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This document is a comment submitted to the Journal of Analytical Toxicology. The authors address and clarify information presented in a previous publication regarding the development of a screening assay for drugs in blood. They discuss the evolution of standards and recommendations for toxicological investigations of drug-impaired driving, highlighting differences between the draft and final versions of the standards. The authors also compare the cutoff concentrations used in their study with the recommendations in place at the time of development and at present. They acknowledge that their method did not meet the analytical sensitivity requirements for certain analytes according to the final published standard. The article discusses the validation and limitations of a published method for screening drugs in blood samples. The authors explain that while the method met sensitivity requirements for immunoassay-based screening, it may not be possible to achieve the increased sensitivity required for confirmatory cutoffs for certain compounds. They also discuss the use of non-human blood for method development and validation, the need for additional guidance on critical validation parameters, and the evolving nature of standards in forensic toxicology. The authors emphasize the importance of considering the versioning of standards and highlight the dynamic nature of the standards environment. [Extracted from the article]

Occupational exposures in the large industrial mining sector contributed significantly to South Africa's high excess death rate due to COVID-19. Historically poor work-protection oversight has perpetuated centuries of risky labor and living conditions within the industry, driving high levels of disease co-morbidities, and supporting enduring social vulnerabilities. In this paper, we offer a syndemic lens to consider the clustering of adversely interacting diseases among mineworkers in South Africa, drawing attention to the complex occupational health crisis and the need to move beyond simply reporting individual diseases or comorbidities among this population. The physically demanding and dangerous working conditions, the lack of adequate changes to crowded and unsanitary working and living situations, the failure to meet social and labor plan targets, the continued precarious nature of working contracts and mines, and the limited access to robust healthcare reflect the historically exploitative nature of industrial mining in South Africa that places miners at increased risk for various syndemics. This assessment of the adverse interactions of diseases and socioeconomic and political conditions highlights the need for focused research and more follow-through in comprehensive occupational reforms. [ABSTRACT FROM AUTHOR]

This paper aims to demonstrate nonlinear risk factor interactions based on a data-driven approach using a Bayesian network model, providing a road safety use case. Road safety is a critical issue worldwide, with approximately 1.3 million road traffic deaths each year (WHO). Traditional road safety risk assessment methods often analyze individual factors separately; however, these assessments fail to capture the complex dynamics of real-world analysis, in which multiple factors interact through nonlinear relationships. In this study, a novel road safety risk assessment approach that uses a Bayesian network model to explore the nonlinear relationships among road safety risk factors is developed. Through the analysis of extensive crash reports from the state of Maryland, the complex interdependencies among various risk factors and their cumulative impact on road safety are investigated. Our findings show that two combined risk factors have different effects on risk level when considered individually. Two case studies related to human state risk factors and environmental risk factors, such as driving under the influence and snowy roads, as well as fatigue and snowy roads, have an amplified effect on the risk level. The findings highlight the importance of considering nonlinear interactions among risk factors when developing effective and targeted strategies for accident prevention and road safety improvement. This research contributes to the field of road safety by presenting a new methodology for understanding and mitigating road safety hazards. [ABSTRACT FROM AUTHOR]

Dinitrogen (N2) fixation represents a key source of reactive nitrogen in marine ecosystems. While the process has been rather well-explored in low latitudes of the Atlantic and Pacific Oceans, other higher latitude regions and particularly the Indian Ocean have been chronically overlooked. Here, we characterize N2 fixation and diazotroph community composition across nutrient and trace metals gradients spanning the multifrontal system separating the oligotrophic waters of the Indian Ocean subtropical gyre from the high nutrient low chlorophyll waters of the Southern Ocean. We found a sharp contrasting distribution of diazotroph groups across the frontal system. Notably, cyanobacterial diazotrophs dominated north of fronts, driving high N2 fixation rates (up to 13.96 nmol N l−1 d−1) with notable peaks near the South African coast. South of the fronts non-cyanobacterial diazotrophs prevailed without significant N2 fixation activity being detected. Our results provide new crucial insights into high latitude diazotrophy in the Indian Ocean, which should contribute to improved climate model parameterization and enhanced constraints on global net primary productivity projections. [ABSTRACT FROM AUTHOR]

Many studies have compared individuals who use cannabis for recreational versus medical purposes, but little is known about the moral norms and risk perceptions toward recreational versus medical cannabis while driving. This study aims to examine young Israeli adults’ behaviors, perceived moral norms, and perceived risk regarding driving under the influence of recreational versus medical cannabis. Methods: The study was conducted using quantitative questionnaires. Participants were 504 young adults, aged 18–30 (M = 25.26; SD = 5.40), of whom 314 (62.3%) were women. Results: Driving under the influence of medical cannabis was perceived as more moral and less risky than driving under the influence of recreational cannabis. Significant positive correlations were observed between perceived risk and perceived moral norms for both types of cannabis. Significant negative correlations were found between the frequency of driving under the influence of recreational cannabis and the perceived risk and perceived moral norms associated with both types of cannabis. Conclusion: Policymakers should promote prevention, harm reduction, and enforcement interventions to address the issue of driving under the influence of both recreational and medical cannabis. [ABSTRACT FROM AUTHOR]

Facebook groups and pages exist that expose the locations of roadside drug testing, potentially undermining police enforcement and enabling punishment avoidance. This study aimed to understand how and why these sites are used, with a focus on Queensland motorists who reported using illicit drugs and/or medical cannabis and used Facebook police location communities. Interviews with 30 participants were conducted. A thematic analysis revealed that participants used police location communities to avoid receiving a charge for driving under the influence of drugs. Upon observation of a relevant roadside drug-testing location on police location communities, participants reported (a) delaying their driving and/or (b) circumventing the operation. Avoidance of roadside drug-testing locations appeared driven by the perception that laws for driving under the influence of drugs were unfair and that a charge for driving under the influence of drugs would negatively impact their life. The findings provide important knowledge regarding police location communities and have implications for how roadside drug testing could be most effectively operated. [ABSTRACT FROM AUTHOR]

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Canada legalized the use of non-medical cannabis in 2018. This study examines youth and young adults’ knowledge and perceptions of harms, benefits, and education around cannabis use since legalization. An online survey was completed by a convenience sample of 1,759 individuals aged 12–25 years living in Manitoba, Canada. Most participants (n = 1,525, 86.7%) reported receiving education on the potential effects/harms related to cannabis; the most common topics included driving and cannabis use (79.9%), the mental harms of cannabis (67.4%), and addiction and dependency (66.3%). Youth who reported using cannabis more than once (n = 1,203) were more knowledgeable about the effects of cannabis than youth who never used cannabis or used cannabis once (n = 580; mean score: 6.6 versus 5.7 out of 8, respectively; p < .001). Vaping cannabis oil was perceived as the most harmful cannabis product among all participants. Among participants with experience using cannabis, the most frequently reported benefits were relaxation, improved sleep, and enhanced enjoyment of food/music. Half of the participants reported ever being in a car with someone driving high, of which, 40% of these participants reported doing so in the last 30 days. Future tailored education is needed to address knowledge related to cannabis use among youth and young adults who use and do not use cannabis. [ABSTRACT FROM AUTHOR]

