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.     

Conclusion: Mental health and legal responses to the adolescent mental health crisis: Raising the bar on best interests and promoting family connectedness in divorcing families

We are currently facing an unprecedented increase in adolescent mental health problems resulting in alarmingly high levels of depression, anxiety, and suicidality. Significant mental health problems among youth pose unique challenges to families in the process of separation and divorce, as well as to family law professionals across all disciplines. The current adolescent mental health crisis calls for new ways of approaching our work with high conflict families to promote family connectedness and shift away from adversarial approaches that may exacerbate conflict and further destabilize families. As a conclusion to the special issue on adolescent mental health needs, the authors make multidisciplinary best practices recommendations and advocate for systems level changes in recognition of the needs of youth in crisis at this pivotal developmental stage.     

Does police patrol in large areas prevent crime? Revisiting the Kansas City Preventive Patrol Experiment

Research Summary

The Kansas City Preventive Patrol Experiment (KCPPE) was seen by its developers to have produced “consistent evidence of the lack of effects of any consequence on crime,” a conclusion that was to have a strong impact on assumptions about police patrol for almost half a century. We identified the original official crime data from the KCPPE, and reanalyzed outcomes focusing on a comparison of the “proactive” versus “control” beats (“reactive beats” were criticized because of violations of treatment integrity); examining broad categories of crime (to increase statistical power); and using count regression models. Our findings are not unequivocal, but point to modest impacts of police patrol on crime in police beats.

Policy Implications

Our findings suggest that lessons drawn for half a century from the KCPPE need to be revisited. The KCPPE does not show that police patrol in large areas has no influence on crime, and this finding is consistent with several more recent studies. At the same time, we note that the effects of patrol in the KCPPE using our analysis strategy, and those found in other studies of preventive patrol in larger areas, are about half that found in hot spots policing studies. This suggests that police agencies ideally should invest in focused hot spots policing initiatives. However, absent an ability to manage such initiatives, or the crime analysis capabilities to identify crime hot spots routinely, simpler preventive patrol schemes to utilize uncommitted patrol time can be seen as potentially effective in preventing crime.     

Where Does Location Affordability Drive Residential Mobility? An Analysis of Origin and Destination Communities

Abstract

Despite an overall decrease in residential mobility after the 2007 housing crisis, many households, particularly those that are low income, continue to move in pursuit of a better life. Traditional theories of residential mobility suggest that mobility will occur when housing and transportation costs are cumulatively greater than the cost of moving to a new location. At the same time, the influence of these factors is not likely to be uniform across geographic contexts or for moves up or down the metropolitan hierarchy. Our analysis examines how well affordability measures explain patterns of county-level residential mobility. Specifically, we contrast conventional measures of affordability focused on the ratio of income to housing expense with measures of location affordability that factor in both housing and transportation costs. We find that whereas households tend to move from lower to higher cost locations, transit affordability at the destination plays an important role in mobility decisions.     

Some issues concerning women in senior management: a case study from Ghana

This article considers issues concerning women's managerial careers in the Ghanaian Civil Service, which have emerged from an analysis of data collected in Accra as part of a Government of Ghana project supported by the United Kingdom Department for International Development. This examined the position and status of Women in Public Life in Ghana and was known as the WIPL project. Within this project, information was collected from women civil servants, and it is this which is presented here. Copyright © 1999 John Wiley & Sons, Ltd.     

UK Abortion Law: Reform Proposals,Private Members’ Bills,Devolution and the Role of the Courts

UK abortion law remains unsettled, and subject to on‐going controversy and reform. This article offers a comprehensive critique of all reforms implemented or proposed since 2016. It examines reforms proposed in both Houses of Parliament and contextualises them within a public law analysis, showing both that the complex parliamentary processes relating to Private Members’ Bills have frustrated reform attempts, and that these attempts have been contradictory in their aims between the two Houses. Secondly, it examines the unique positions of Northern Ireland, Scotland and Wales to show the extent to which devolutionary settlements have influenced both reforms and executive involvement. Finally, it examines the potential impact of the courts on abortion law following Re Northern Ireland Human Rights Commission's Application for Judicial Review, showing that the Supreme Court's reframing of the debate in human rights terms is likely to affect abortion law, not only in Northern Ireland, but in the whole of the UK.     

Analyzing and Interpreting Lime Burials from the Spanish Civil War (1936–1939): A Case Study from La Carcavilla Cemetery

Over 500 victims of the Spanish Civil War (1936–1939) were buried in the cemetery of La Carcavilla (Palencia, Spain). White material, observed in several burials, was analyzed with Raman spectroscopy and powder XRD, and confirmed to be lime. Archaeological findings at La Carcavilla's cemetery show that the application of lime was used in an organized way, mostly associated with coffinless interments of victims of Francoist repression. In burials with a lime cast, observations made it possible to draw conclusions regarding the presence of soft tissue at the moment of deposition, the sequence of events, and the presence of clothing and other evidence. This study illustrates the importance of analyzing a burial within the depositional environment and taphonomic context.     

Sickle cell trait-associated deaths: a case series with a review of the literature

This study presents a series of 16 carriers of hemoglobin S (HbS) who died during various circumstances. Many of the cases were associated with mild to moderate exertion. The onset and/or duration of symptoms varied from a few minutes to several hours with many displaying a prolonged lucid interval with stable vital signs. Despite seeking medical treatment, sickle cell trait-related micro-occlusive crisis was never considered in the differential diagnosis. Several cases were associated with sudden death. In those deaths which were delayed, high anion gap and uncompensated metabolic acidosis were typical and were not heat related. Also characteristic were large increases in creatine kinase, alanine aminotransferase, and aspartate aminotransferase along with myoglobinemia. Although the antemortem diagnosis of rhabdomyolysis was made, the underlying cause was never deduced by the clinicians. The sickling found at autopsy is not always a postmortem artifact, and in the right circumstances can be diagnostic.     

Quantitative assessment of the percent fat in domestic animal bone marrow

Measurement of the amount of fat in femoral bone marrow can provide a quantitative assessment of the nutritional status of an individual animal. An analytical method is presented for quantitating the percent fat in bone marrow from three domestic species: bovine, canine, and equine. In this procedure, fat is extracted from bone marrow using pentane, and the percent fat recovered is determined gravimetrically. Based on analyses from adult animals (normal body condition scores), the average percentage of fat in the bone marrow was >80%. In cases in which animals have been diagnosed as emaciated or exhibit serous atrophy of fat (body scores of 1 or 2), the femoral bone marrow fat was less than 20%. In domestic animals, bone marrow fat analysis can be a useful, quantitative measure that, when used in conjunction with all other data available, can support a diagnosis of starvation or malnutrition.