Frequency of cannabis and illicit opioid use among people who use drugs and report chronic pain: A longitudinal analysis.

BACKGROUND:Ecological research suggests that increased access to cannabis may facilitate reductions in opioid use and harms, and medical cannabis patients describe the substitution of opioids with cannabis for pain management. However, there is a lack of research using individual-level data to explore this question. We aimed to investigate the longitudinal association between frequency of cannabis use and illicit opioid use among people who use drugs (PWUD) experiencing chronic pain. METHODS AND FINDINGS:This study included data from people in 2 prospective cohorts of PWUD in Vancouver, Canada, who reported major or persistent pain from June 1, 2014, to December 1, 2017 (n = 1,152). We used descriptive statistics to examine reasons for cannabis use and a multivariable generalized linear mixed-effects model to estimate the relationship between daily (once or more per day) cannabis use and daily illicit opioid use. There were 424 (36.8%) women in the study, and the median age at baseline was 49.3 years (IQR 42.3-54.9). In total, 455 (40%) reported daily illicit opioid use, and 410 (36%) reported daily cannabis use during at least one 6-month follow-up period. The most commonly reported therapeutic reasons for cannabis use were pain (36%), sleep (35%), stress (31%), and nausea (30%). After adjusting for demographic characteristics, substance use, and health-related factors, daily cannabis use was associated with significantly lower odds of daily illicit opioid use (adjusted odds ratio 0.50, 95% CI 0.34-0.74, p < 0.001). Limitations of the study included self-reported measures of substance use and chronic pain, and a lack of data for cannabis preparations, dosages, and modes of administration. CONCLUSIONS:We observed an independent negative association between frequent cannabis use and frequent illicit opioid use among PWUD with chronic pain. These findings provide longitudinal observational evidence that cannabis may serve as an adjunct to or substitute for illicit opioid use among PWUD with chronic pain

Evaluation of a Head-Worn Display with Ambient Vision Cues for Unusual Attitude Recovery

A Commercial Aviation Safety Team (CAST) study of 18 loss-of-control events determined that a lack of external visual references was a contributing factor in 17 of these events. CAST recommended that manufacturers should develop and implement virtual day-VMC display systems, such as synthetic vision (SV) or equivalent systems (CAST Safety Enhancement, SE-200). In support of this recommended action, CAST has requested studies to define minimum requirements for virtual day-visual meteorological conditions (VMC) displays to improve flight crew awareness of airplane attitude. NASAs research in Virtual day-VMC displays, known as synthetic vision systems, are intended to support intuitive flight crew attitude awareness similar to a day-VMC-like environment, especially if they could be designed to create visual dominance. A study was conducted to evaluate the utility of ambient vision (AV) cues paired with virtual Head-Up Display (HUD) symbology on a prototype head-worn display (HWD) during recovery from unusual attitudes in a simulated environment. The virtual-HUD component meets the requirement that the HWD may be used as an equivalent display to the HUD. The presence of AV cueing leverages the potential that a HWD has over the HUD for spatial disorientation prevention. The simulation study was conducted as a single-pilot operation, under realistic flight scenarios, with off-nominal events occurring that were capable of inducing unusual attitudes. Independent variables of the experiment included: 1) AV capability (on vs off) 2) AV display opaqueness (transparent vs opaque) and display location (HWD vs traditional head- down displays); AV cues were only present when the HWD was being worn by the subject pilot

The Challenges of Projecting the Public Health Impacts of Marijuana Legalization in Canada Comment on “Legalizing and Regulating Marijuana in Canada: Review of Potential Economic, Social, and Health Impacts”

A recent editorial in this journal provides a summary of key economic, social, and public health considerations of the forthcoming legislation to legalize, regulate, and restrict access to marijuana in Canada. As our government plans to implement an evidence-based public health framework for marijuana legalization, we reflect and expand on recent discussions of the public health implications of marijuana legalization, and offer additional points of consideration. We select two commonly cited public concerns of marijuana legalization – adolescent usage and impaired driving – and discuss how the underdeveloped and equivocal body of scientific literature surrounding these issues limits the ability to predict the effects of legalization. Finally, we discuss the potential for some potential public health benefits of marijuana legalization – specifically the potential for marijuana to be used as a substitute to opioids and other risky substance use – that have to date not received adequate attention

Disorientation Research Device Testing of Synthetic Vision Display Technologies

A Commercial Aviation Safety Team (CAST) study of 18 worldwide loss-of control accidents and incidents determined that the lack of external visual references was associated with a flight crew’s loss of attitude awareness or energy state awareness in 17 of these events. CAST recommended development and implementation of virtual day-Visual Meteorological Condition (VMC) display systems, such as synthetic vision systems, to promote flight crew attitude awareness similar to a day-VMC environment. This paper describes the results of a joint NASA/NAMRU-D study that evaluated virtual day-VMC displays and a “background attitude indicator” concept as an aid to pilots in recovery from unusual attitudes. Experimental results and future research directions under this CAST initiative and the NASA “Technologies for Airplane State Awareness” research project are described

Regular MDMA Use is Associated with Decreased Risk of Drug Injection Among Street-Involved Youth Who Use Illicit Drugs.