Amphetamine (AMP) and methamphetamine (METH) use is increasing globally. Illegal AMP is generally a racemic mixture, whereas AMP-containing attention-deficit hyperactivity disorder drugs prescribed in Iceland consist of S-AMP. AMP is also a main metabolite of interest after METH intake. Distinguishing between legal and illegal AMP intake is vital in forensic toxicology. A chiral UPLC–MS-MS method was used to determine the enantiomeric profile of AMP and METH in circulation in Iceland by analysing blood samples from drivers suspected of driving under the influence of drugs (DUID) and seized drug samples from 2021 and 2022. All seized AMP samples (n  = 48) were racemic, whereas all but one seized METH sample (n  = 26) were enantiopure. Surprisingly, a large portion of the enantiopure METH samples was R-METH. DUID blood samples positive for AMP (n  = 564) had a median blood concentration of 180 ng/mL (range 20–2770 ng/mL) and a median enantiomeric fraction (EFR) of 0.54 (range 0–0.73), whereas samples positive for METH (n  = 236) had a median blood concentration of 185 ng/mL (range 20–2300 ng/mL) and a median EFR of 0.23 (range 0–1). The findings of this study show a significantly lower blood concentration in drivers with only S-AMP detected compared with when the R-isomer is also detected. No significant difference in blood concentration was detected between the sample groups containing S-METH, R-METH or both enantiomers. The occurrence of R-METH in both seized drug samples and DUID cases indicates a change in drug supply and a need for better scientific knowledge on R-METH abuse. [ABSTRACT FROM AUTHOR]

The Tennessee Bureau of Investigation (TBI) serves all 95 counties of Tennessee, but the data included in this article are primarily focused in Upper East and East Tennessee (the parts of the state included in the eastern time zone). The forensic chemistry (seized drug) unit of the TBI began reporting nitazene analogues in late 2019. The primary analogues found in forensic chemistry cases were isotonitazene and metonitazene. After discussion and review of reporting statistics, the forensic toxicology unit began to monitor for these compounds in toxicology samples by using ion characteristics with the nitazene analogues. Between March 2021 and December 2023, TBI toxicology received 49,639 cases statewide. Of those, 20,105 (40.5%) received toxicology testing. Approximately 95% of TBI toxicology cases are related to Driving Under the Influence (DUI)/motor vehicle–related incidents. Fatal overdoses and cases from the medical examiner office comprise <5% of TBI toxicology caseload. The toxicology section utilizes the SCIEX 3200 Qtrap with a SCIEX Exion LC AC autosampler system to monitor multiple reaction monitoring transition of nitazene analogues. The ion monitoring for two nitazene analogues, isotonitazene and metonitazene, started in March 2021. Ion monitoring should not be construed as a confirmed result but rather as an indication that a drug may be present. A comparison of this data from the forensic toxicology and forensic chemistry units revealed the rise of new drugs that required a more in-depth review to understand the magnitude and scope. This article is also intended to encourage collaboration between forensic toxicology and forensic chemistry (seized drug) units. [ABSTRACT FROM AUTHOR]

Drug-impaired driving is an increasing public safety concern across Canada, particularly due to the demonstrated increase in use of recreational drugs such as cocaine. Cocaine is a central nervous system stimulant drug; however, it can impair an individual's driving ability in both the stimulant and crash phases. Despite the scientific consensus regarding cocaine's potential for driving impairment, there is relatively little information available regarding blood concentrations and associated observations of impairment in suspected impaired drivers. Retrospective data analysis was performed to evaluate suspected impaired driving cases in which cocaine and/or benzoylecgonine were detected alone, or in combination with other drugs, in blood and urine samples submitted to the Toxicology Section of the Centre of Forensic Sciences with incident dates between 2021 and 2022. Cocaine and/or benzoylecgonine were detected in 46% (blood) and 66% (urine) of the total impaired driving samples submitted. In 41 cases where cocaine and/or benzoylecgonine were the only drug finding in blood, concentrations of cocaine and benzoylecgonine ranged from 0.0073 to 0.26 mg/L (mean 0.096 mg/L) and 0.13 to 5.3 mg/L (mean 2.1 mg/L), respectively. Driving observations reported by the arresting officer in cases where cocaine and/or benzoylecgonine were the only drug finding in blood and urine included the driver being involved in a collision, the vehicle leaving the roadway, erratic driving and the driver being asleep at the wheel; observations of drug impairment reported by the drug recognition expert at the time of driver evaluation included abnormal speech patterns, poor balance/incoordination, abnormal body movements and the individual falling asleep. The results provide concentrations of cocaine and benzoylecgonine observed in suspected impaired drivers, insight into observations that may be associated with prior cocaine use and additional information to inform on the effects of cocaine on driving. [ABSTRACT FROM AUTHOR]

This study examines criminal behavior over the welfare payment cycle. Using unique individual‐level administrative data on welfare recipients, we exploit exogenous variation in payment dates over time and across Dutch municipalities. The results suggest that financially motivated crime increases by 12% over the payment cycle, indicating serious financial constraints toward the end of the month. Non‐financially motivated offenses, particularly sex and violent offenses and driving under the influence offenses (DUIs), peak directly after benefits receipt and decrease over the payment cycle, suggesting an underlying spike in consumption conducive to crime. Public order offenses and DUIs also increase with weekend disbursement. [ABSTRACT FROM AUTHOR]

We investigate whether state health insurance parity laws adopted in the 1990s and 2000s for substance use disorder (SUD) treatment reduce traffic fatalities in the United States. Impaired driving is a major contributing factor to US traffic fatalities. State health insurance parity laws compel private insurers to cover SUD treatment more generously—on par with physical health services. We employ 21 years of administrative data from the Fatality Analysis Reporting System. We estimate both two-way fixed-effects regressions and an interaction-weighted estimator that is robust to potential bias attributable to heterogenous and dynamic treatment effects with staggered policy adoption. Our findings indicate that state parity law passage reduces overall traffic fatality rates by 2.8 percent, with larger effects for fatalities that involve alcohol. These findings suggest that state regulations requiring private insurers to equitably cover SUD treatment can improve traffic safety. [ABSTRACT FROM AUTHOR]

The concentration of drugs in a driver's system can change between an impaired driving arrest or crash and the collection of a biological specimen for drug testing. Accordingly, delays in specimen collection can result in the loss of critical information that has the potential to affect impaired driving prosecution. The objectives of the study were: (1) to identify factors that influence the time between impaired-driving violations and specimen collections (time-to-collection) among crash-involved drivers, and (2) to consider how such delays affect measured concentrations of drugs, particularly with respect to common drug per se limits. Study data included blood toxicology results and crash-related information from 8,923 drivers who were involved in crashes and arrested for impaired driving in Wisconsin between 2019 and 2021. Analyses examined how crash timing and severity influenced time-to-collection and the effects of delays in specimen collection on blood alcohol concentrations (BACs) and blood delta-9-tetrahydrocannabinol (THC) concentrations. The mean time-to-collection for the entire sample was 1.80 h. Crash severity had a significant effect on time-to-collection with crashes involving a fatality having the longest duration (M = 2.35 h) followed by injury crashes (M = 2.06 h) and noninjury crashes (M = 1.69 h). Time of day also affected time-to-collection; late night and early morning hours were associated with shorter durations. Both BAC (r = −0.11) and blood THC concentrations (r = −0.16) were significantly negatively correlated with time-to-collection. Crash severity and the time of day at which a crash occurs can result in delays in the collection of blood specimens after impaired driving arrests. Because drugs often continue to be metabolized and eliminated between arrest and biological specimen collection, measured concentrations may not represent the concentrations of drugs that were present at the time of driving. This has the potential to affect drug-impaired driving prosecution, particularly in jurisdictions whose laws specify per se impairment thresholds. [ABSTRACT FROM AUTHOR]

