Weight force during prone restraint and respiratory function

Prone maximal restraint position (PMRP, also known as hogtie or hobble) is often used by law enforcement and prehospital personnel on violent combative individuals in the field setting. Weight force is often applied to the restrained individual's back and torso during the restraint process. We sought to determine the effect of 25 and 50 lbs weight force on respiratory function in human subject volunteers placed in the PMRP. We performed a randomized, cross-over, controlled trial on 10 subjects placed in 4 positions for 5 minutes each: sitting, PRMP, PRMP with 25 lbs weight force (PMRP+25), and PRMP with 50 lbs weight force placed on the back (PMRP+50). We measure pulse oximetry, end-tidal CO2 levels, and forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1). FVC and FEV1 were significantly lower in all restraint positions compared with sitting but not significantly different between restraint positions with and without weight force. Moreover, mean oxygen saturation levels were above 95% and mean end-tidal CO2 levels were below 45 mm Hg for all positions. We conclude that PMRP with and without 25 and 50 lbs of weight force resulted in a restrictive pulmonary function pattern but no evidence of hypoxia or hypoventilation.     

毛泽东农地政策思想研究

毛泽东农地思想的主线一直都是坚持农地的国有化,中间经历了短暂的私有化阶段,是出于对当时中国国情的具体考量,在1953年,也就是解放后不到四年的时间,正式开始了农地公有制进程,而毛泽东的农地思想的变化,始终是为了发展生产力,解决中国农村的生产力与生产关系的矛盾的需要。     

Distribution of morphine in body fluids and tissues in fatal overdose

Two cases of fatal overdose with morphine are presented. Large amounts of the drug were involved in both cases, one by oral ingestion, the other by intravenous injection. Morphine concentrations in various body fluids and tissues are compared to those in the literature.     

An evolving technology-transfer system in an R&D consortium: The EPRI approach

The Electric Power Research Institute (EPRI) is a consortium of utility companies whose existence depends on member perceptions that valuable technologies and information have been developed and transferred. This paper outlines eight issues that EPRI, after 17 years of operation had determined to be critical in transferring technology: [1] establishing a perception of value received, [2] creating a sense of full partnership, [3] balancing the R&D portfolio with projects for different members, [4] packaging results for easy understanding and use, [5] reducing information overload by using targeted media, [6] assuring that members have the needed infrastructure to receive and process transfer, [7] integrating EPRI's R&D program with those of the members, and [8] monitoring impact to be sure that value is being received.     

A high-throughput urinalysis of abused drugs based on a SPE-LC-MS/MS method coupled with an in-house developed post-analysis data treatment system

A rapid urinalysis system based on SPE-LC-MS/MS with an in-house post-analysis data management system has been developed for the simultaneous identification and semi-quantitation of opiates (morphine, codeine), methadone, amphetamines (amphetamine, methylamphetamine (MA), 3,4-methylenedioxyamphetamine (MDA) and 3,4-methylenedioxymethamphetamine (MDMA)), 11-benzodiazepines or their metabolites and ketamine. The urine samples are subjected to automated solid phase extraction prior to analysis by LC-MS (Finnigan Surveyor LC connected to a Finnigan LCQ Advantage) fitted with an Alltech Rocket Platinum EPS C-18 column. With a single point calibration at the cut-off concentration for each analyte, simultaneous identification and semi-quantitation for the above mentioned drugs can be achieved in a 10 min run per urine sample. A computer macro-program package was developed to automatically retrieve appropriate data from the analytical data files, compare results with preset values (such as cut-off concentrations, MS matching scores) of each drug being analyzed and generate user-defined Excel reports to indicate all positive and negative results in batch-wise manner for ease of checking. The final analytical results are automatically copied into an Access database for report generation purposes. Through the use of automation in sample preparation, simultaneous identification and semi-quantitation by LC-MS/MS and a tailored made post-analysis data management system, this new urinalysis system significantly improves the quality of results, reduces the post-data treatment time, error due to data transfer and is suitable for high-throughput laboratory in batch-wise operation.     

Roadside detection of impairment under the influence of ketamine--evaluation of ketamine impairment symptoms with reference to its concentration in oral fluid and urine

Although there are many roadside testing devices available for the screening of abused drugs, none of them can be used for the detection of ketamine, a popular abused drug in Hong Kong. In connection to local drug driving legislation, effective roadside detection of ketamine in suspected drug-impaired drivers has to be established. According to the drug evaluation and classification program (DEC), ketamine is classified in the phencyclidine (PCP) category. However, no study has been performed regarding the signs and symptoms exhibited by users under the influence of ketamine. In a study to develop a protocol for effective roadside detection of drug-impaired drivers, 62 volunteers exiting from discos were assessed using field impairment tests (FIT) that included measurements of three vital signs (i.e. body temperature, pulse rate and blood pressure), three eye examinations [pupil size, lack of convergence (LOC) and horizontal gaze nystagmus (HGN)] and four divided attention tests (Romberg, one-leg stand, finger-to-nose and walk-and-turn tests). Subsequent laboratory analysis of oral fluid and urine samples from the participants revealed the presence of common abused drugs in both the urine and oral fluid samples of 55 subjects. The remaining 7 subjects with no drug in their oral fluid samples were used as drug-free subjects. In addition, 10 volunteers from the laboratory who were regarded as drug-free subjects were also assessed using the same FIT. Among the 62 volunteers, 39 of them were detected with ketamine in their oral fluid. Of these ketamine users, 21 of them (54%) with only ketamine found in their oral fluid samples while the rest (18 subjects) of them had other drugs (i.e. MA, MDMA, benzodiazepines and/or THC) in addition to ketamine. Of the 21 ketamine-only users, 15 of them (71%) were successfully identified by FIT. It was found that when salivary ketamine concentrations were greater than 300 ng/mL, signs of impairment became evident, with over 90% detection rate using the FIT. By comparing the FIT observations on the 21 ketamine-only users with the drug-free subjects, the typical signs and symptoms observable for subjects under the influence of ketamine included LOC, HGN, elevated pulse rate and in general, failing the divided attention tests, especially the walk-and-turn and one-leg stand.     

Aconitum alkaloid content and the high toxicity of aconite tincture

Although proprietary medicines and decoction of processed aconite roots are the most widely used, tincture accounts for the great majority of aconite poisoning cases in China, indicating that it is much more toxic than other formulations. Aconite tincture is often self-prepared at home and raw aconite plants or roots are often used. Even if processed aconite roots were used to make the tincture, the amount of Aconitum alkaloids is highly variable, depending on the adequacy of processing and quality control. Aconitum alkaloids dissolve efficiently in alcohol. For these reasons, tincture contains very high concentrations of Aconitum alkaloids. Despite its high intrinsic toxicity, overdose of aconite tincture by the users has been common. Severe aconite poisoning can be complicated by fatal ventricular tachyarrhythmias and asystole. The public should be repeatedly warned of the danger of taking aconite tincture by mouth.