OBJECTIVES: Childhood trauma is common among street-involved youth and is associated with injection drug use. Illicit 3,4-Methylenedioxymethamphetamine (MDMA) use is also common among street-involved youth, and data suggest this substance has clinical utility in management of post-traumatic stress disorder (PTSD) and associated harms. Despite this, little is known about co-occurring patterns of MDMA use and injection drug use. METHODS: Data were derived from a prospective cohort of street-involved youth using illicit drugs in Vancouver, Canada. Using multivariable generalized estimating equation logistic regression, we examined the association between MDMA use and the use of injection drugs, adjusting for confounders such as polysubstance use and sociodemographic factors. RESULTS: 4941 surveys from 1208 participants between September 2005 and May 2015 were included. Of these, 829 (68.6%) were male, 815 (67.5%) reported white ethnicity, and median age was 21.7 years. Overall, 599 (49.6%) participants reported MDMA use, 544 (45.0%) reported injection drug use, and 244 (20.2%) reported concurrent MDMA and injection drug use at least once during the study period. In multivariable analyses, regular MDMA use was significantly negatively associated with injection drug use (Adjusted Odds Ratio [AOR] = 0.57, 95% CI: 0.46-0.69). DISCUSSION: After accounting for socio-demographic factors and polysubstance use, periods of reported regular MDMA use were negatively associated with reported injection drug use among this cohort. These findings suggest that, unlike the use of most other non-injection drugs, illicit MDMA use does not appear to promote injection drug use but rather is associated with a reduced likelihood of injection drug use

Food insecurity during pregnancy in high-income countries, and maternal weight and diet: a systematic review and meta-analysis

Food insecurity is a well-established obesity driver. Less is known about food insecurity in pregnancy. This review (PROSPERO:CRD42022311669) aimed to explore associations between food insecurity, maternal obesity, gestational weight gain (GWG) and nutrition. Searches included seven databases, grey literature, references, citations, and contacting authors. Observational studies reporting data from January 1st 2008 to 21 November 2023 in high-income countries were included. Duplicate screening, data extraction and quality assessments were performed. Random effects meta-analysis estimated odds ratios (OR), mean difference (MD) and 95% confidence intervals (CI). Narrative synthesis was conducted when data could not be pooled. Database searches identified 22,272 results; 20 studies were included (n=19 North America, n=1 Europe; n=32,803 women). Food insecurity significantly increased obesity (OR 1.53 95%CI 1.39, 1.66), but not underweight (OR 1.12 95%CI 0.89, 1.34) or overweight (OR 1.18 95%CI 0.90, 1.46). Food insecurity significantly reduced GWG (MD -0.42kg 95%CI -0.62, -0.22) and increased inadequate GWG (OR 1.16 95%CI 1.05, 1.28), but not excessive GWG (OR 1.04 95%CI 0.96, 1.13). Diet outcomes were inconsistent, with some evidence of reduced vitamin E and diet quality and increased red/processed meat consumption. Further studies outside of North America are needed to inform practice and policy to support maternal health

Use of Nanofibers to Strengthen Hydrogels of Silica, Other Oxides, and Aerogels

Research has shown that including up to 5 percent w/w carbon nanofibers in a silica backbone of polymer crosslinked aerogels improves its strength, tripling compressive modulus and increasing tensile stress-at-break five-fold with no increase in density or decrease in porosity. In addition, the initial silica hydrogels, which are produced as a first step in manufacturing the aerogels, can be quite fragile and difficult to handle before cross-linking. The addition of the carbon nanofiber also improves the strength of the initial hydrogels before cross-linking, improving the manufacturing process. This can also be extended to other oxide aerogels, such as alumina or aluminosilicates, and other nanofiber types, such as silicon carbide

Magnetic Ordering in a Vanadium-Organic Coordination Polymer Using a Pyrrolo[2,3-\u3cem\u3ed\u3c/em\u3e:5,4-\u3cem\u3ed\u27\u3c/em\u3e]bis(thiazole)-Based Ligand