Objective: To describe the changes in alcohol and drug use by Brazilian adolescents during the COVID-19 pandemic (April-August 2021), and to analyze the relationship between alcohol use changes and psychiatric symptomatology. Methods: A secondary analysis with a longitudinal approach was performed with data from a cluster-randomized controlled trial, conducted in 73 public middle schools in three Brazilian cities, to evaluate the effectiveness of a drug use prevention program. The sample included 535 students (61% girls; Mage = 15.2 years). Data were collected pre-intervention (February-March 2019), after 9 months (November-December 2019), and after 26 months (April-August 2021), when the students were in their first year of high school. The authors analyzed drug use prevalence (alcohol, binge drinking, tobacco, inhalants, marijuana, cocaine, and crack) in a lifetime, past year, and past month periods, and the association between alcohol use change subsamples with psychiatric symptoms. Logistic regressions were adjusted by sex, age, socioeconomic status, city, and group (control and intervention). Results: The present findings suggest that the COVID-19 pandemic led to a decrease in pastyear substance use and in past-month substance use frequency, despite the gradually increased (but decelerating) prevalence of lifetime use. However, some adolescents initiated, maintained, or increased the frequency of their alcohol use. Mainly, they were more likely to present behavioral problems, as well as symptoms of inattentive hyperactivity, and peer and emotional problems. Conclusions: Despite the extensive decline in substance use during the pandemic period, these results suggest an association between previous mental health conditions and behavioral risk factors, leading to increased alcohol consumption and behavioral disorders manifestations. [ABSTRACT FROM AUTHOR]

In this study, a novel high-speed flyer launching strategy based on electric explosion and laser coupling was proposed to improve the launching ability of electro-explosively actuators and expand the dynamic high-pressure loading method. First, an electro-explosively actuated flyer launcher with a transparent glass substrate was fabricated by microelectromechanical system (MEMS) scale methods, which acted as a carrier to verify the idea of electric explosion and laser coupling. Then, a device of electric explosion combined with laser driving high-speed flyers was established to study the influence of nanosecond pulsed laser on the flyer launching ability of electro-explosively actuators. Finally, the velocity characteristics of the flyer and the plasma characteristics under coupled conditions are studied. The test results indicated that the introduction of laser had a positive effect on increasing the speed of the flyer. In addition, it was found that the acceleration history of the flyer is affected by the energy of electric explosion, laser energy, and the introduction time of laser. [ABSTRACT FROM AUTHOR]

Warming temperatures are altering communities and trophic networks across Earth's ecosystems. While the overall influence of warming on food webs is often context‐dependent, increasing temperatures are predicted to change communities in two fundamental ways: (1) by reducing average body size and (2) by increasing individual metabolic rates. These warming‐induced changes have the potential to influence the distribution of food web fluxes, food web stability, and the relative importance of deterministic and stochastic ecological processes shaping community assembly. Here, we quantified patterns and the relative distribution of organic matter fluxes through stream food webs spanning a broad natural temperature gradient (5–27°C). We then related these patterns to species and community trait distributions of mean body size and population biomass turnover (P:B) within and across streams. We predicted that (1) communities in warmer streams would exhibit smaller body size and higher P:B and (2) organic matter fluxes within warmer communities would increasingly skew toward smaller, higher P:B populations. Across the temperature gradient, warmer communities were characterized by smaller body size (~9% per °C) and higher P:B (~7% faster turnover per °C) populations on average. Additionally, organic matter fluxes within warmer streams were increasingly skewed toward higher P:B populations, demonstrating that warming can restructure organic matter fluxes in both an absolute and relative sense. With warming, the relative distribution of organic matter fluxes was decreasingly likely to arise through the random sorting of species, suggesting stronger selection for traits driving high turnover with increasing temperature. Our study suggests that a warming world will favor energy fluxes through "smaller and faster" populations, and that these changes may be more predictable than previously thought. [ABSTRACT FROM AUTHOR]

The general use of cocaine is increasing in recent years, while the trend for 3,4-methylenedioxymethamphetamine (MDMA) is less clear. The relationship between blood concentrations and impairment is poorly understood, which complicates interpretation. The aims of this study were to report prevalence and blood concentrations of cocaine and MDMA in drugged drivers, and to investigate the relationship between blood concentrations and impairment. Samples of whole blood were collected from apprehended drivers in the period 2000 – 2022, and a clinical test of impairment (CTI) was simultaneously performed. The samples were initially analyzed for cocaine and MDMA using gas chromatography–mass spectrometry (until 2009 and 2012, respectively), and later using ultra-high-performance liquid chromatography–tandem mass spectrometry. Overall, cocaine was detected in 2,331 cases and MDMA in 2,569 cases. There were 377 and 85 mono cases of cocaine and MDMA, respectively. In the mono cases, the median cocaine concentration was 0.09 mg/L (range: 0.02–1.15 mg/L), and 54% of the drivers were clinically impaired. The median MDMA concentration was 0.19 mg/L (range: 0.04–1.36 mg/L), and 38% were clinically impaired. There was a statistically significant difference in the median cocaine concentration between drivers assessed as not impaired (0.07 mg/L) and drivers assessed as impaired (0.10 mg/L) (P  = 0.009). There was also a significant effect of the blood concentration of cocaine (adjusted odds ratio [aOR] = 6.42, 95% confidence interval [CI] = 1.13–36.53, P  = 0.036) and driving during the evening/night-time (aOR = 2.17, 95% CI = 1.34–3.51, P  = 0.002) on the probability of being assessed as impaired on the CTI. No significant differences were found for MDMA. Many drivers are not assessed as impaired on a CTI following cocaine or especially MDMA use. For cocaine, a relationship between blood concentrations and impairment was demonstrated, but this could not be shown for MDMA. [ABSTRACT FROM AUTHOR]

Hexahydrocannabinol (HHC), 6,6,9-trimethyl-3-pentyl-6a,7,8,9,10,10a-hexahydrobenzo[c]chromen-1-ol, is a semi-synthetic cannabinoid that has presented challenges to analytical laboratories due to its emergence and spread in the drug market. The lack of information on human pharmacokinetics hinders the development and application of presumptive and confirmatory tests for reliably detecting HHC consumption. To address this knowledge gap, we report the analytical results obtained from systematic forensic toxicological analysis of body-fluid samples collected from three individuals suspected of drug-impaired driving after HHC consumption. Urine and plasma samples were analyzed using non-targeted liquid chromatography–high-resolution tandem mass spectrometry. The results provided evidence that HHC undergoes biotransformation reactions similar to other well-characterized cannabinoids, such as ∆9-tetrahydrocannabinol or cannabidiol. Notably, HHC itself was only detectable in plasma samples, not in urine samples. The observed Phase I reactions involved oxidation of C11 and the pentyl side chain, leading to corresponding hydroxylated and carboxylic acid species. Additionally, extensive glucuronidation of HHC and its Phase I metabolites was evident. [ABSTRACT FROM AUTHOR]

