The Views of Police Officers Toward Gun Legislation and Public Health Policies Driven by Firearm Safety Concerns.

Gun violence is a principal cause of premature death in America. It has been suggested that solutions to gun violence may be found using a public health approach, which is broader than dealing with the problem via law enforcement alone. A component of a public health approach to gun violence is the implementation of policies or laws. Unfortunately, there is a serious gap in our understanding of how street-level police officers view proposed or existing firearms legislation. This is an important omission, because it is line-level personnel who are tasked with enforcing these policies within highly discretionary contexts. We surveyed police from three jurisdictions to establish a baseline understanding of officers' views about potential gun legislation and identify possible resistance and implementation barriers of firearms laws. The findings suggest that those responsible for enforcing new laws show limited or mixed support for the same. Officers were most supportive of laws that increase the presence of trained gun owners within certain contexts and ensure that individuals with criminal backgrounds or mental health concerns do not have access to firearms. Most officers support prohibiting gun ownership following conviction of a domestic violence offense. However, officers generally opposed gun legislation banning assault weapons, large capacity magazines, and internet ammunition purchases. Finally, officers with the Buffalo Police Department-which recently had experienced an active-shooter event-were more supportive of almost all types of legislation. Respondents expressing greater concern about officer safety related to firearms were supportive of several types of firearm legislation.

The impact of COVID-19 on the spatial distribution of shooting violence in Buffalo, NY.

OBJECTIVES: This paper examines the extent to which hotspots of shooting violence changed following the emergence of COVID-19. METHODS: This analysis uses Andresen's Spatial Point Pattern test on 1500 by 1500 foot grid cells, correcting for multiple comparisons, on a 10-year sample of geocoded shooting data from Buffalo New York. RESULTS: This work finds zero micro-grid cells are not statistically different from pre to post COVID stay at home orders and instead that the observed rise in shootings in the sample appears to be a consistent proportional increase across the city. CONCLUSIONS: These findings provide law enforcement with useful information about how to respond to the recent rise in shooting violence, but additional work is needed to better understand what, among a number of competing theories, is driving the increase. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11292-021-09497-4.

Blood lead concentrations among pediatric patients with abdominal pain: a prospective cross-sectional study.

BACKGROUND: Lead exposure is one of the most menacing of environmental exposures, particularly in children. Children are more susceptible to the effects of lead which manifest in many organ systems, including interference with mental and motor development. Lead poisoning can cause colicky abdominal pain. In this study, the authors sought to evaluate the prevalence of elevated blood lead level (BLL) and its contributing factors among pediatric patients presenting with abdominal pain. An epidemic of lead poisoning in adults was previously uncovered, and thus a concern for pediatric lead poisoning was raised. METHODS: Pediatric patients presenting to two pediatric clinics in Tehran with abdominal pain were eligible for enrollment in a descriptive prospective cross-sectional study. A predesigned questionnaire was filled for each patient by their consenting parents. The questionnaire queried demographic information, environmental, social, and other relevant parameters for lead exposure. After completion of the questionnaire, biometrics were obtained, and a blood sample was taken from each patient for measurement of BLL and complete blood count. RESULTS: A total of 187 patients were enrolled in the study. Of them, almost 20% had BLL ≥ 5 µg/dL. Univariate analysis showed that age (p = 0.002, OR 3.194, CI 95% 1.504-6.783), weight (p = 0.009, OR 2.817, CI 95% 1.266-6.269), height (p = 0.003, OR 3.155, CI 95% 1.443-6.899), and playing with both plastic and cotton toys (p = 0.03, OR 2.796, CI 95% 1.072-7.295) were significant predictors of high BLLs. Maternal level of education correlated with blood lead concentrations (p = 0.048, OR 2.524, CI 95% 1.006-6.331). CONCLUSIONS: A clinically significant number of cases of abdominal pain may have high BLLs. Specific attention should be paid to children presenting with abdominal pain, especially due to the detrimental effects of lead on their mental and motor development.

Environmental assessment of pediatric Lead exposure in Tehran; a prospective cross-sectional study.

