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Background A 239-question cross-sectional survey was sent out via email in January 2017 to gather comprehensive information on cannabis use from Canadian medical cannabis patients registered with a federally authorized licensed cannabis producer, resulting in 2032 complete surveys. Methods The survey gathered detailed demographic data and comprehensive information on patient patterns of medical cannabis use, including questions assessing the self-reported impact of cannabis on the use of prescription drugs, illicit substances, alcohol, and tobacco. Results Participants were 62.6% male ( n  = 1271) and 91% Caucasian ( n  = 1839). The mean age was 40 years old, and pain and mental health conditions accounted for 83.7% of all respondents ( n  = 1700). Then, 74.6% of respondents reported daily cannabis use ( n  = 1515) and mean amount used per day was 1.5 g. The most commonly cited substitution was for prescription drugs (69.1%, n  = 953), followed by alcohol (44.5%, n  = 515), tobacco (31.1%, n  = 406), and illicit substances (26.6%, n  = 136). Opioid medications accounted for 35.3% of all prescription drug substitution ( n  = 610), followed by antidepressants (21.5%, n  = 371). Of the 610 mentions of specific opioid medications, patients report total cessation of use of 59.3% ( n  = 362). Conclusions This study offers a unique perspective by focusing on the use of a standardized, government-regulated source of medical cannabis by patients registered in Canada’s federal medical cannabis program. The findings provide a granular view of patient patterns of medical cannabis use, and the subsequent self-reported impacts on the use of opioids, alcohol, and other substances, adding to a growing body of academic research suggesting that increased regulated access to medical and recreational cannabis can result in a reduction in the use of and subsequent harms associated with opioids, alcohol, tobacco, and other substances.

The Autoimmune Connection explains the links between autoimmune diseases and offers up-to-date information on diagnosis, treatments, and risks for women with one or more autoimmune disease, such as lupus, rheumatoid arthritis, or Crohn's disease.

BackgroundMedicinal cannabis registries typically report pain as the most common reason for use. It would be clinically useful to identify patterns of cannabis treatment in migraine and headache, as compared to arthritis and chronic pain, and to analyze preferred cannabis strains, biochemical profiles, and prescription medication substitutions with cannabis.MethodsVia electronic survey in medicinal cannabis patients with headache, arthritis, and chronic pain, demographics and patterns of cannabis use including methods, frequency, quantity, preferred strains, cannabinoid and terpene profiles, and prescription substitutions were recorded. Cannabis use for migraine among headache patients was assessed via the ID Migraine™ questionnaire, a validated screen used to predict the probability of migraine.ResultsOf 2032 patients, 21 illnesses were treated with cannabis. Pain syndromes accounted for 42.4% (n = 861) overall; chronic pain 29.4% (n = 598;), arthritis 9.3% (n = 188), and headache 3.7% (n = 75;). Across all 21 illnesses, headache was a symptom treated with cannabis in 24.9% (n = 505). These patients were given the ID Migraine™ questionnaire, with 68% (n = 343) giving 3 “Yes” responses, 20% (n = 102) giving 2 “Yes” responses (97% and 93% probability of migraine, respectively). Therefore, 88% (n = 445) of headache patients were treating probable migraine with cannabis. Hybrid strains were most preferred across all pain subtypes, with “OG Shark” the most preferred strain in the ID Migraine™ and headache groups. Many pain patients substituted prescription medications with cannabis (41.2–59.5%), most commonly opiates/opioids (40.5–72.8%). Prescription substitution in headache patients included opiates/opioids (43.4%), anti-depressant/anti-anxiety (39%), NSAIDs (21%), triptans (8.1%), anti-convulsants (7.7%), muscle relaxers (7%), ergots (0.4%).ConclusionsChronic pain was the most common reason for cannabis use, consistent with most registries. The majority of headache patients treating with cannabis were positive for migraine. Hybrid strains were preferred in ID Migraine™, headache, and most pain groups, with “OG Shark”, a high THC (Δ9-tetrahydrocannabinol)/THCA (tetrahydrocannabinolic acid), low CBD (cannabidiol)/CBDA (cannabidiolic acid), strain with predominant terpenes β-caryophyllene and β-myrcene, most preferred in the headache and ID Migraine™ groups. This could reflect the potent analgesic, anti-inflammatory, and anti-emetic properties of THC, with anti-inflammatory and analgesic properties of β-caryophyllene and β-myrcene. Opiates/opioids were most commonly substituted with cannabis. Prospective studies are needed, but results may provide early insight into optimizing crossbred cannabis strains, synergistic biochemical profiles, dosing, and patterns of use in the treatment of headache, migraine, and chronic pain syndromes.

