Evaluation and applicability of Alere iCup DX 14 for rapid postmortem urine drug screening at autopsy

Performing point‐of‐care urine drug screen testing at autopsy by a forensic pathologist may provide an early indication of the presence of analytes of interest during autopsy. An evaluation for the screening of 14 classes of common drugs of abuse in postmortem urine by the point‐of‐care screening device, Alere iCup DX 14, is presented. One hundred ninety postmortem urine samples were screened with the iCup occurring at autopsy by the forensic pathologist. Positive and negative results obtained from the screening kit were evaluated against confirmatory test results obtained using routine forensic toxicology analyses that employed LC‐MS/MS and GC‐MS to detect a combination of over 85 common drugs of abuse and medications. Sensitivity for each respective iCup drug class ranged from 66% (buprenorphine) to 100% (methadone, tricyclic antidepressants). Specificity for each respective iCup drug class ranged from 89% (benzodiazepines) to 100% (amphetamines, barbiturates, buprenorphine, 3,4‐methylenedioxymethamphetamine, methadone). Positive predictive values ranged from 44% (benzodiazepines) to 100% (amphetamines, barbiturates, buprenorphine, methylenedioxymethamphetamine, methadone), while negative predictive values ranged from 96% (methamphetamine) to 100% (barbiturates, methadone, tricyclic antidepressants). A high false‐positive rate was yielded by the benzodiazepine class. The lack of fentanyl screening in the point‐of‐care device is a significant limitation considering its prolific prevalence in forensic casework. The results obtained in the study should be acknowledged when considering the use of the Alere iCup DX 14 in the context of postmortem casework to help indicate potential drug use contemporaneously with autopsy and when requiring such preliminary results prior to the release of a final forensic toxicology report.     

Soft budgets and hard rents: a note on Kornai and Gomulka

This note shows how Kornai's concept of the soft budget constraint can be decomposed into separate elements of technical inefficiency and relative price distortion. The distinction between r-budget softness and m-budget softness introduced by Gomulka is shown to correspond to the equivalent and compensating variation measures of efficiency loss. It is also argued that budget softness should be viewed as the outcome of a rent-seeking process in which a firm's action in the control sphere incurs an opportunity cost in the real sphere. Adopting such a perspective leads to a re-definition of the resource loss associated with budget softness and results in much higher estimates of the social costs of soft budgets than those proposed in the existing literature.     

Making Tradeoffs in Federal Block Grant Programs: Understanding the Interplay Between SSBG and TANF

Welfare reform gave states the option of transferring up to10 percent of their annual federal Temporary Assistance forNeedy Families (TANF) award to the Social Services Block Grant(SSBG). Drawing on administrative data, we consider the impactof TANF transfers on SSBG. We find evidence suggesting thatmore innovative states, states that experienced larger TANFcaseload declines, and states that transferred a higher percentageof TANF funds to the Child Care Development Fund (CCDF) havetransferred higher portions of their TANF allocations to SSBG,all else equal. Preliminary analysis of changes in SSBG expenditurepatterns from FY 1995 to FY 2000 indicates that states are transferringsignificant sums to SSBG, but that TANF transfers do not appearto have a consistent effect on SSBG spending priorities acrossstates.     

State Courts, the U.S. Supreme Court, and the Protection of Civil Liberties

Advocates of federalism, both in the United States and elsewhere, often cite the potential for enhanced protection of individual civil liberties as an emerging rationale for a federal system dividing governmental responsibilities between central and regional governments and central and regional judiciaries. Echoing this, some judicial officials and scholars, confronting an increasingly conservative U.S. Supreme Court, have called for state supreme courts to use the state constitutional grounds to preserve and increase the protections of the Bill of Rights. Using event count analysis, we examine state search-and-seizure cases for 1981 to 1993 to ascertain under what circumstances state courts would use this opportunity to eliminate Supreme Court review. We find that the relative ideological position of the state supreme courts and the U.S. Supreme Court often prevents, or does away with the need for, liberal courts to use the adequate and independent state grounds doctrine to expand the rights of criminal defendants and that state supreme court justices react more predictably in the assertion of constitutional protection law than the general consensus suggests.     

Evaluating Public Sector R&D Programs: The Advanced Technology Program's Investment in Wavelength References for Optical Fiber Communications

Griliches (1958) [Journal of Political Economy,66: 419--431] and Mansfield et al. (1977) [Quarterly Journal of Economics 91: 221--240] pioneered the application of fundamental economic insight to the development of measurements of private and social rates of return to innovative investments. This paper illustrates field-based methods for measuring the social rates of return to innovative investments by the public sector. The case study described herein relates to the development of an improved standard reference material for the measurement of the wavelength of light in an optical fiber network.