BACKGROUND: Ingestion and inhalation are common routes of exposure for lead in humans. Developing countries still have unacceptably high rates of lead toxicity, especially in children. Studies on probable risk factors of lead poisoning in Iranian children are insufficient. In this study, we aimed to evaluate possible environmental factors in children with high blood lead concentrations living in Tehran and neighboring cities. METHODS: In a prospective cross-sectional study between March 2018 and March 2019 we followed all children referred from two pediatric gastrointestinal clinics with blood lead level (BLL) > 5 µg/dL in metropolitan Tehran to investigate possible environmental risk factors in their home. Household specimens including scratched wall paint, house floor dust, windowsill dust, tap water, and consumed spice were evaluated using atomic absorption method to detect lead concentrations. Epidemiological and environmental data collected through in-depth interviews with parents/guardians. Industrial areas were defined based on municipality maps on industrial places. RESULTS: Thirty of 56 parents/guardians with BLL > 5 µg/dL agreed to be followed through environmental investigation. The only categorical statistically significant risk factor was a history of lead poisoning in the family and living in an industrial zone. There was a positive correlation between BLL and interior windowsills dust lead level, r = 0.46, p = 0.01. Scratched paint lead level and BLL showed a significant positive correlation, r = 0.50, p = 0.005. House floor dust lead level (median = 77.4, p < 0.001) and interior windowsill dust lead level (median = 291, p = 0.011) were both significantly higher than the environmental protection agency (EPA) standards of 40 µg/ft2, 250 µg/ft2. Interior windowsill dust lead concentrations were significantly higher in industrial areas (p = 0.026). CONCLUSION: Children's playing environment should be cleaned more often to reduce dust. Moreover, specific rules may need to be implemented for paint lead concentrations and air pollution, especially in industrial areas.

When COVID-19 and guns meet: A rise in shootings.

OBJECTIVE: The present study examines the impact of the COVID-19 stay-at-home order on gun violence in Buffalo, New York: fatal shootings, all non-fatal shootings, non-fatal shootings with injury, and non-fatal shootings without injury. It also estimated its impact on gang and non-gang related shootings. METHODS: Weekly crime data are analyzed at the city level using ARIMA and poisson models. Forecasting is used to verify the validity of both ARIMA and poisson models. RESULTS: The effect of the pandemic was conditional upon the types of gun violence and impact models of intervention. The pandemic caused a temporary increase in fatal shootings while leading to a long-term increase in all non-fatal shootings, non-fatal shootings with injury, non-fatal shootings without injury, and gang related shootings. CONCLUSIONS: The pandemic has changed the volume of gun violence possibly due to increased strain and/or changed routine activities. This study not only promotes further research but also has policy implications for public health and safety. From a public policy perspective, criminal justice agencies should focus more attention and resources on gun violence resulting from a sense of strain and fear among individuals during the pandemic.

Poly(carboxypyrrole)s That Depolymerize from Head to Tail in the Solid State in Response to Specific Applied Signals.

This Article describes the design, synthesis, and analysis of a new class of polymer that is capable of depolymerizing continuously, completely, and cleanly from head to tail when a detection unit on the head of the polymer is exposed to a specific applied signal. The backbone of this polymer consists of 1,3-disubstituted pyrroles and carboxy linkages similar to polyurethanes. Diverse side chains or reactive end-groups can be introduced readily, which provides modular design of polymer structure. The designed depolymerization mechanism proceeds through spontaneous release of carbon dioxide and azafulvene in response to a single triggering reaction with the detection unit. These poly(carboxypyrrole)s depolymerize readily in nonpolar environments, and even in the bulk as solid-state plastics.

Lead poisoning; a neglected potential diagnosis in abdominal pain.