In his paper “The Mumford dynamical system and hyperelliptic Kleinian functions” [Funkts. Anal. Prilozhen. 57 (4), 27–45 (2023)] Victor Buchstaber developed the differential-algebraic theory of the Mumford dynamical system. The key object of this theory is the -recursion introduced in his paper. In the present paper, we further develop the theory of the -recursion and describe its connections to the Korteweg–de Vries hierarchy, the Lenard operator, and the Gelfand–Dikii recursion.

Dissolved organic carbon (DOC) trends, predominantly showing long-term increases in concentration, have been observed across many regions of the Northern Hemisphere. Elevated DOC concentrations are a major concern for drinking water treatment plants, owing to the effects of disinfection byproduct formation, the risk of bacterial regrowth in water distribution systems, and treatment cost increases. Using a unique 30-year data set encompassing both extreme wet and dry conditions in a eutrophic drinking water reservoir in the Great Plains of North America, we investigate the effects of changing source-water and in-lake water chemistry on DOC. We employ novel wavelet coherence analyses to explore the coherence of changes in DOC with other environmental variables and apply a generalized additive model to understand predictor–DOC responses. We found that the DOC concentration was significantly coherent with (and lagging behind) flow from a large upstream mesotrophic reservoir at long (> 18-month) timescales. DOC was also coherent with (lagging behind) sulfate and in phase with total phosphorus, ammonium, and chlorophyll a concentrations at short (≤ 18-month) timescales across the 30-year record. These variables accounted for 56 % of the deviance in DOC from 1990 to 2019, suggesting that water-source and in-lake nutrient and solute chemistry are effective predictors of the DOC concentration. Clearly, climate and changes in water and catchment management will influence source-water quality in this already water-scarce region. Our results highlight the importance of flow management to shallow eutrophic reservoirs; wet periods can exacerbate water quality issues, and these effects can be compounded by reducing inflows from systems with lower DOC. These flow management decisions address water level and flood risk concerns but also have important impacts on drinking water treatability.

Although the links between stratospheric dynamics, climate and weather have been demonstrated, direct observations of stratospheric winds are lacking, in particular at altitudes above 30 km. We report observations of winds between 8 and 0.01 hPa (~35–80 km) from October 2009 to April 2010 by the Superconducting Submillimeter-Wave Limb-Emission Sounder (SMILES) on the International Space Station. The altitude range covers the region between 35–60 km where previous space-borne wind instruments show a lack of sensitivity. Both zonal and meridional wind components were obtained, though not simultaneously, in the latitude range from 30° S to 55° N and with a single profile precision of 7–9 m s–1 between 8 and 0.6 hPa and better than 20 m s–1 at altitudes above. The vertical resolution is 5–7 km except in the upper part of the retrieval range (10 km at 0.01 hPa). In the region between 1–0.05 hPa, an absolute value of the mean difference < 2 m s–1 is found between SMILES profiles retrieved from different spectroscopic lines and instrumental settings. Good agreement (absolute value of the mean difference of ~2 m s–1) is also found with the European Centre for Medium-Range Weather Forecasts (ECMWF) analysis in most of the stratosphere except for the zonal winds over the equator (difference > 5 m s−1). In the mesosphere, SMILES and ECMWF zonal winds exhibit large differences (> 20 m s–1), especially in the tropics. We illustrate our results by showing daily and monthly zonal wind variations, namely the semi-annual oscillation in the tropics and reversals of the flow direction between 50–55° N during sudden stratospheric warmings. The daily comparison with ECMWF winds reveals that in the beginning of February, a significantly stronger zonal westward flow is measured in the tropics at 2 hPa compared to the flow computed in the analysis (difference of ~20 m s–1). The results show that the comparison between SMILES and ECMWF winds is not only relevant for the quality assessment of the new SMILES winds, but it also provides insights on the quality of the ECMWF winds themselves. Although the instrument was not specifically designed for measuring winds, the results demonstrate that space-borne sub-mm wave radiometers have the potential to provide good quality data for improving the stratospheric winds in atmospheric models.