Coca tea is a popular drink in some countries of South America, where it is presented as a safe energy preparation, based on a limited total content of cocaine of ∼3–5 mg. Tea bags can be bought with no legal considerations in these countries both by locals and tourists, but its consumption can have consequences when consumed overseas. Driving under the influence of cocaine is banned in most of the places in the world and can be documented by oral fluid testing. A study was implemented with coca tea bags (Coca & Muna) purchased in Peru, after a French attorney-at-law contacted the laboratory to assess the involvement of coca tea in the positive oral fluid results of a driver. Ten healthy volunteers consumed 250 mL of coca tea containing 4.5 mg of cocaine. No volunteer reported any change in behavioral effects after consumption of the coca tea. Oral fluid was collected with a swab (FloqSwab™, Copan) over 8 h to follow the elimination of cocaine and its major metabolites (benzoylecgonine and ecgonine methylester). This is the procedure used by the French police. All samples were analyzed by UHPLC–MS-MS after Quantisal™ buffer desorption. As the device does not allow measurement of the amount of collected fluid, the results are qualitative. This is in accordance with the French law that requires a yes or no response about the presence of cocaine, with a minimum required performance level of 10 ng/mL of cocaine or benzoylecgonine. Parent cocaine was identified for 30–120 min. Benzoylecgonine and ecgonine methylester were identified between 1 and 8 h, with a large inter-individual variation. Although it is generally accepted that a 4–5 mg cocaine dose has no significant pharmacological effect, the consumption of coca tea can lead to the suspension of a person's driving license due to a positive oral fluid test. [ABSTRACT FROM AUTHOR]

In December 2022, the Ministry of Health, Labour and Welfare (MHLW) of Japan issued and implemented the guideline for evaluating the effects of psychotropic drugs on motor vehicle driving performance. This guideline recommends the use of a tiered approach to assess clinically meaningful driving impairment. It is noted that adverse events cannot be solely explained by pharmacokinetics, as the onset and duration of these events vary. Among these adverse events, those affecting alertness, such as drowsiness caused by psychotropic drugs on driving performance, are more frequently observed during initial treatment stages and dose escalation. Hence, when evaluating the effects of psychotropic drugs on driving performance, it becomes crucial to assess the persistence of clinically meaningful impairment. Therefore, the MHLW guideline, developed by the authors, emphasizes the need to assess the temporal profile of adverse events affecting driving in all clinical trials. Additionally, the guideline states that when conducting driving studies, the timing of multiple dosing should consider not only the pharmacokinetics of the investigational drug but also its tolerance. [ABSTRACT FROM AUTHOR]

The increasing use and misuse of gabapentin pose a major risk to public health and traffic safety. Gabapentin has been approved by the Food and Drug Administration (FDA) since 1993 for adjunctive therapy in the treatment of epilepsy and neuralgia but is increasingly being prescribed for numerous off-label uses including insomnia, anxiety, depression, and migraine. Reported side effects include blurred vision, drowsiness, and loss of coordination. Driving behaviors such as exiting the lane of travel and crashes have been reported in connection to drugged driving investigations concerning gabapentin. To further assist with the toxicological interpretation of gabapentin in driving under the influence of drugs (DUID) scenarios, a review of approximately 108,000 gabapentin-positive DUID cases was conducted. Of those, 858 cases met inclusion criteria and underwent additional evaluation. Blood specimens were screened via enzyme-linked immunosorbent assay (ELISA) and confirmed by liquid chromatography tandem mass spectrometry (LC-MS/MS) for quantitation of gabapentin. This review found an overall DUID gabapentin positivity of 7.9% between January 2020 and December 2022; 17 states from various geographical regions had at least one positive gabapentin DUID case. Observations in six driving and human performance cases where gabapentin was the only drug reported were consistent with the known adverse effects of the medication. Half of the case histories reviewed involved crashes where the driver was determined to be at fault. Additionally, 94% of the cases in this review involved gabapentin in combination with other drugs. The most prevalent drug combinations were opioids and gabapentin present in 64% of cases. [ABSTRACT FROM AUTHOR]

Hexahydrocannabinol (HHC) was first reported in the EU in May 2022. HHC has three chiral carbon atoms, but only (6aR,9R,10aR)-HHC (9R-HHC) and (6aR,9S,10aR)-HHC (9S-HHC) have been encountered in HHC products. The aim of this study was to develop and validate a method for the quantitative analysis of 9R-HHC, 9S-HHC, 11-OH-9R-HHC, 9R-HHC-COOH, 9S-HHC-COOH and 8-OH-9R-HHC. In addition, an objective was to investigate the immunochemical cross-reactivity. Blood samples from driving under the influence of drugs (DUID) cases screened positive for cannabis using enzyme-linked immunoadsorbent assay (ELISA) and confirmed negative for tetrahydrocannabinol (THC), 11-hydroxy-THC and THC-COOH were reanalyzed with a newly validated HHC method to investigate the presence of HHC and metabolites. The LC–MS-MS method was validated for matrix effects, lower limit of quantification (LLOQ), calibration model, precision, bias and autosampler stability. Cross-reactivity on an ELISA method was investigated separately for 9R-HHC-COOH and 9S-HHC-COOH at a concentration range between 5 and 200 ng/mL. The cross-reactivity was found to be 120% for 9R-HHC-COOH and 48% for 9S-HHC-COOH. In the LC–MS-MS method, 9R-HHC-COOH, 9S-HHC-COOH and 11-OH-9R-HHC showed matrix effects <25% at both concentrations, while 8-OH-9R-HHC, 9R-HHC and 9S-HHC matrix effects exceeded 25% at both concentrations but showed good precision (<10% for both inter and intra day) and low bias (<6%) in the further validation. The LLOQ was investigated and established at 0.2 ng/mL for all analytes except the carboxylated metabolites that had an LLOQ of 2.0 ng/mL. The upper LOQ was 20 and 200 ng/mL, respectively. Reanalysis of cases (n =  145) confirmed HHC and metabolites in 32 cases (22%). It was determined that the major metabolite in blood after administration of HHC was 9R-HHC-COOH followed by 11-OH-9R-HHC and that presumptive positive cases are caught by the routine ELISA screening for cannabis. [ABSTRACT FROM AUTHOR]

Background: Cannabis use among youth is increasing; this study aimed to assess college students' knowledge, attitude, and expectancies toward cannabis use. Methods: Cross-sectional survey using standardized tools among undergraduate and postgraduate college students in urban Bangalore, India (N = 405). Results: Ten percent reported past three-month cannabis use, with 1% reporting daily use. Users were significantly older (median age 21, IQR 22,20 [vs. 20, IQR 21,19], p <.001) and belonged to families with higher monthly incomes (p =.02). Use was significantly higher among males than females (65.9% vs. 34.1%, p =.006) and postgraduate students than undergraduates (51.2% vs. 48%, p =.001). Users were also significantly more favorable toward cannabis use (median score 4, IQR 6,2 [vs. median 3, IQR 4,2], p =.005) and had more positive expectancies from use (median score 2, IQR 3,2 [vs. median 2, IQR 2,0], p =.001). Nearly 30% were unaware that cannabis can affect a person's ability to drive safely or that it can affect executive functions, including academic performance. Over one-third were unaware of the current legal status of cannabis in India. Overall, 36%, 25%, and 17%, respectively, said that cannabis use is safe when used for recreational purposes, cannabis should be legalized as it helps to relieve stress, and cannabis use among youngsters should be acceptable in society as it is "part of college life." Conclusion: Findings build on existing literature on cannabis use among college youth in India, which can guide preventive interventions and policies for this vulnerable group. [ABSTRACT FROM AUTHOR]