BACKGROUND: Abdominal pain may be a presenting symptom of lead poisoning and is often difficult to diagnose. This study aimed to determine the prevalence of abdominal pain in patients seen in the Laghman Hakim Hospital ED and GI clinic who were lead-intoxicated, with or without opiate use disorder. METHODS: Between July 2017 and January 2018, patients seen in the ED and GI clinic of Loghman Hakim Hospital with unexplained abdominal pain or abdominal pain resistant to treatment were enrolled. Informed consent was obtained from potential enrollees. For standardization, a pre-designed data collection tool was developed for uniform data acquisition. Opiate use was determined historically. For this study, lead poisoning was defined as a blood lead level (BLL) greater than or equal to 30 µg/dL (1.45 µmol/L) with concomitant GI symptoms. RESULTS: Of 125 patients admitted, 28 (22.4%) had BLLs higher than 30 µg/dL. None of the patients had signs and symptoms of opioid withdrawal syndrome during evaluation. Elevated BLLs were significantly correlated with oral opium use/abuse, history of addiction for over the preceding 12 years. The daily opium use was more than 2.75 g. There was a statistical correlation between lead toxicity and abdominal pain consistency and intensity, constipation, and paresthesias. Anemia, leukocytosis, and abnormal liver enzyme tests were laboratory findings associated with lead toxicity. Four patients died, one of whom was diagnosed with lead toxicity. CONCLUSION: Lead toxicity should be considered in the potential differential diagnosis of severe and resistant abdominal pain in patients referring to general EDs or GI clinics if a positive history of opium abuse exists.

Seeing cilia: imaging modalities for ciliary motion and clinical connections.

The respiratory tract is lined with multiciliated epithelial cells that function to move mucus and trapped particles via the mucociliary transport apparatus. Genetic and acquired ciliopathies result in diminished mucociliary clearance, contributing to disease pathogenesis. Recent innovations in imaging technology have advanced our understanding of ciliary motion in health and disease states. Application of imaging modalities including transmission electron microscopy, high-speed video microscopy, and micron-optical coherence tomography could improve diagnostics and be applied for precision medicine. In this review, we provide an overview of ciliary motion, imaging modalities, and ciliopathic diseases of the respiratory system including primary ciliary dyskinesia, cystic fibrosis, chronic obstructive pulmonary disease, and idiopathic pulmonary fibrosis.

Microgravity-induced ocular changes are related to body weight.

On Earth, tissue weight generates compressive forces that press on body structures and act on the walls of vessels throughout the body. In microgravity, tissues no longer have weight, and tissue compressive forces are lost, suggesting that individuals who weigh more may show greater effects from microgravity exposure. One unique effect of long-duration microgravity exposure is spaceflight-associated neuroocular syndrome (SANS), which can present with globe flattening, choroidal folds, optic disk edema, and a hyperopic visual shift. To determine whether weight or other anthropometric measures are related to ocular changes in space, we analyzed data from 45 individual long-duration astronauts (mean age 47, 36 male, 9 female, mean mission duration 165 days) who had pre- and postflight measures of disk edema, choroidal folds, and manifest ocular refraction. The mean preflight weights of astronauts who developed new choroidal folds [78.6 kg with no new folds vs. 88.6 kg with new folds ( F = 6.2, P = 0.02)] and disk edema [79.1 kg with no edema vs. 95 kg with edema ( F = 9.6, P = 0.003)] were significantly greater than those who did not. Chest and waist circumferences were also significantly greater in those who developed folds or edema. The odds of developing disk edema or new choroidal folds were 55% in the highest- and 9% in the lowest-weight quartile. In this cohort, no women developed disk edema or choroidal folds, although women also weighed significantly less than men [62.9 vs. 85.2 kg ( F = 53.2, P < 0.0001)]. Preflight body weight and anthropometric factors may predict microgravity-induced ocular changes.

Motor and Sensory Deficits in the teetering Mice Result from Mutation of the ESCRT Component HGS.

