Loperamide as a Potential Drug of Abuse and Misuse: Fatal Overdoses at the Medical University of South Carolina

Loperamide is an over‐the‐counter, μ‐opioid receptor agonist commonly used as an antidiarrheal agent. Loperamide was thought to have minimal abuse potential due to its low bioavailability and limited central nervous system activity; however, there have been increasing reports of loperamide misuse in supratherapeutic doses to achieve euphoria and/or avoid opioid withdrawal. A literature review suggests a rise in loperamide abuse was inevitable, with substantial increases in reported cases over the last decade. Five fatal cases of toxic medication use where loperamide was listed as a primary or contributory cause of death were identified at the Medical University of South Carolina. The characteristic autopsy demographics and findings are described, and the mechanisms of abuse and toxicity of loperamide are reviewed. Loperamide overdoses are a growing concern from both a forensic and clinical standpoint, and the frequency of reported cases will likely increase as awareness grows within the medical and toxicological communities.     

Prototypicality analysis of the Comprehensive Assessment of Psychopathic Personality (CAPP): A cross-cultural perspective

The Comprehensive Assessment of Psychopathic Personality (CAPP) model is a new lexically based concept of psychopathy that has potential clinical utility. The main purpose of this research is to investigate the generalizability of the CAPP conceptual model in South Korea. In the current study, 88 experts and 1727 laypeople in South Korea were asked to evaluate the prototypicality of the symptoms of psychopathy (CAPP items) by using a Korean translation of the CAPP model (K-CAPP). In addition, 11 international prototypicality studies were systematically compared to the ratings by experts in the present study. As a result, it indicated that Korean experts and laypeople, on average, rated K-CAPP symptoms as moderately to highly prototypical of psychopathy, and more prototypical of psychopathy than symptoms theoretically unrelated to psychopathy (foils). Also, prototypicality ratings of K-CAPP symptoms made by those two groups were similar to each other as well as to ratings by experts and laypeople using the CAPP in other 11 countries. In conclusion, these results clearly show that both experts and laypeople in the current study conceptualized PPD in almost the same way as experts and laypeople from previous studies using the CAPP model.     

Fatal non-accidental pediatric cranial fracture risk and three-layered cranial architecture development

This study examines the influence of three-layered cranial architecture development upon blunt force trauma (BFT) cranial outcomes associated with pediatric non-accidental injury (NAI). Macroscopic and microscopic metric and morphological comparisons of subadult crania ranging from perinatal to 17 years of age chronicle the ontogenetic development and spatial and temporal variability in the emergence of a mature cranial architecture. Cranial vault thickness increases with subadult age, accelerating in the first 2 years of life due to rapid brain growth during this period. Three-layer differentiation of the cranial tables and diploë initiates by 3–6 months but is not consistently observed until 18 months to 2 years; diploë formation is not well developed until after age 4 and does not manifest a mature appearance until after age 8. These results allow topographic documentation of cortical and diploic development and temporal and spatial variability across the growing cranium. The lateral cranial vault is identified as expressing delayed development and reduced expression of the three-layer architecture, a pattern that continues into adulthood. Comparison of fracture locations from known BFT pediatric cases with identified cranial fracture high-risk impact regions shows a concordance and suggests the presence of a higher fracture risk associated with non-accidental BFT in the lateral vault region in subadults below the age of 2. The absence or lesser development of a three-layered architecture in subadults leaves their cranial bones, particularly in the lateral vault, thin and vulnerable to the effects of BFT.     

Colonization of diatoms in and on porcine bone substrate and considerations of diatom ecology for forensic science

The presence of diatom algae in bone marrow has been used as forensic evidence of drowning for several decades; however, these studies are based on known or suspected recent drowning events. This study addresses the potential for diatoms to enter the bone marrow of skeletal remains, that is, de-fleshed long bones post-mortem. In laboratory and field experiments, bones were either inflicted with two access points by a cut and acid pitting or left intact. The bones were submerged in water for at least 1 week and up to 3 months. Samples of the bone surface and marrow were inspected for diatoms. The analysis considered the time required for diatoms to enter marrow and whether genus characteristics like size or mobility affect entry. The presence of an access point influenced diatom entry in that bones without an introduced access point had zero to one diatom present in the marrow, whereas a bone with an access point had >150 diatoms present in the marrow. The results of both laboratory and field phases suggest that diatoms will reliably colonize bone in as quickly as 1 week, establishing and maintaining communities for at least 3 months. However, the bone surface assemblages differ from the source community. Bone marrow displayed even more restrictive access to diatom colonization, resulting in communities dominated by small raphid diatoms. Based on these findings, we suggest some caveats on the use of diatoms as trace evidence in forensic science with recommendations for future avenues of research.     

An assessment of the proportionality of regulation of ‘over the top’ communications services under Europe's common regulatory framework for electronic communications networks and services

‘Over the top’ communications services such as Skype and FaceTime are changing the way we communicate, carrying voice and video traffic over the Internet. Unlike traditional mobile and fixed line alternatives, these services fall outside the reach of the common regulatory framework. Whilst an absence of regulation is not appropriate, neither is subjecting these services to the full gamut of regulation the path forward: an analysis of the core elements of the regulatory frameworks reveals that, in respect of data retention and privacy, harmonisation of regulation is appropriate. The remaining challenge is determining whether effective regulation could indeed be imposed on services offered from outside the EU.     

The ‘middle peasant thesis’ and the roots of rural agitation in India, 1914–1947

Peasant agitations during the last decades of British rule in India are now receiving increasing attention. Despite a diversity of arguments concerning their origins within the peasantry, one popular model is that developed by Wolf and Alavi of the potential radicalism of a landowning subsistence middle peasantry. The thesis is here examined both in terms of its general analytical value for India and by studying one particular movement, the campaign in Bardoli, Gujarat in 1928. From this, some conclusions are suggested about the nature of successful peasant political action in India and other parts of Asia.     

Estimating Environmental Costs

A database of environmental remediation costs is described as the response cost database (RCD). The database, which contains both capital and operating costs, includes 220 entries for complete activities ranging from studies to remedy components, such as caps, dredging, and pump and treat systems. Information and data sources for the RCD included actual costs from the literature, construction handbooks, and U.S. Environmental Protection Agency-approved software such as RACER. Costs were compared to benchmarks, such as from actual projects, when possible. Guidance on assumptions and scaling is provided with unit costs. The database was developed by environmental engineers experienced in the activities included and thus represents insightful estimation. The RCD may be useful for valuation of environmental portfolios or projects for planning, financial reporting, project management, financing, or mergers/acquisitions.