Drug use and road traffic injuries (RTIs) are significant public health concerns globally, with the majority of RTIs occurring in low- and middle-income countries. Driving under the influence of alcohol and drugs is a major factor in RTIs, as psychoactive drugs can impair mental functioning and vehicular control. While alcohol-related traffic deaths have declined, drug-impaired driving is increasing. In India, RTIs are on the rise, and there is a need for more research on drug use and driving under the influence. The lack of research evidence in India contributes to a lack of comprehensive laws and policies for prevention and treatment of drug-related RTIs. It is recommended that research focus on various aspects of drug-impaired driving, and trauma centers should be equipped with testing and treatment services. [Extracted from the article]

Existing literature on driving under the influence during adolescence is sparse, especially for driving after the use of non-medical prescription drugs (DAP). This study examines the prevalence of driving after use of alcohol (DAA), cannabis (DAC), and DAP, and examines the role of several potential risk and protective factors. This was a secondary analysis of the 2022 Rhode Island Study Survey, a cross-sectional survey of middle and high school students. Separate multivariable regressions were conducted for each outcome among lifetime users for each substance, controlling for current substance use, individual-, perceived parental-, and perceived friend-substance use risk perception, age, sexual/gender minority (SGM) status, race, ethnicity, school level, and town poverty level. Among lifetime users of alcohol (n = 3849), cannabis (n = 2289), and non-medical prescription drugs (n = 611), the prevalence of DAA, DAC, and DAP was 4.9, 14.3, and 16.9%, respectively. Current substance use, high individual risk perception, being nonwhite, and being Hispanic were risk factors for DAA while perceiving parent's risk perception as negative and being heterosexual cisgender-female were protective. Current substance use, negative individual risk perception, and being nonwhite were risk factors for DAC while perceiving parent's risk perception as negative and being in high school were protective. Current substance use and older age were risk factors for DAP while perceiving parent's risk perception as negative and perceiving friend's risk perception as negative were protective. Driving under the influence is a concern among adolescent substance users. Current substance use and perceived parental risk perception as negative are common risks and protective factors, respectively. Findings suggest substance-specific, heterogeneous interventions are needed. For example, interventions focusing on peer perceptions are most relevant for DAP, while shifting personal perceptions of harm are most relevant for DAC. [ABSTRACT FROM AUTHOR]

The first aim of the study was to identify sex differences in the use of psychoactive substances among subjects with a previous driving under the influence (DUI) episode. The secondary objective was to propose specific strategies for medico-legal improvements. This was a retrospective observational study that took place between June 1, 2019, and August 31, 2023. It was conducted on DUI subjects examined for reinstatement of their driver's license using an integrated medico-legal and toxicological approach. Ethyl glucuronide (EtG) and illicit psychoactive substances were determined from hair samples. We performed descriptive statistical analyses for the entire sample as well as separately by sex. Additionally, we conducted binary logistic regression analyses separately for males and females to identify protective/risk factors associated with previous road accidents and judgments of unfitness to drive due to excessive alcohol consumption (EtG ≥ 30 pg/mg). The study included 2,221 subjects, comprising 1,970 men and 251 women. Men exhibited a higher prevalence of tobacco, alcohol, and illicit psychoactive substance use. Women were more frequently co-users of alcohol and psychoactive substances and involved in road accidents at the time of DUI. Among the men, being married or having a partner was found to be a protective factor concerning past traffic accidents. For both sexes, a DUI episode with a blood alcohol concentration (BAC) exceeding 1.5 g/L or the co-ingestion of alcohol and drugs was identified as a risk factor for road accident involvement. For men, smoking more than 20 cigarettes per day and, for women, having a DUI episode with a BAC over 1.5 g/L were the main factors indicating unfitness to drive, as determined through high hair EtG levels (> 30 pg/mg). Women with a previous history of road accidents were less likely to have EtG levels of 30 pg/mg or more. The study confirmed sex differences in subjects with a previous DUI episode. A BAC exceeding 1.5 g/L or the simultaneous use of alcohol and drugs at the time of DUI necessitate careful assessment of both men and women seeking driver's license reinstatement. In women, a BAC exceeding 1.5 g/L is considered a risk factor for a subsequent judgment of unfitness to drive. The medico-legal assessment should also involve a thorough investigation of smoking habits in men, as these habits could be related to an increased risk of excessive alcohol consumption. [ABSTRACT FROM AUTHOR]

Despite widespread kratom use, there is a lack of knowledge regarding its effects on driving. We evaluated the self-reported driving behaviors of kratom consumers and assessed their simulated-driving performance after self-administering kratom products. We present results from: 1) a remote, national study of US adults who regularly use kratom, and 2) an in-person substudy from which we re-recruited participants. In the national study (N = 357), participants completed a detailed survey and a 15-day ecological momentary assessment (EMA) that monitored naturalistic kratom use. For the remote study, outcomes were self-reported general and risky driving behaviors, perceived impairment, and driving confidence following kratom administration. For the in-person substudy, 10 adults consumed their typical kratom products and their driving performance on a high-fidelity driving simulator pre- and post-kratom administration was evaluated. Over 90% of participants surveyed self-reported driving under the influence of kratom. Most reported low rates of risky driving behavior and expressed high confidence in their driving ability after taking kratom. This was consistent with EMA findings: participants reported feeling confident in their driving ability and perceived little impairment within 15-180 min after using kratom. In the in-person substudy, there were no significant changes in simulated driving performance after taking kratom. Using kratom before driving appears routine, however, self-reported and simulated driving findings suggest kratom effects at self-selected doses among regular kratom consumers do not produce significant changes in subjective and objective measures of driving impairment. Research is needed to objectively characterize kratom's impact on driving in regular and infrequent consumers. [ABSTRACT FROM AUTHOR]

A simple and rapid electrochemical sensing method with high sensitivity and specificity of aptamers was developed for the detection of methylamphetamine (MAMP). A short anti-MAMP thiolated aptamer (Apt) with a methylene blue (MB) probe at 3ʹ-end was immobilized on the surface of a gold electrode (MB-Apt-S/GE). The electrochemical signal appeared when MAMP presenting in the sample solution competed with cDNA for binding with MB-Apt-S. Under optimized conditions, the liner range of this signal-on electrochemical aptasensor for the detection of MAMP achieved from 1.0 to 10.0 nmol/L and 10.0–400 nmol/L. LOD 0.88 nmol/L were obtained. Satisfactory spiked recoveries of saliva and urine were also obtained. In this method, only 5 min were needed to incubate before the square wave voltammetry (SWV) analysis, which was much more rapid than other electrochemical sensors, leading to a bright and broad prospect for the detection of MAMP in biological sample. This method can be used for on-site rapid detection on special occasions, such as drug driving scenes, entertainment venues suspected of drug use, etc. [ABSTRACT FROM AUTHOR]