Neurons are particularly vulnerable to perturbations in endo-lysosomal transport, as several neurological disorders are caused by a primary deficit in this pathway. In this report, we used positional cloning to show that the spontaneously occurring neurological mutation teetering (tn) is a single nucleotide substitution in hepatocyte growth factor-regulated tyrosine kinase substrate (Hgs/Hrs), a component of the endosomal sorting complex required for transport (ESCRT). The tn mice exhibit hypokenesis, muscle weakness, reduced muscle size and early perinatal lethality by 5-weeks of age. Although HGS has been suggested to be essential for the sorting of ubiquitinated membrane proteins to the lysosome, there were no alterations in receptor tyrosine kinase levels in the central nervous system, and only a modest decrease in tropomyosin receptor kinase B (TrkB) in the sciatic nerves of the tn mice. Instead, loss of HGS resulted in structural alterations at the neuromuscular junction (NMJ), including swellings and ultra-terminal sprouting at motor axon terminals and an increase in the number of endosomes and multivesicular bodies. These structural changes were accompanied by a reduction in spontaneous and evoked release of acetylcholine, indicating a deficit in neurotransmitter release at the NMJ. These deficits in synaptic transmission were associated with elevated levels of ubiquitinated proteins in the synaptosome fraction. In addition to the deficits in neuronal function, mutation of Hgs resulted in both hypermyelinated and dysmyelinated axons in the tn mice, which supports a growing body of evidence that ESCRTs are required for proper myelination of peripheral nerves. Our results indicate that HGS has multiple roles in the nervous system and demonstrate a previously unanticipated requirement for ESCRTs in the maintenance of synaptic transmission.

Coupling Activity-Based Detection, Target Amplification, Colorimetric and Fluorometric Signal Amplification, for Quantitative Chemosensing of Fluoride Generated from Nerve Agents.

The G-class nerve agents, which include sarin, soman, and cyclosarin, react readily with nucleophilic reagents to produce fluoride. Thus, a chemosensing protocol has been designed for these agents that pairs the nucleophilic reactivity of oximates for generating fluoride with an autoinductive target amplification reaction to amplify the quantity of fluoride for facile colorimetric and fluorescent optical quantification. The chemosensing protocol was demonstrated by using the nerve agent surrogate diisopropyl fluorophosphate (DFP) and benzaldoxime as the nucleophile. Autoinductive fluoride amplification responds to fluoride released from DFP by amplifying the fluoride concentration and a yellow reporter molecule. The reporter is a conjugated oligomer with a nominal repeating unit that originates from 4-aminobenzaldehyde. Exposure of the amplified fluoride to a fluoride-specific ratiometric fluorescent reporter provides a fluorescent readout, in which three fluorophores are generated per fluoride. Both colorimetric and fluorescent readouts enable quantitative assays with low micromolar limits of detection for fluoride resulting from DFP. More importantly, this work demonstrates the successful merging of multiple complex reactions for achieving selective, sensitive, and quantitative chemosensing.

Stimuli-Responsive Polymer Film that Autonomously Translates a Molecular Detection Event into a Macroscopic Change in Its Optical Properties via a Continuous, Thiol-Mediated Self-Propagating Reaction.

This Communication describes a chemically responsive polymer film that is capable of detecting low levels of a specific applied molecular signal (thiol) and subsequently initiating a self-propagating reaction within the material that converts the nonfluorescent film into a globally fluorescent material. We illustrate that the intensity of the resulting fluorescent material is independent of the quantity of the applied thiol, whereas the rate to reach the maximum level of signal is directly proportional to the quantity of the signal. In contrast, a control film, which lacks functionality for mediating the self-propagating reaction, provides a maximum change in fluorescence that is directly proportional to the quantity of the applied thiol. This level of nonamplified signal is 78% lower in intensity (when initiated with 100 µM of applied thiol) than is achieved when the material contains functionality that supports the self-powered, self-propagating amplification reaction.

Surface-accessible detection units in self-immolative polymers enable translation of selective molecular detection events into amplified responses in macroscopic, solid-state plastics.

This Communication describes a strategy for incorporating detection units onto each repeating unit of self-immolative CDr polymers. This strategy enables macroscopic plastics to respond quickly to specific applied molecular signals that react with the plastic at the solid-liquid interface between the plastic and surrounding fluid. The response is a signal-induced depolymerization reaction that is continuous and complete from the site of the reacted detection unit to the end of the polymer. Thus, this strategy retains the ability of CDr polymers to provide amplified responses via depolymerization while simultaneously enhancing the rate of response of CDr-based macroscopic plastics to specific applied signals. Depolymerizable poly(benzyl ethers) were used to demonstrate the strategy and now are capable of depolymerizing in the context of rigid, solid-state polymeric materials.

