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Recent upticks of stimulant presence in overdose deaths suggest the opioid epidemic is morphing, which raises questions about what drugs are involved and who is impacted. We investigate annual and growth rate trends in combined opioid-stimulant overdose toxicology between 2013 and 2019 for White, Black, and Hispanic male and female decedents in Delaware. During these years, toxicology shifted to illegal drugs for all with fentanyl leading the increase and opioid-cocaine combinations rising substantially. While combined opioid-cocaine toxicology grew among Black and Hispanic Delawareans, White males continue to report the highest rates overall. These findings depart from historical patterns and may challenge existing opioid epidemic policies. [ABSTRACT FROM AUTHOR]

Intimate partner homicide (IPH) continues to be a form of violence disproportionately affecting women in the United States, and access to firearms can greatly increase the likelihood that intimate partner violence becomes lethal. In response to concerns about firearms violence and their prevalence in IPH incidents specifically, states have passed restrictive firearms laws and policies. In this study, we provide an analysis of female IPH victimization disaggregated by race/ethnicity that incorporates state‐level firearms legislation. Our analytical approach is informed by intersectionality and accounts for other key intimate partner violence policies and structural predictors. We find that the relationship between firearms legislation and IPH varies in magnitude and direction across specific race/ethnicity female victimization groups. As such, our findings provide support for an intersectional framework in that restrictive firearms laws are not consistently associated with lower levels of IPH when incidents are disaggregated by gender and race/ethnicity. [ABSTRACT FROM AUTHOR]

The journey to drug crime literature has found that, in cities, Black people travel shorter distances from their homes before being arrested relative to White people. Per race and rationality theory, the racialization of space shapes the decision-making processes of people arrested for drug offenses. Because residential segregation patterns and racialized social structures differ across levels of urbanization, this study uses negative binomial regression models to evaluate Black-White differences in journeys to crime for drug possessions, and the study assesses socioeconomic and opportunity characteristics of offense locations at the micro-level using drug arrest reports across the State of Delaware. We find that travel distances and predictors of offense locations differ across geographic areas (i.e., small cities, suburban areas, small towns, rural areas, and touristic rural areas). A place's racial composition, concentrated disadvantage, and opportunity characteristics differently impact offense locations across geographic areas. Accordingly, in studying journeys to crime, researchers should consider the various ways that race shapes constructions of crime and place across the rural–urban continuum. [ABSTRACT FROM AUTHOR]

The study aims to expand our understanding of escalation from intimate partner violence to intimate partner homicide (IPH) by exploring the known circumstances leading up to a lethal event. The study draws on qualitative data from law enforcement reports and coroner/medical examiner reports within the National Violent Death Reporting System to identify themes preceding and surrounding IPH incidents. Findings support the utility of risk assessments in identifying escalation while illustrating the complex ways that violence between current or former intimate partners can escalate to lethality, particularly the role of separation and the use of firearms. [ABSTRACT FROM AUTHOR]

Journeys to crime, or distances traveled from residences to places of alleged crimes, describe how people enter into the criminal justice system. Race, as an ascribed characteristic of individuals and a determinant of community conditions, introduces disparities in journeys to crime. Use of opioids among nonurban, White populations and changing law enforcement responses prompt inquiry into how race affects journeys to crime associated with opioid possession. This study evaluates Black–White differences in travel among persons arrested for opioid possession in Delaware. It applies race and rationality theory to assess the effects of race and racialized context on travel patterns. Multilevel models reveal travel to possess opioids is greater for White relative to Black Delawareans. Community conditions such as marijuana possession arrest rates and concentrated disadvantage have varying impacts on travel from various geographic areas. Racial–spatial differences in travel show persistent disparities in drug law enforcement amid efforts to curb opioid misuse. [ABSTRACT FROM AUTHOR]

This study empirically examines recent race-specific police shootings and offers a theoretical test of racial threat arguments. Our analysis includes all aspects of threat – economic, political, and racial composition – when examining state-level counts of police shootings of Black citizens spanning 2014–2016. For comparison, police shootings of Whites were also analyzed. Significant findings for racial composition are reported across both races, while political predictors are significant in the Black-specific model when controlling for other structural features. Our results also highlight the need to disaggregate police shootings by race. With partial support for racial threat arguments, we offer directions for future research. [ABSTRACT FROM AUTHOR]

Police shootings have received considerable attention recently. While official data have often been used to capture police use of lethal force, "unofficial" databases have been developed to document lethal force patterns throughout the United States. Thus, it is now possible to systematically compare databases, exploring racial differences and potential causes, which is important given longstanding criticisms of official records. Here, we examine police shootings using Mapping Police Violence and Supplemental Homicide Reports data and investigate the impact of commonly used structural predictors on race-specific police shootings. Significant differences are revealed across official and unofficial databases, particularly by race. We conclude that the data used to estimate police shootings matter, which has key implications for future work on this important topic. [ABSTRACT FROM AUTHOR]