Driving under the influence of cannabis (DUIC) is a major cause of preventable death and a growing public health concern. News media coverage of DUIC may influence public perceptions of causal factors for DUIC, risks of DUIC, and potential policy solutions. This study examines Israeli news media coverage of DUIC, and contrasts media coverage according to whether news items refer to cannabis use for medical vs. non-medical purposes. We conducted a quantitative content analysis of news articles related to driving accidents and cannabis use (N = 299) from eleven of the highest circulation newspapers in Israel between 2008 and 2020. We apply attribution theory to analyze media coverage of accidents that were linked to medical cannabis, use compared with non-medical use. News items describing DUIC in the context of non-medical (vs. medical) cannabis use were more likely to: (a) emphasize individual causes (vs. social and political); (b) describe drivers in negative terms (vs. neutral or positive); (c) refer to an increased accident risk due to cannabis use (vs. inconclusive or low risk); and (d) call for increased enforcement rather than education. Results show that Israeli news media coverage of cannabis-impaired driving varied significantly depending on whether it referred to cannabis use for medical purposes, or non-medical purposes. News media coverage may influence public perceptions of the risks of DUIC, the factors that are associated with this issue, and potential policy solutions that may reduce the prevalence of DUIC in Israel. [ABSTRACT FROM AUTHOR]

Research has shown the heightened risk for sexually transmitted infections (STIs), sexual risk behavior, and substance use in sexual and gender minority (SGM) individuals. Further research is necessary to understand understudied sexual risk behaviors in a sample of casual substance users as the implications of substance use are not just experienced by individuals with substance use disorders. Many emerging adults (ages 18-29) experiment with substance use during the transition from adolescence to adulthood and the relationship with sexual risk behaviors are important to understand in this population. Data were collected online through Prolific from 75 participants between the ages of 18-29 who identified as being a SGM. Participants completed a survey in March 2020 indicating their substance use. In November 2021, participants indicated their risky sexual behaviors. A path analysis indicated that cannabis use at Time 1 was significantly associated with greater oral sex without a condom or dental dam, sex under the influence of alcohol and other substances at Time 2. Cocaine use at Time 1 was significantly associated with increased sex under the influence of alcohol and sex with a stranger. Results illustrate long-term implications of casual substance use in SGM populations and highlights understudied sexual risk behaviors. [ABSTRACT FROM AUTHOR]

Adaptive signal control technology (ASCT) is an advanced traffic control system that optimizes signal timing based on real-time traffic demand. ASCT can potentially improve the operation and safety of intersections by establishing dynamic coordination among signalized intersections in real-time. This study used a binary Bayesian logit model with random effects, which accounts for unobserved heterogeneity, to explore the impacts of ASCT on the severity of intersection-related crashes in Florida. Two distinct ASCT types (Type I and II) were analyzed to assess their impacts on crash severity. The analysis revealed that ASCT reduced the likelihood of a fatal plus injury (FI) crash by 14.6%. This reduction was significant at a 90% Bayesian credible interval (BCI). Also, each ASCT type (Type I and II) showed a potential reduction in the likelihood of a FI crash, although the decrease was not significant at a 90% BCI. Other factors such as driving under the influence, angle crashes, dark lighting conditions, posted speed limit, and median along a minor approach, were associated with a higher risk of a FI crash. Transportation agencies could use the study results to justify the deployment and expansion of ASCT at signalized intersections with a high frequency of severe crashes. [ABSTRACT FROM AUTHOR]

Tobacco and alcohol co‐use are two major lifestyle modifiable risk factors. Understanding the determinants of both behaviors helps to develop interventions to prevent these exposures. However, previous studies have focused on predictors of individual tobacco or alcohol use. This study aims to explore the potential predictors of tobacco and alcohol co‐use among Spanish university graduates from the "Seguimiento Universidad de Navarra" (SUN) cohort study. A total of 7175 participants who were co‐users of tobacco and alcohol were selected for this cross‐sectional analysis. Their mean age was 39.1 years (12.04 SD) and 57.3% were women. Univariate regression models were used to select the potential predictors of tobacco and alcohol co‐use, and the areas under the ROC curves (AUC) were calculated. Multivariable logistic regression models were used to create a predictive model. Baseline potential predictors included sociodemographic factors, lifestyle habits, and perceived personality aspects. In the multivariable model, the main significant potential predictors of tobacco and alcohol co‐use were driving under the influence of alcohol (odds ratio [OR] = 1.65 [1.43–1.90]), drinking 1–2 cups of coffee daily (OR = 1.50 [1.24–1.84]), drinking three or more cups of coffee daily (OR = 1.61 [1.35–1.91]), and doing more physical activity than recommended (OR = 1.18 [1.02–1.34]) when compared with the reference group. Conversely, those who were married (OR = 0.87 [0.75–0.99], ate at home 7 days a week (OR = 0.69 [0.60–0.80]), or had a high perceived level of competitiveness (OR = 0.83 [0.72–0.95]) had a lower risk of co‐use (AUC 0.61 [confidence interval 95% 0.59–0.63]), compared to the reference group. These results could be used by healthcare professionals, especially nurses, to effectively assess patients at higher risk of tobacco and alcohol co‐use. [Correction added on 16 February 2024, after first online publication: The abstract section has been revised to provide more clarity in this version.] [ABSTRACT FROM AUTHOR]

Policing of driving under the influence (DUI) has varied widely over both time and place in the U.S. While some limited research has explored informal social norms and spatial variation in DUI enforcement, none have examined this phenomenon longitudinally. This is particularly important since public opinion about DUI and its enforcement has changed since the 1980's. Thus, this project examines how structural factors associated with alcohol norms such as anti-alcohol religious populations, county prohibition of alcohol sales, and large universities with athletic programs are related to change in DUI enforcement from 1985—2014. The results indicate that pro-alcohol measures such as large universities and pro-alcohol religion are related to decreased DUI enforcement, and anti-alcohol religious population are associated with increased enforcement levels. Overall, these findings support the argument that the change in DUI enforcement may be conditioned by the informal norms relating to alcohol in each community. [ABSTRACT FROM AUTHOR]

It has been demonstrated that alcohol continues to be the most prevalent reason causing traffic accidents. This study aimed to evaluate the alcohol levels in the traffic accident cases admitted to Ege University Hospital. Blood samples of the 4,266 cases were analyzed with the enzymatic immunoassay method between 2016 and 2017. The data was obtained from the hospital automation system and analyzed statistically. Of all cases (n = 20,058) admitted to the hospital department, the rate of traffic accidents was 21.3% (n = 4,266). The mean age was 32.38 ± 12.4, and 70.4% of the cases were male. Ethyl alcohol was positive in 9.6% (n = 409) of the cases, and 33.1% (n = 136) of them were in the 25–34 age range. A significant increase was observed in 2017 compared to 2016 (p < 0.05). About 87.6% (n = 360) of the positive cases were above the legal limit of 0.50 g/L for drivers except for professional drivers. About 57.7% (n = 237) of the positive traffic accident cases were passengers, and 27.2% (n = 112) were motor vehicle and motorcycle drivers. This paper presented an updated ethyl alcohol determination in the traffic accidents of the Izmir region in order to have an overall picture of Turkey. Continuous and systematic follow-up studies may help to monitor the alcohol use problem. [ABSTRACT FROM AUTHOR]