Design, Synthesis, and Characterization of Small-Molecule Reagents That Cooperatively Provide Dual Readouts for Triaging and, When Necessary, Quantifying Point-of-Need Enzyme Assays.

A newly designed small molecule reagent provides both qualitative and quantitative readouts in assays that detect enzyme biomarkers. The qualitative readout enables rapid triaging of samples so that only samples that contain relevant concentrations of the target analyte must be quantified. The reagent is accessible in essentially three steps and 34% overall yield, is stable as a solid when heated to 44 °C for >1 month, and does not produce background signal when used in an assay. This paper describes the design and synthesis of the reagent, characterizes its response properties, and establishes the scope of its reactivity.

Self-Immolative Poly(4,5-dichlorophthalaldehyde) and its Applications in Multi-Stimuli-Responsive Macroscopic Plastics.

End-capped poly(4,5-dichlorophthalaldehyde) (PCl2PA), which is a new self-immolative CD(r) polymer with the unique capability of depolymerizing continuously and completely in the solid state when an end cap is cleaved from the polymer by reaction with a specific molecular signal, is described. End-capped poly(4,5-dichlorophthalaldehyde) is sufficiently stable to enable patterning of three-dimensional macroscopic polymeric materials by selective laser sintering. These unique materials are capable of 1) autonomously amplifying macroscopic changes in the material in response to specific molecular inputs, and 2) altering their responses depending on the identity of the applied signal. Thus, not only does end-capped PCl2PA provide new and unique capabilities compared to the small subset of existing CD(r) polymers, but it also provides access to a new class of stimuli-responsive materials.

Rapid, On-Command Debonding of Stimuli-Responsive Cross-Linked Adhesives by Continuous, Sequential Quinone Methide Elimination Reactions.

Adhesives that selectively debond from a surface by stimuli-induced head-to-tail continuous depolymerization of poly(benzyl ether) macro-cross-linkers within a poly(norbornene) matrix are described. Continuous head-to-tail depolymerization provides faster rates of response than can be achieved using a small-molecule cross-linker, as well as responses to lower stimulus concentrations. Shear-stress values for glass held together by the adhesive reach 0.51±0.10 MPa, whereas signal-induced depolymerization via quinone methide intermediates reduces the shear stress values to 0.05±0.02 MPa. Changing the length of the macro-cross-linkers alters the time required for debonding, and thus enables the programmed sequential release of specific layers in a glass composite material.

Adaptive use of bubble wrap for storing liquid samples and performing analytical assays.

This paper demonstrates that the gas-filled compartments in the packing material commonly called "bubble wrap" can be repurposed in resource-limited regions as containers to store liquid samples, and to perform bioanalyses. The bubbles of bubble wrap are easily filled by injecting the samples into them using a syringe with a needle or a pipet tip, and then sealing the hole with nail hardener. The bubbles are transparent in the visible range of the spectrum, and can be used as "cuvettes" for absorbance and fluorescence measurements. The interiors of these bubbles are sterile and allow storage of samples without the need for expensive sterilization equipment. The bubbles are also permeable to gases, and can be used to culture and store micro-organisms. By incorporating carbon electrodes, these bubbles can be used as electrochemical cells. This paper demonstrates the capabilities of the bubbles by culturing E. coli, growing C. elegans, measuring glucose and hemoglobin spectrophotometrically, and measuring ferrocyanide electrochemically, all within the bubbles.

Enhancing the revenue cycle experience for patients.

In 2013, Texas Health Resources began to record discussions with patients at each revenue cycle touch point, from scheduling through registration. The recordings give leaders insight on the accuracy and consistency of information communicated at each touch point and provide a tool for improving customer service. The initiative has improved patient satisfaction and increased point-of-service collections.