Here we present the synthesis and characterization of a hybrid vanadium-organic coordination polymer with robust magnetic order, a Curie temperature TC of ∼110 K, a coercive field of ∼5 Oe at 5 K, and a maximum mass magnetization of about half that of the benchmark ferrimagnetic vanadium(tetracyanoethylene)~2 (V·(TCNE)~2). This material was prepared using a new tetracyano-substituted quinoidal organic small molecule 7 based on a tricyclic heterocycle 4-hexyl-4H-pyrrolo[2,3-d:5,4-d′]bis(thiazole) (C6-PBTz). Single crystal X-ray diffraction of the 2,6-diiodo derivative of the parent C6-PBTz, showed a disordered hexyl chain and a nearly linear arrangement of the substituents in positions 2 and 6 of the tricyclic core. Density functional theory (DFT) calculations indicate that C6-PBTz-based ligand 7 is a strong acceptor with an electron affinity larger than that of TCNE and several other ligands previously used in molecular magnets. This effect is due in part to the electron-deficient thiazole rings and extended delocalization of the frontier molecular orbitals. The ligand detailed in this study, a representative example of fused heterocycle aromatic cores with extended π conjugation, introduces new opportunities for structure–magnetic-property correlation studies where the chemistry of the tricyclic heterocycles can modulate the electronic properties and the substituent at the central N-position can vary the spatial characteristics of the magnetic polymer

Urinary eicosanoid metabolites in HIV-infected women with central obesity switching to raltegravir: an analysis from the women, integrase, and fat accumulation trial.

Chronic inflammation is a hallmark of HIV infection. Eicosanoids reflect inflammation, oxidant stress, and vascular health and vary by sex and metabolic parameters. Raltegravir (RAL) is an HIV-1 integrase inhibitor that may have limited metabolic effects. We assessed urinary F2-isoprostanes (F2-IsoPs), prostaglandin E2 (PGE-M), prostacyclin (PGI-M), and thromboxane B2 (TxB2) in HIV-infected women switching to RAL-containing antiretroviral therapy (ART). Thirty-seven women (RAL = 17; PI/NNRTI = 20) with a median age of 43 years and BMI 32 kg/m(2) completed week 24. TxB2 increased in the RAL versus PI/NNRTI arm (+0.09 versus -0.02; P = 0.06). Baseline PGI-M was lower in the RAL arm (P = 0.005); no other between-arm cross-sectional differences were observed. In the PI/NNRTI arm, 24-week visceral adipose tissue change correlated with PGI-M (rho = 0.45; P = 0.04) and TxB2 (rho = 0.44; P = 0.005) changes, with a trend seen for PGE-M (rho = 0.41; P = 0.07). In an adjusted model, age ≥ 50 years (N = 8) was associated with increased PGE-M (P = 0.04). In this randomized trial, a switch to RAL did not significantly affect urinary eicosanoids over 24 weeks. In women continuing PI/NNRTI, increased visceral adipose tissue correlated with increased PGI-M and PGE-M. Older age (≥ 50) was associated with increased PGE-M. Relationships between aging, adiposity, ART, and eicosanoids during HIV-infection require further study

Food insecurity in adults with severe mental illness living in Northern England: Peer research interview findings

Food insecurity means that a person does not have access to sufficient nutritiousfood for normal growth and health. Food insecurity can lead to many healthproblems such as obesity, heart disease, diabetes, and other long term healthconditions. People living with a severe mental illness are more likely to experiencefood insecurity than people without mental illness. Peer-ledin-depthinterviewswere conducted with adults with severe mental illness from Northern England,during which their experiences of food insecurity and strategies to tackle foodinsecurity were discussed. Interviews took place between March and December2022, with interviews being transcribed and analysed using deductive andinductive thematic analysis. Thirteen interviews were conducted, finding that foodinsecurity in adults with severe mental illness was often a long-standingissue.Unemployment, the cost-of-livingcrisis and fuel poverty impacted on experiencesof food insecurity. Difficulties accessing food banks such as transport, stigma,and the limited selection of available food was also discussed. Strategies to tacklefood insecurity centred on making food banks more accessible and improving thequality of available food. Future research should aim to eradicate food insecurityfor adults with severe mental illness, as limited research and action focuses onthis population group over and above ‘mental illness’ or ‘poor mental health’.Removing barriers to accessing food such as lack of transport, and providing foodwhich is of adequate nutritional quality, should be prioritised, as well as tacklingthe stigma and accessibility issues surrounding food banks use