Objectives: How prevalent is drugged driving among Colorado drivers convicted of Driving Under the Influence (DUI)? What are the conviction rates of Colorado drivers charged with DUI, including impairment by marijuana's delta-9 tetrahydrocannabinol (THC)? Is Colorado's THC permissible inference law effective? To answer these questions, this report analyzes data published primarily in appendices of Colorado drugged driving reports. Methods: In 2017 Colorado began requiring annual analyses of Driving Under the Influence (DUI) offenses, including causes and judicial consequences of DUI offenses. These analyses are performed by the Division of Criminal Justice's Office of Research and Statistics (ORS) within the Department of Public Safety. Each analysis requires ORS to link toxicology and court data bases. Data linking enables reporting of charges and convictions by categories including alcohol only, THC only, and polydrug use (two or more drugs simultaneously). Reports have been published annually for 5 years, the latest published in 2023 which covers case filings for 2020. Results: A rough estimate of one-half of the state's DUI filings were attributed to drug use and half were attributed to alcohol only. The largest component of drugged driving was polydrug impairment, rather than impairment by a single drug like THC. Conviction rates in 2020 were 91% for alcohol only, 90% for polydrug cases, and 72% for THC only. Blood drug levels and law structure (per se, permissible inference, DUI definition) affected conviction rates significantly by defendant subsets. THC conviction rates in 2020 ranged from 11% to 100%, depending on blood drug levels and the legal charges. Conclusions: Efforts to educate the public about the dangers of drugged driving should emphasize polydrug impairment, not simply THC impairment. States should analyze data on causes and consequences of DUI arrests to understand what their drugged driving problems are and what they are not. Non-zero drug per se levels and defining DUI as "incapable of safe driving" can severely reduce the effectiveness of DUI laws. [ABSTRACT FROM AUTHOR]

This study examined the effects of bystander or victim intoxication during a crime on juror perceptions and decision-making. Mock jurors (N = 261) read testimony from a bystander or victim to an assault, who mentioned that they had consumed alcohol, cannabis, amphetamines, or no substances prior to the crime. Participants delivered a verdict, rated the defendant's guilt, and rated the bystander/victim on their honesty, credibility, and cognitive competence. Witness intoxication and witness role did not influence defendant guilt. However, participants judged any witness intoxicated by amphetamines as less credible and cognitively competent than a sober witness. Furthermore, victims were judged to have lower credibility, cognitive competence, and honesty than bystanders. These findings suggest that jurors' decision-making about defendant guilt might not be influenced by witness intoxication or witness type. A witness' testimony, however, might be evaluated as less credible when delivered by a victim or an amphetamine-intoxicated witness. [ABSTRACT FROM AUTHOR]

Background: Up to 41% of women face challenges achieving orgasm, a statistic unchanged for 50 years. Aim: To evaluate the effect of cannabis use before partnered sex on women with and without difficulty achieving orgasm. Methods: This observational study evaluated responses from female study participants relating to their demographics, sexual activities, mental well-being, cannabis usage, and orgasm-related questions from the Female Sexual Function Index (FSFI). Outcomes: Outcomes included orgasm frequency, difficulty, and satisfaction related to cannabis use or lack of use before partnered sex, largely based on the FSFI orgasm subscale. Results: Of the 1037 survey responses, 410 were valid and complete. Twenty-three surveys (5.6% returned) were excluded due to failure to meet the study's criteria. Of the valid surveys, most women (52%, n = 202) reported difficulty achieving orgasm during sexual activity with a partner. These women were primarily between 25 and 34 years of age (45%, n = 91); 75% identified their race as White (n = 152/202); 52% (n = 105) identified as LGBTQI+ (lesbian, gay, bisexual, transgender, queer/questioning, intersex, or other); and 82% (n = 165) were married or in a relationship. Among participants who experienced challenges in achieving orgasm, 72.8% (n = 147, P < .001) reported that cannabis use before partnered sex increased orgasm frequency, 67% stated that it improved orgasm satisfaction (n = 136, P < .001), and 71% indicated that cannabis use made orgasm easier (n = 143, P < .001). The frequency of cannabis use before partnered sex correlated with increased orgasm frequency for women who experienced difficulties achieving orgasm (n = 202, P < .001). The reasons for cannabis use before partnered sex resulted in a more positive orgasm response (n = 202, P = .22). Clinical Implications: Cannabis may be a treatment for women with difficulty achieving orgasm during partnered sex. Strengths and Limitations: The researchers examined the challenge of achieving orgasm and considered the covariates reported in the literature, including the FSFI orgasm subscale. The findings may not be generalizable to women who rarely or never use cannabis before sex, women who have never experienced an orgasm, or women who do not have female genitalia. Additionally, the specific type of cannabis used, its chemical composition, the quantity used, and whether or not the partner used cannabis were not assessed in this study. Conclusion: Cannabis-related treatment appears to provide benefit to women who have female orgasm difficulties or dysfunction. [ABSTRACT FROM AUTHOR]

The vast diversity of mammalian adaptive antigen receptors allows for robust and efficient immune responses against a wide number of pathogens. The antigen receptor repertoire is built during the recombination of B and T cell receptor (BCR, TCR) loci and hypermutation of BCR loci. V(D)J recombination rearranges these antigen receptor loci, which are organized as an array of separate V, (D), and J gene segments. Transcription activation at the recombining locus leads to changes in the local three-dimensional architecture, which subsequently contributes to which gene segments are utilized for recombination. The endogenous retrovirus (ERV) mouse mammary tumor provirus 8 (Mtv8) resides on mouse chromosome 6 interposed within the large array of light chain kappa V gene segments. As ERVs contribute to changes in genomic architecture by driving high levels of transcription of neighboring genes, it was suggested that Mtv8 could influence the BCR repertoire. We generated Mtv8-deficient mice to determine if the ERV influences V(D)J recombination to test this possibility. We find that Mtv8 does not influence the BCR repertoire. [ABSTRACT FROM AUTHOR]

Background: One enforcement strategy used to address illegal sales of alcohol to intoxicated patrons (i.e., overservice) is Place of Last Drink (POLD). When law enforcement responds to an alcohol-related incident, they ask persons involved in the incident where they had their last drink; POLD data can then be used to track patterns of overservice. Methods: We evaluated potential effects of a POLD initiative in one state (USA) on the attitudes and perceptions of serving staff (i.e., bartenders and servers) about their experiences in refusing sales to intoxicated customers. We conducted interviews with 44 serving staff across 24 communities (14 communities that participated in the POLD initiative and 10 comparison communities). We analyzed the interview transcripts using a qualitative matrix to identify major themes. Results: We found few differences across the two study conditions, with interview participants having no apparent awareness of POLD and many stating that overservice occurs frequently without law enforcement getting involved. One difference we identified was serving staff from communities in the POLD initiative reporting generally positive experiences with their managers when refusing sales to intoxicated patrons, whereas serving staff in comparison communities more commonly saying they were overruled by their managers. It is possible that these differences are the result of the POLD initiative; however, more research is needed. Conclusions: In general, serving staff across communities share many similar perceptions and attitudes around overservice. These findings can inform future implementation of POLD and other strategies to reduce overservice of alcohol. [ABSTRACT FROM AUTHOR]

The given text explores the character development of Kendall in the TV show "Succession" and his response to a traumatic event. Kendall experiences emotional distress and guilt following the death of Andrew, but ultimately denies his involvement in the incident. The text also draws comparisons to the Chappaquiddick incident involving Ted Kennedy, highlighting the theme of unaccountability among the wealthy. The article provides insights into Kendall's character and the complexities of his reactions to the event. [Extracted from the article]