Discover how the University of Florida's team prepared for the most difficult collegiate-level robotic competition. The Web extra at https://youtu.be/ODmYL8SQcN8 showcases the development of the NaviGator Autonomous Maritime System for participation in the 2016 Maritime RobotX Challenge in Hawaii. [ABSTRACT FROM PUBLISHER]

Background: both acute and chronic renal dysfunction (ARD and CRD) have been reported to influence outcomes after neck of femur fractures. We have examined the relationship between the length of stay, mortality and renal dysfunction using biomarkers. These included pre-operative (admission) serum concentrations of urea, creatinine and albumin, and estimated glomerular filtration rates (eGFR) derived from four- and six-variable Modification of Diet in Renal Disease (MDRD) study equations.Methods: complete outcomes data for 566 patients and the patterns of variations in the biomarkers were analysed using generalised linear models. Cox-proportional hazard analyses investigated the association between kidney function (as assessed by the above-mentioned biochemical data) and post-operative length of stay and mortality. All patients were stratified for CRD according to their eGFR.Results: serum urea and creatinine were significantly, positively correlated with age. After adjusting for age and sex, risk of mortality was positively related to six-variable eGFR and creatinine, and marginally so for urea. One-year mortality risk thus worsened with stages of CRD (1–4), increasing age and male gender. Risk of discharge from trauma ward, the length of stay in trauma ward and the overall length of stay were not related to urea and creatinine, but were negatively related to both four- and six-variable eGFR.Conclusions: the study has identified elderly renal-impaired males as the subgroup of patients most at risk for poor survival. This subgroup may require a more targeted approach to the management of their fluid and electrolyte homoeostasis to help improve their outcomes. [ABSTRACT FROM PUBLISHER]

The article presents a medical case concerning the cognitive effects of fat embolus syndrome. The patient, a 23-year-old female, discussed in the paper recovered after the development of fat embolus syndrome following an isolated femoral diaphyseal fracture. On comprehensive neuropsychological testing, specific and quantifiable defects in cognitive function were detected.

The aim of the present investigation was to characterise the opioid receptor subtypes present in the rat ileum using a method that detects drug action on the enteric nerves innervating the circular and longitudinal muscles.Neurogenic contractions were reversibly inhibited by morphine (circular muscle pEC50, 6.43±0.17, Emax 81.7±5.0%; longitudinal muscle pEC50, 6.65±0.27, Emax 59.7±7.8%), theµ-opioid receptor-selective agonist, DAMGO ([D-Ala2,N-Me-Phe4,Gly5-ol]enkephalin acetate) (circular pEC50, 7.85±0.04, Emax 97.8±3.6%; longitudinal pEC50, 7.35±0.09, Emax 56.0±6.1%), thed-selective agonist DADLE ([D-Ala2,D-Leu5]enkephalin acetate) (circular pEC50, 7.41±0.17, Emax, 93.3±8.4%; longitudinal pEC50, 6.31±0.07, Emax 66.5±5.2%) and the?-selective agonist U 50488H (trans-(±)-3,4-dichloro-N-methyl-N-[2-(1-pyrrolidinyl)cyclohexyl]benzeneacetamide methanesulphonate) (circular pEC50, 5.91±0.41, Emax, 83.5±26.8%; longitudinal pEC50, 5.60±0.08, Emax 74.3±7.2%). Agonist potencies were generally within expected ranges for activity at the subtype for which they are selective, except for U 50488H, which was less potent than expected.Theµanddreceptor-selective antagonists, CTAP (H-D-Phe-Cys-Tyr-D-Trp-Arg-Thr-Pen-Thr-NH2) and naltrindole, caused progressive, parallel rightward shifts in the DAMGO and DADLE curves, respectively. Analysis indicated conformity to theoretical simple competitive antagonist behaviour. U 50488H effects were insensitive to the?-selective antagonist, n-BNI. A high concentration (1?µM) of naltrexone caused apparent potentiation of U 50488H effects.CTAP pKB estimates were consistent with previously reported values forµreceptor antagonism (circular 7.84±0.17, longitudinal 7.64±0.35). However, the naltrindole pKB estimates indicated lower antagonist potency than expected (circular 8.22±0.23, longitudinal 8.53±0.35).It is concluded thatµand possibly atypicaldreceptors (but not?receptors) mediate inhibition of contraction in this model. Nonopioid actions of U 50488H are probably responsible for the inhibitory effects seen with this compound.British Journal of Pharmacology (2005) 144, 687-694. doi:10.1038/sj.bjp.0706107 [ABSTRACT FROM AUTHOR]

We present a case of distal radius fracture. Several sequential unfortunate events resulted in a poor outcome. The patient was poorly selected because the degree of early dementia was not fully appreciated, due to intermittent periods of lucidity. Having elected to treat this distal radius fracture with Kirschner wires, a wire snapped during the procedure and was deemed safe to leave within the medullary cavity. Subsequently, the patient was left in a cast for 4 weeks without regular pin site inspection. When the cast was removed a gross osteomyelitis had developed. This series of events, led to unnecessary morbidity and extended the immobilisation time with reduced wrist function. This case highlights the importance of careful patient selection, surgical tactics and continuity of care. [ABSTRACT FROM AUTHOR]