Fatal intoxication involving 2-methyl AP-237

Novel synthetic opioids contribute considerably to the opioid epidemic, especially with the frequent emergence of structurally similar compounds. This case report describes a fatal intoxication involving 2-methyl AP-237. A 54-year-old Caucasian male was found deceased from an apparent drug overdose. A plastic container labeled “2MAP” and a cut straw were found in the decedent's backpack at the scene. A white substance found in the container tested positive for fentanyl by field testing. According to his medical history, the decedent was treated for a drug overdose 3 years prior to his death. With no diagnostic findings at autopsy, the case was submitted for toxicological analysis. An unknown substance was detected in peripheral blood and urine using gas chromatography with nitrogen phosphorous detection (GC-NPD). Further testing was conducted using gas chromatography–mass spectrometry (GC–MS) and liquid chromatography-quadrupole-time-of-flight mass spectrometry (LC-QTOF-MS) which confirmed the presence of 2-methyl AP-237 and potential metabolites in blood and urine. Quantitation by GC-NPD revealed concentrations of 2-methyl AP-237 in blood and urine at 480 ng/mL and 4200 ng/mL, respectively. The toxicological analysis also identified and quantitated alprazolam in the blood at 55 ng/mL. Additionally, the metabolism of 2-methyl AP-237 was investigated and three hydroxylated metabolites were identified in peripheral blood and urine. Limited literature is available for the detection and quantitation of 2-methyl AP-237 in postmortem specimens. Given the toxicological findings with unremarkable autopsy findings, this case is an example of a fatal intoxication involving 2-methyl AP-237.     

Pulp volume quantification methods in cone-beam computed tomography for age estimation: A critical review and meta-analysis

The secondary dentin deposition that occurs after the tooth formation process results in a decrease in pulp cavity volume in adolescents and adults. The purpose of this critical review was to correlate pulpal and/or dental volume on cone-beam computed tomography (CBCT) with chronological age approximation. A subobjective was to investigate which methodology and CBCT technical parameters would be most appropriate to evaluate this correlation. This critical review followed the PRISMA guidelines, and it was conducted by a search through PubMed, Embase, SciELO, Scopus, Web of Science, Cochrane Library databases, as well as gray literature. Primary studies that used pulp volume, or pulp chamber to tooth volume ratio measured using CBCT were included. Seven hundred and eight indexed and 31 non-indexed records were identified. A qualitative analysis was performed including 25 selected studies with a total of 5100 individuals, age ranging from 8 to 87 years without sex predilection. The most used method was pulp volume/tooth volume. CBCT voxel size ranged between 0.09 and 0.5. Manual segmentation associated with threshold algorithms was used in most of the studies. Correlation between the pulp volume/tooth volume ratio was moderate: −0.66 for the upper central incisors, −0.59 for upper canines and −0.56 for lower canines. High heterogeneity was observed among the studies. It is concluded that pulp volume should be used with caution in age estimation. Evidence supports the preferable use of upper incisors with pulp volume/tooth volume ratio for age estimation. There is not enough evidence that voxel size interferes in age estimation by pulp volume.     

Fatal exsanguination following complete transection of femoral vessels due to angle grinder injury in an industrial accident

Angle grinders are one of the most dangerous and frequently used tools in industrial settings. Angle grinder injuries range from superficial cuts to deep penetrating injuries with underlying fracture-dislocation and vascular trauma. The injuries caused by angle grinders mostly involve the head, face, or upper limbs, while the lower limb is an unusual site. The high-speed rotating disc of the angle grinders does not respect anatomical boundaries or structures; therefore, the injuries caused may be disfiguring, permanently incapacitating, or even fatal. We report a fatal case of an angle grinder injury to the lower limb. The victim sustained a sharp cut over the left thigh while woodworking in an industrial setup. The rotating disc of an angle grinder had transected the skin, subcutaneous fat and muscles, and both the femoral vessels of the left side, which led to fatal exsanguination within 10 min of the incident.     

