DOP-Coroners’ Study 2019 Final Report: Assessing Coroners’ Needs

The Nebraska Department of Health and Human Services (DHHS) partnered with Support and Training for the Evaluation of Programs (STEPs) at the University of Nebraska at Omaha to assess the needs of Nebraska county coroners in conducting drug overdose death investigations. To develop a clear understanding of the Nebraska county coroners’ needs, STEPs conducted an online survey of 91 county coroners who are serving 93 Nebraska counties, according to Nebraska DHHS’s internal data. STEPs administered the survey on July 23, 2019, and closed it on August 16, 2019. 28 people participated in the survey and 25 completed it, giving a response rate of 27%. At least three responses were received from each of the six Nebraska Behavioral Health regions

A Lagrangian analysis of ice-supersaturated air over the North Atlantic

Understanding the nature of air parcels that exhibit ice-supersaturation is important because they are the regions of potential formation of both cirrus and aircraft contrails, which affect the radiation balance. Ice-supersaturated air parcels in the upper troposphere and lower stratosphere over the North Atlantic are investigated using Lagrangian trajectories. The trajectory calculations use ERA-Interim data for three winter and three summer seasons, resulting in approximately 200,000 trajectories with ice-supersaturation for each season. For both summer and winter, the median duration of ice-supersaturation along a trajectory is less than 6 hours. 5% of air which becomes ice-supersaturated in the troposphere, and 23% of air which becomes ice-supersaturated in the stratosphere will remain ice-supersaturated for at least 24 hours. Weighting the ice-supersaturation duration with the observed frequency indicates the likely overall importance of the longer duration ice-supersaturated trajectories. Ice-supersaturated air parcels typically experience a decrease in moisture content while ice-supersaturated, suggesting that cirrus clouds eventually form in the majority of such air. A comparison is made between short-lived (less than 24 h) and long-lived (greater than 24 h) ice-supersaturated air flows. For both air flows, ice-supersaturation occurs around the northernmost part of the trajectory. Short-lived ice-supersaturated air flows show no significant differences in speed or direction of movement to subsaturated air parcels. However, long-lived ice-supersaturated air occurs in slower moving air flows, which implies that they are not associated with the fastest moving air through a jet stream

Routine genetic screening with a multi-gene panel in patients with pheochromocytomas

PURPOSE: Several new gene mutations have been reported in recent years to be associated with a risk of familial pheochromocytoma. However, it is unclear as to whether extensive genetic testing is required in all patients. METHODS: The clinical data of consecutive patients operated for pheochromocytoma over a decade in a tertiary referral center were reviewed. Genetic screening was performed using a 10-gene panel: RET, VHL, SDHB, SDHD, SDHA, SDHC, SDHAF2, MAX, TMEM127 and FH. RESULTS: A total of 166 patients were analyzed: 87 of them had genetic screening performed (39 M: 44.8%, 48 F: 55.2%, age range 6-81 years, mean 45±16.8 years). In total, 22/87 (25.3%) patients had germline mutations, while 65/87 (74.7%) patients presented with apparently sporadic tumors. Germline VHL mutations were identified in 11.7% of patients, RET in 6.8% (five MEN2A/MEN2 and one MEN2B/MEN3), SDHD in 2.3%, MAX in 2.3%, SDHB in 1.1%, and TMEM127 in 1.1% of patients. At diagnosis, 15.1% of patients with unilateral non-syndromic pheochromocytoma showed germline mutations. We identified 19.7% of mutations in patients with unilateral-non-recurrent pheochromocytomas within 5 years vs. 50% in the recurrent-bilateral-metastatic group (p = 0.01). Germline mutations were more frequently seen with bilateral pheochromocytomas (p = 0.001): 80% of patients with bilateral disease had germline mutations (4 VHL, 3 RET, 1 MAX). CONCLUSIONS: The advent of rapid genetic screening using a gene-panel makes it feasible to screen large cohorts of patients and provides a valuable tool to contribute to the prediction of bilateral and malignant disease and to screen family members

Sun Tzu and The Art of Healing: Executive Dashboards and Data Mining for Business Intelligence in Integrated, Lean Military Medical Supply Logistics for the 21st Century

The combined Air Force, Army, and Navy Surgeons General are now achieving integrated oversight of their medical supplies and resources. This allows a Business Intelligence approach to decisions which is now being enhanced with real-time interactive data-mining tools and executive dashboards. Resources can be efficiently reallocated to military, veteran, family, or civilian purposes, inventories can be maintained at lean levels, and peak demands can be managed with executive dashboards to reduce overload and errors

Phylogeography and dispersal in the velvet gecko (Oedura lesueurii), and potential implications for conservation of an endangered snake (Hoplocephalus bungaroides).

ABSTRACT: BACKGROUND: To conserve critically endangered predators, we also need to conserve the prey species upon which they depend. Velvet geckos (Oedura lesueurii) are a primary prey for the endangered broad-headed snake (Hoplocephalus bungaroides), which is restricted to sandstone habitats in southeastern Australia. We sequenced the ND2 gene from 179 velvet geckos, to clarify the lizards' phylogeographic history and landscape genetics. We also analysed 260 records from a longterm (3-year) capture-mark-recapture program at three sites, to evaluate dispersal rates of geckos as a function of locality, sex and body size. RESULTS: The genetic analyses revealed three ancient lineages in the north, south and centre of the species' current range. Estimates of gene flow suggest low dispersal rates, constrained by the availability of contiguous rocky habitat. Mark-recapture records confirm that these lizards are highly sedentary, with most animals moving < 30 m from their original capture site even over multi-year periods. CONCLUSION: The low vagility of these lizards suggests that they will be slow to colonise vacant habitat patches; and hence, efforts to restore degraded habitats for broad-headed snakes may need to include translocation of lizards

Notes

Notes by Sidney Baker, James D. Matthews, Henry M. Shine, Arthur B. Curran, Jr., William G. Mahoney, Jr., and James W. Oberfell

Extended Theory of Planned Behavior as Model of Anabolic Androgenic Steroid Use by Indonesian Bodybuilders

This correlational study explored the psychological antecedents of Indonesian bodybuilders' intentions to use anabolic–androgenic steroids (AAS), based on the Theory of Planned Behavior (TPB). The purpose of this research was to identify factors that influence an Indonesian bodybuilder's intention to use AAS and offer a better understanding of AAS use behavior based on the extended Theory of Planned Behavior (TPB). The three predictor variables of (1) attitude, (2) subjective norms, and (3) perceived behavioral control accounted for the variation in the outcome measure of the intention to reuse the AAS. Likewise, (1) attitude and (2) intention accounted for of the variation in the outcome measure of the reuse of AAS. This research combined two methods which are qualitative and quantitative. The respondents who were used in this research are professional bodybuilders located in Jakarta, Bandung, Surabaya, and Yogyakarta. The result of this research shows that the attitude of bodybuilders in using AAS tends to have values that are adopted by themselves. The result of this research differs from Bagozzi et al (1989) who stated that attitude influenced behavior directly as a nonpurposeful reaction or indirectly through intention as an aimed response. The result of this research clearly shows that attitude can influence behavior directly as a purposeful reaction, because the bodybuilders consume AAS to achieve a particular purpose and it is strengthened by achievement value in themselves. This research suggests also that attitude and subjective norms are not causally independent. They appear to reflect similar beliefs and to influence each other. These results differ from Titah and Barki (2009), as suggested by Chang (1998) and Aarts et al. (1998), who stated that a person whose positive subjective norms move them toward overt behavior, it will lead to a positive attitude toward the behavior. Future research directions are suggested regarding several areas