify the size of this D3S1358 long allele and to ensure it was not part of a trialle pattern in the neighboring locus, the sample was amplified using three of the European new generation STR multiplex kits: NGM^TM (Applied Biosystem), Powerplex™ ESX and ESI (Promega). The results of these amplifications determined the variant to be a 22 allele. Subsequent sequencing confirmed this designation and revealed a nucleotide polymorphism. Ten additional SGM Plus™ profiled samples with D3S1358 alleles larger than 19, were re-analyzed using NGM^TM and Powerplex™ ESX which also showed discordance in the calculated results between original SGM Plus™ designations and those obtained with the European new generation multiplexes.     

Long Allele Designations at D2S1338 and D19S433 Loci as Influenced by Various Multiplex STR Kits

European forensic laboratories are replacing the STR multiplex kits with the new generation 16/17 STR kits. This study examines the influence of the new generation kits and the new Applied Biosystems 3500xL Genetic Analyzer on the designation of long D2S1338 and D19S433 off‐ladder alleles. Different allele calls were obtained using the new NGM? (Applied Biosystems) and PowerPlex^® ESI? (Promega) kits compared with AmpF?STR^® SGM Plus? kit (Applied Biosystems). Sequence analysis was used to determine accurate allele designation. The new multiplex kits and the 3500xL Genetic Analyzer improved accuracy of long allele designations. DNA databases worldwide include countless profiles obtained by previous kits. Discrepancies between the new and former technologies may cause failure to detect hits. Discordance is expected due to primer sequence differences between various kits. An additional discordance, occurring in long alleles, independent of primer sequence is reported in this study.     

Reduction of Powerplex® Y23 Reaction Volume for Genotyping Buccal Cell Samples on FTATM Cards

PowerPlex^® Y23 is a novel kit for Y‐STR typing that includes new highly discriminating loci. The Israel DNA Database laboratory has recently adopted it for routine Y‐STR analysis. This study examined PCR amplification from 1.2‐mm FTA punch in reduced volumes of 5 and 10 μL. Direct amplification and washing of the FTA punches were examined in different PCR cycle numbers. One short robotically performed wash was found to improve the quality and the percent of profiles obtained. The optimal PCR cycle number was determined for 5 and 10 μL reaction volumes. The percent of obtained profiles, color balance, and reproducibility were examined. High‐quality profiles were achieved in 90% and 88% of the samples amplified in 5 and 10 μL, respectively, in the first attempt. Volume reduction to 5 μL has a vast economic impact especially for DNA database laboratories.     

Reproductive health policy‐makers: Comparing the influences of international and domestic institutions on abortion policy

Do policies protecting women's rights correspond with norm change at the state level or the level of international institutions? We examine this question, comparing domestic and international institutional activity in correlation with reproductive health policy change, specifically, abortion access policy. At the domestic level, we examine female legislators and policies set to encourage gender equality, namely, electoral gender quotas. In the international arena, our theory distinguishes regional from international inter‐governmental bodies. Original data with measurement innovations introduced here—including the Comparative Abortion Policy Index (CAPI1 and CAPI2)—are analysed for over 150 countries for close to two decades. We find a heretofore‐overlooked relationship between international entities and reproductive health. Gender quotas, however, do not correspond with the general association between female representation and pro‐women policy. When researchers and policy‐makers consider gender quotas to promote women's rights, they may be advised to encourage female political participation through more organic means.