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.     

液基细胞学技术应用于血样羊水栓塞的诊断

目的：建立基于液基细胞学技术的血样羊水栓塞的诊断方法,并对其有效性进行研究。方法收集羊水栓塞者血液样本,分别用两种直接涂片法（上清涂片法、沉淀涂片法）和两种液基细胞涂片法（自动涂片法、人工涂片法）对血液样本中的羊水成分进行检测,对4种方法的羊水成分检出率进行比较。结果建立的两种液基细胞涂片法的羊水成分检出率（分别为84.6%、92.3%）明显高于直接涂片法（分别为53.8%、61.5%）。结论液基细胞涂片法可以提高羊水栓塞的检出率。     

The impact of fentanyl on DUIDs and traffic fatalities: Blood and oral fluid data

Fentanyl has emerged as the most prolific drug in the ongoing opioid epidemic and has greatly impacted traffic safety in recent years. This study aimed to evaluate fentanyl prevalence and concentrations in blood and oral fluid in driving under the influence of drugs (DUID) cases in three different regions (i.e., Alabama, Orange County, CA, and Houston, TX) from 2017 to 2022. Furthermore, traffic fatalities were evaluated for Alabama and Orange County, CA. Fentanyl positivity in DUID and traffic fatalities increased for most years in this study. In Alabama, the prevalence of fentanyl DUID cases increased 4-fold in 2022 compared to 2017. Orange County's increase from 2017 to 2022 was 14-fold. In Houston, the increase was approximately 2-fold from 2019 to 2022. The greatest increase for all laboratories coincided with the start of the COVID-19 pandemic. In 2022, the median fentanyl DUID blood concentrations were 4.7, 11, and 4.7 ng/mL in Alabama, Orange County, and Houston, respectively. Most fentanyl cases were polydrug cases (≥90%). Methamphetamine, THC, and alprazolam were the most frequently detected drugs in combination with fentanyl. Alabama has collected oral fluid and blood in DUID cases since 2018. The detection of fentanyl in oral fluid was comparable to blood. However, 59% and 8.7% of fentanyl-positive cases had concentrations of >20 ng/mL in oral fluid and blood, respectively. Therefore, oral fluid as an alternative or supplemental specimen to blood is an attractive approach for fentanyl in DUID cases. This study contributes to understanding recent fentanyl trends and their impact on traffic safety.     

Vertical Lip Position and Thickness in Facial Reconstruction: A Validation of Commonly Used Methods for Predicting the Position and Size of Lips

This study examined several methods used to estimate oral fissure position, lip margin position, and lip thickness recommended by Angel, George, Lebedinskaya, Taylor, Wilkinson et al., Balueva and Veselovskaya. A sample of 86 lateral head cephalograms of adult subjects from central Europe were measured and the actual and predicted dimensions were compared. The best estimation for oral fissure position was “opposite the lower ¾ mark of maxillary incisors” (error of 1.3 mm). Upper lip margin was predicted best by “upper ¼ mark of maxillary incisors” (error of 1.7 mm), and lower lip margin by “cementum‐enamel junction of mandibular incisors” (error of 2.3 mm). The regression equations of Wilkinson et al. displayed least error (1.3 mm and 1.8 mm, respectively) for upper and lower lip thickness, and method of George (error of 3.4 mm) for total lip thickness.     

"粳"字音读刍议

"粳"字是个异读字,有[ck(eη)][ctψi(η)]两读.本文阐述了"粳"字产生异读的原因及其语音演变的过程,并对<现代汉语词典>只收录"粳"字[ctψi(η)]音的作法,发表了自己的见解.     

略论法学专业教学中对学生口头表达能力的培养

本人曾就如何在专业教学中培养学生的口头表达能力的问题作过一些探讨。但基于法学专业的特殊性和教学对象的特定性 ,现再就此问题作一些补充论证 ,以求在我们的法学专业教学中进一步给学生提供一些有效并能使学生乐于接受的方法 ,从而将提高学生的口头表达能力与法学专业教学目标相结合。     

论强制口供的存在必要--沉默权理论与实践反差的思考

沉默权作为西方刑事诉讼制度的重要内容被我国接受.然而,它在实践中不仅存在理论与实践的重大反差,而且存在法律文化的冲突,更为关键的是法律制度的建立和发展,应当照应社会发展的文明趋势,不能以单纯的人权取向为转移.所以,沉默权作为西方一定历史时期的法律产物,未必适应中国社会,未必是先进的诉讼制度,不应当盲目采纳.而强制口供不仅在中国而且在世界,不仅在过去而且在现在,都是普遍的法律制度和法治现象,具有不容忽视的存在理由和存在价值.