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.     

Epistemic emotions in prosecutorial decision making

The article examines epistemic emotions as part of the emotive-cognitive processes of prosecutors’ knowledge seeking and decision making in preliminary investigation and court proceedings. Drawing on ethnographic fieldwork, interviews, and shadowing of prosecutors in Sweden, we show how emotions motivate and orient prosecutors’ inquiries and the fundamental role of the ‘certainty–doubt spiral’ for ‘doing objectivity’. In conclusion, we discuss the centrality of emotions for conscientious and well-considered decisions in legal work. The study contributes to the field of law and emotion by exploring the epistemic quality of emotions, notably the certainty–doubt spiral, in legal work.     

Performance Measurement and Cost Accounting: Are They Complementary or Competing Systems of Control?

In the public administration literature, research on performance measurement has recognized the important place of cost accounting in relation to performance. Extant research, such as the North Carolina Benchmarking Program, supports the proposition that performance and cost accounting naturally complement each other to increase trust in performance information and increase organizational learning. Other statements about cost accounting suggest that performance measurement and cost accounting compete as systems of control. This research uses general cost accounting plan information and performance measurements in the budgets of large U.S. cities to test the competing and complementary control relationship at the organizational and service levels. It finds that performance measurements and cost accounting are negatively related at the service level, which supports the competing control system hypothesis. At the organizational level, performance and cost accounting are positively related but not at traditional levels of significance.     

Development of an Index of Subsidized Housing Availability and its Relationship to Housing Insecurity

Housing insecurity is a known threat to child health understanding predictors of housing insecurity can help inform policies to protect the health of young children in low-income households. This study sheds light on the relationship between housing insecurity and availability of housing that is affordable to low-income households.

We developed a county-level index of availability of subsidized housing needed to meet the demand of low-income households. Our results estimate that if subsidized units are made available to an additional 5% of the eligible population, the odds of overcrowding decrease by 26% and the odds of families making multiple moves decrease by 31%. Both of these are known predictors of poor child health outcomes. Thus, these results suggest that state and federal investments in expanding the stock of subsidized housing could reduce housing insecurity and thereby also improve the health and well-being of young children, including their families' food security status.     

Untangling Housing Cost and Transportation Interactions: The Location Affordability Index Model—Version 2 (LAIM2)

Abstract

It is now accepted that to have an understanding of housing affordability one must consider not only housing costs, but also the transportation costs associated with that household location. To make this information readily accessible to the public, the United States government created an Internet resource, the Location Affordability Portal – Version 2 (www.locationaffordability.info), to provide housing and transportation costs for every neighborhood in all 50 states and the District of Columbia. Although the statistical model at the heart of this resource was designed for predictive accuracy, its design and parameter estimates can provide additional insights into the interaction of housing cost and transportation choices (and thus its cost). This study describes the development and explores the policy implications (and limitations) of this structural equations model, the Location Affordability Index Model – Version 2 (LAIM2).     

Position Effect on Facial Soft Tissue Depths: A Sonographic Investigation

The head is positioned erect for an approximation; yet most facial soft tissue depths (FSTD) used are measured from supine subjects. Depth difference might be significant, but there is a paucity of data to verify. This study compared erect and supine values for 17 landmarks from 30 healthy New Zealand (European population affinity) women (18–30 or 40–55 years) in erect then supine positions. Height, weight, and sonographic FSTD data, totaling 1020 measurements, were obtained. Three midline and seven averaged bilateral values were compared using ANOVA, p values, and Pearson's correlations. Correlative strength of age and body mass index, BMI (kg/m²), was determined by values. Results showed averaged erect and supine differences were significant for four of ten FSTDs. Between individuals, difference was various and not unidirectional. In conclusion, depth differences were observed but not all significant or unidirectional, BMI significantly influenced nine FSTD values, but age group did not.