Fiscal Consolidations: Quality,Economic Conditions,and Success

Recent research has demonstrated theimportance of good quality of fiscaladjustments for the success of governmentbudget consolidations. We extend thisapproach to analyze the importance of theeconomic conditions in which fiscalconsolidations are started for theirsuccess. The cyclical positions of thedomestic and international economy, theinitial debt level and the stance of fiscalpolicy in the OECD are all importantdeterminants of the likelihood of fiscalconsolidations. They also affect thegovernment's choice of consolidationstrategy, making them importantdeterminants of the success of fiscalconsolidations. In contrast, the monetarypolicy stance plays only a negligible rolefor fiscal consolidations. We use theanalysis to test for any Maastricht effectson the performance of European governmentsduring the 1990s. Such effects are weak atbest and occurred only during the firsthalf of the decade.     

Computer assisted modeling of ethyl sulfate pharmacokinetics

For 12 volunteers of a drinking experiment the concentration–time-courses of ethyl sulfate (EtS) and ethanol were simulated and fitted to the experimental data. The concentration–time-courses were described with the same mathematical model as previously used for ethyl glucuronide (EtG). The kinetic model based on the following assumptions and simplifications: a velocity constant k_form for the first order formation of ethyl sulfate from ethanol and an exponential elimination constant k_el. The mean values (and standard deviations) obtained for k_form and k_el were 0.00052 h^?1 (0.00014) and 0.561 h^?1 (0.131), respectively. Using the ranges of these parameters it is possible to calculate minimum and maximum serum concentrations of EtS based on stated ethanol doses and drinking times. The comparison of calculated and measured concentrations can prove the plausibility of alleged ethanol consumption and add evidence to the retrospective calculation of ethanol concentrations based on EtG concentrations.     

Sustainable Development in Developing Countries: The Role of Social Entrepreneurs

Internationally, there has been a general trend towards crime prevention and community safety measures. The main policy ideas and instruments associated with this trend have spread widely in Western countries. This article examines the Swedish national crime prevention policy. As Sweden is a welfare society with a long tradition of social crime prevention, it is of great interest to explore to what extent the aforementioned trend has influenced its crime prevention policy. We do this by examining Sweden's national policy and how its concepts have spread to the local level—specifically, to municipalities and their local crime prevention councils. We find that there has been a preventive shift in Sweden, although not as far-reaching as in many other European countries. Substantial changes have occurred in the understanding and direction of crime prevention work, and the question is to what extent this development will continue.     

Does density exacerbate income segregation? Evidence from U.S. metropolitan areas, 1980 to 2000

Abstract

A fundamental goal of many smart growth efforts is to promote greater socioeconomic equity through more compact development. In this article, we point out that the connection between the built environment and socioeconomic outcomes may be more complex than it is generally portrayed to be, particularly in light of recent trends in urban and regional development.

Through an empirical analysis involving two measures of income segregation, dissimilarity and isolation, in a national data set of metropolitan areas from 1980 to 2000, we illustrate that the relationship between density and income segregation follows a quadratic function, first rising, then falling, as densities increase. Moreover, changes in density—whether increases or decreases—always increased segregation. These findings suggest that, if greater socioeconomic equity is a goal, smart growth programs need to pay as much attention to market forces and the underlying political landscape as they do to the built environment.     

Internet of things – Governance quo vadis?

The Internet of Things (IoT) as an emerging global Internet-based information architecture facilitating the exchange of goods and services is gradually developing. While the technical aspects are being discussed in detail a legal framework does not exist so far. The first supranational organization trying to work out an IoT governance framework has been the European Commission by appointing a large group of experts to examine the relevant aspects of a possible IoT governance regime. In the meantime, however, the activities have been degraded. Nevertheless, even if the differences between the IoT and the Internet have been overestimated at the beginning, many elements of the IoT differ in part from the corresponding problems in the Internet. Therefore, an analysis of the major IoT governance issues (legitimacy, transparency, accountability, anticompetitive behavior) seems to be worthwhile to conduct.