Key Points: Question: What is the prevalence of self-reported Δ8-tetrahydrocannabinol (THC) and marijuana use among 12th-grade students in the US and its distribution across sociodemographic factors and state cannabis policies? Findings: In this nationally representative 2023 survey, 11.4% of 2186 US 12th-grade students self-reported Δ8-THC use and 30.4% self-reported marijuana use in the past year. Δ8-THC use prevalence was higher in the South and Midwest US and in states without legal adult-use marijuana or Δ8-THC regulations. Marijuana use prevalence did not differ by cannabis policies. Meaning: Δ8-THC use prevalence is appreciable among US adolescents and is a potential public health concern. Importance: Gummies, flavored vaping devices, and other cannabis products containing psychoactive hemp-derived Δ8-tetrahydrocannabinol (THC) are increasingly marketed in the US with claims of being federally legal and comparable to marijuana. National data on prevalence and correlates of Δ8-THC use and comparisons to marijuana use among adolescents in the US are lacking. Objective: To estimate the self-reported prevalence of and sociodemographic and policy factors associated with Δ8-THC and marijuana use among US adolescents in the past 12 months. Design, Setting, and Participants: This nationally representative cross-sectional analysis included a randomly selected subset of 12th-grade students in 27 US states who participated in the Monitoring the Future Study in-school survey during February to June 2023. Exposures: Self-reported sex, race, ethnicity, and parental education; census region; state-level adult-use (ie, recreational) marijuana legalization (yes vs no); and state-level Δ8-THC policies (regulated vs not regulated). Main Outcomes and Measures: The primary outcome was self-reported Δ8-THC and marijuana use in the past 12 months (any vs no use and number of occasions used). Results: In the sample of 2186 12th-grade students (mean age, 17.7 years; 1054 [48.9% weighted] were female; 232 [11.1%] were Black, 411 [23.5%] were Hispanic, 1113 [46.1%] were White, and 328 [14.2%] were multiracial), prevalence of self-reported use in the past 12 months was 11.4% (95% CI, 8.6%-14.2%) for Δ8-THC and 30.4% (95% CI, 26.5%-34.4%) for marijuana. Of those 295 participants reporting Δ8-THC use, 35.4% used it at least 10 times in the past 12 months. Prevalence of Δ8-THC use was lower in Western vs Southern census regions (5.0% vs 14.3%; risk difference [RD], −9.4% [95% CI, −15.2% to −3.5%]; adjusted risk ratio [aRR], 0.35 [95% CI, 0.16-0.77]), states in which Δ8-THC was regulated vs not regulated (5.7% vs 14.4%; RD, −8.6% [95% CI, −12.9% to −4.4%]; aRR, 0.42 [95% CI, 0.23-0.74]), and states with vs without legal adult-use marijuana (8.0% vs 14.0%; RD, −6.0% [95% CI, −10.8% to −1.2%]; aRR, 0.56 [95% CI, 0.35-0.91]). Use in the past 12 months was lower among Hispanic than White participants for Δ8-THC (7.3% vs 14.4%; RD, −7.2% [95% CI, −12.2% to −2.1%]; aRR, 0.54 [95% CI, 0.34-0.87]) and marijuana (24.5% vs 33.0%; RD, −8.5% [95% CI, −14.9% to −2.1%]; aRR, 0.74 [95% CI, 0.59-0.94]). Δ8-THC and marijuana use prevalence did not differ by sex or parental education. Conclusions and Relevance: Δ8-THC use prevalence is appreciable among US adolescents and is higher in states without marijuana legalization or existing Δ8-THC regulations. Prioritizing surveillance, policy, and public health efforts addressing adolescent Δ8-THC use may be warranted. This cross-sectional nationally representative classroom-based survey of US 12th-grade students examines the self-reported prevalence of and sociodemographic and policy factors associated with Δ8-THC and marijuana use during a 12-month period. [ABSTRACT FROM AUTHOR]

An analytical strategy for identification by an LC–MS/MS multitarget screening method and a suitable LC–MS/MS based quantification were developed for the psychotropic drug phenibut. The samples analyzed were collected during traffic control and were associated with driving under the influence of drugs. A positive sample for phenibut was identified in a single case of driving under the influence. The quantification revealed a drug concentration of 1.9 μg/mL. An interaction with blood alcohol (BAC = 0.10%) was discussed as the explanation of the way of driving and deficit manifestations observed (swaying, nystagmus, quivering of the eyelid, and reddened eyes). According to the available information, the quantified phenibut concentration could be explained by an intake of four tablets (self‐reported) during the day containing 250 mg of the drug. Chromatography was performed with a Luna 5 μm C18 (2) 100 A, 150 mm × 2 mm analytical column, and a buffer system consisted of 10 mM ammonium acetate and 0.1% acetic acid (v/v) included in mobile phases marked as A (H2O/methanol = 95/5, v/v) and B (H2O/methanol = 3/97, v/v). An effective limit of detection (LOD = 0.002 μg/mL) could be achieved for the multitarget screening method. The quantification of phenibut was performed on a second LC–MS/MS system with LOD/LOQ values of 0.22/0.40 μg/mL. Since phenibut quantification data are rare, the presented information can be used with caution for evaluation of positive cases in the future. [ABSTRACT FROM AUTHOR]

Ramipril is a popular angiotensin-converting enzyme inhibitor applied in the treatment of hypertension. Its therapeutic effect is oriented on the concentration of the active metabolite ramiprilat. The information about toxic drug levels is missing in the literature. Therefore, the aim of this work was an indication of possible toxic ranges based on the analysis of real samples with high ramiprilat concentrations. For these purposes, an appropriate analytical LC–MS/MS method was developed and validated according to forensic guidelines and applied in the routine. Most real samples targeted for ramipril/ramiprilat were associated with the typical therapeutic drug range of 1–40 ng/mL described in the literature. However, higher drug levels with ramiprilat concentrations above 100 ng/mL could also be observed infrequently in cases of driving under the influence of drugs or attempted suicides. To the best of the author's knowledge, this is the first time antemortem ramipril and ramiprilat concentrations associated with driving under the influence of drugs and suicide attempts were discussed from a forensic point of view. The collected data enabled an indication of the ramiprilat toxic concentration range from about 600 ng/mL to at least 3500 ng/mL. The toxic concentration range discussed can be applied in the forensic practice as a reference for future cases. [ABSTRACT FROM AUTHOR]

China has experienced remarkable achievements in terms of reducing the number of extraordinarily severe traffic crashes (ESTCs) that cause more than 10 deaths each crash. However, ESTCs still occur occasionally and result in extremely adverse social impacts. This study aims at investigating the common characteristics, characteristic patterns, and changes of characteristics of ESTCs in China with the expectation to learn from the past and act for the future. A total of 373 ESTCs occurred in 2004–2019 were collected, and characteristics of driver factors, road factors, vehicle factors, environment factors, and other factors were analyzed through the multiple correspondence analysis (MCA). The results show that run off road crashes, not qualified drivers, improper driving, large bus, overload, class II highway, and straight road sections are the most common categories of characteristics. In addition, four underlying characteristic patterns are identified through the MCA. Significant changes in characteristics and characteristic patterns are also found, and these changes are the results of various law enforcement, safety policies, educational interventions, and engineering interventions. It is also inferred that the specific law enforcement targeting to certain category of characteristics is more effective than the corresponding safety campaigns or policies in terms of ESTC prevention. [ABSTRACT FROM AUTHOR]