•  Background •  Search strategies •  Haematopoietic growth factors •  Granulocyte colony‐stimulating factor ‐  G‐CSF and experimental stroke ‐  G‐CSF and human stroke ‐  Ongoing studies ‐  Current evidence and future perspectives •  Erythropoietin ‐  EPO and experimental stroke ‐  EPO and human stroke ‐  Ongoing studies ‐  Current evidence and future perspectives •  Granulocyte‐macrophage colony‐stimulating factor ‐  GM‐CSF and experimental stroke ‐  GM‐CSF and human stroke ‐  Current evidence and future perspectives •  Vascular endothelial growth factor ‐  VEGF and experimental stroke ‐  VEGF and human stroke ‐  Ongoing studies ‐  Current evidence and future perspectives •  Stromal cell‐derived factor‐1 ‐  SDF‐1 in experimental stroke ‐  Current evidence and future perspectives •  Stem cell factor ‐  Current evidence and future perspectives •  Other growth factors: neurotrophins ‐  Brain–derived neurotrophic factor ‐  Current evidence and future perspectives ‐  Basic fibroblast growth factor ‐  Current evidence and future perspectives ‐  Insulin‐like growth factor 1 ‐  Current evidence and future perspectives ‐  Glial cell line‐derived neurotrophic factor ‐  Current evidence and future perspectives ‐  Heparin‐binding EGF‐like growth factor ‐  Current evidence and future perspectives •  Discussion Data from pre‐clinical and clinical studies provide evidence that colony‐stimulating factors (CSFs) and other growth factors (GFs) can improve stroke outcome by reducing stroke damage through their anti‐apoptotic and anti‐inflammatory effects, and by promoting angiogenesis and neurogenesis. This review provides a critical and up‐to‐date literature review on CSF use in stroke. We searched for experimental and clinical studies on haemopoietic GFs such as granulocyte CSF, erythropoietin, granulocyte‐macrophage colony‐stimulating factor, stem cell factor (SCF), vascular endothelial GF, stromal cell‐derived factor‐1α and SCF in ischemic stroke. We also considered studies on insulin‐like growth factor‐1 and neurotrophins. Despite promising results from animal models, the lack of data in human beings hampers efficacy assessments of GFs on stroke outcome. We provide a comprehensive and critical view of the present knowledge about GFs and stroke, and an overview of ongoing and future prospects.

Stratospheric Inferred Winds (SIW) is a Swedish mini sub-millimeter limb sounder selected for the 2nd InnoSat platform, with launch planned for around 2022. It is intended to fill the altitude gap between 30 and 70 km in atmospheric wind measurements and also aims at pursuing the limb observations of temperature and key atmospheric constituents between 10 and 90 km when current satellite missions will probably come to an end. Line-of-sight winds are retrieved from the Doppler shift of molecular emission lines introduced by the wind field. Observations will be performed with two antennas pointing toward the limb in perpendicular directions in order to reconstruct the 2-D horizontal wind vector. Each antenna has a vertical field of view (FOV) of 5 km. The chosen spectral band, near 655 GHz, contains a dense group of strong O3 lines suitable for exploiting the small amount of wind information in stratospheric spectra. Using both sidebands of the heterodyne receiver, a large number of chemical species will be measured, including O3 isotopologues, H2O, HDO, HCl, ClO, N2O, HNO3, NO, NO2, HCN, CH3CN and HO2. This paper presents a simulation study that assesses measurement performance. The line-of-sight winds are retrieved between 30 and 90 km with the best sensitivity between 35 and 70 km, where the precision (1σ) is 5–10 m s−1 for a single scan. Similar performance can be obtained during day and night conditions except in the lower mesosphere, where the photo-dissociation of O3 in daytime reduces the sensitivity by 50 % near 70 km. Profiles of O3, H2O and temperature are retrieved with high precision up to 50 km ( < 1 %,  < 2 %, 1 K, respectively). Systematic errors due to uncertainties in spectroscopic parameters, in the radiometer sideband ratio and in the radiance calibration process are investigated. A large wind retrieval bias of 10–30 m s−1 between 30 and 40 km could be induced by the air-broadening parameter uncertainties of O3 lines. This highlights the need for good knowledge of these parameters and for studying methods to mitigate the retrieval bias.

ObjectiveTo perform an external validation of this RC-pentafecta.MethodBetween January 2014 and December 2019, 104 consecutive patients who underwent RARC with ICUD within 6 urological centers were analyzed retrospectively. Patients who simultaneously demonstrated negative soft tissue surgical margins (STSMs), a lymph node (LN) yield ≥ 16, absence of major (Clavien–Dindo grade III–V) 90-day postoperative complications, absence of UD-related long-term sequelae, and absence of 12-month clinical recurrence were considered to have achieved RC-pentafecta. A multivariable logistic regression model was used to measure predictors for achieving RC-pentafecta. We analyzed the influence of this RC-pentafecta on survival, and the impact ofthe surgical experience.ResultsSince 2014, 104 patients who had completed at least 12 months of follow-up were included. Over a mean follow-up of 18 months, a LN yield ≥ 16, negative STSMs, absence of major complications at 90 days, and absence of UD-related surgical sequelae and clinical recurrence at ≤ 12 months were observed in 56%, 96%, 85%, 81%, and 91% of patients, respectively, resulting in a RC-pentafecta rate of 39.4%. Multivariate analysis showed that age was an independent predictor of pentafecta achievement (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.90. 0.99; p = 0.04). The surgeon experience had an impact on the validation of the criteria.ConclusionThis study confirmed that the RC-pentafecta is reproducible and could be externally used for the outcome assessment after RARC with ICUD. Therefore, the RC-pentafecta could be a useful tool to assess surgical success and its impact on different outcomes.