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As cannabinoid-based medications gain popularity in the treatment of refractory medical conditions, it is crucial to examine the neurocognitive effects of commonly prescribed products to ensure associated safety profiles. The present study aims to investigate the acute effects of a standard 1 mL sublingual dose of CannEpil®, a medicinal cannabis oil containing 100 mg cannabidiol (CBD) and 5 mg Δ9-tetrahydrocannabinol (THC) on neurocognition, attention, and mood. A randomised, double-blind, placebo-controlled, within-subjects design assessed 31 healthy participants (16 female, 15 male), aged between 21 and 58 years, over a two-week experimental protocol. Neurocognitive performance outcomes were assessed using the Cambridge Neuropsychological Test Automated Battery, with the Profile of Mood States questionnaire, and the Bond-Lader Visual Analogue Scale used to assess subjective state and mood. CannEpil increased Total Errors in Spatial Span and Correct Latency (median) in Pattern Recognition Memory, while also increasing Efficiency Score (lower score indicates greater efficiency) relative to placebo (all p <.05). Subjective Contentedness (p <.01) and Amicability (p <.05) were also increased at around 2.5 h post dosing, relative to placebo. Drowsiness or sedative effect was reported by 23 % of participants between three to six hours post CannEpil administration. Plasma concentrations of CBD, THC, and their metabolites were not significantly correlated with any observed alterations in neurocognition, subjective state, or adverse event occurrence. An acute dose of CannEpil impairs select aspects of visuospatial working memory and delayed pattern recognition, while largely preserving mood states among healthy individuals. Intermittent reports of drowsiness and sedation underscore the inter-individual variability of medicinal cannabis effects on subjective state. (ANZCTR; ACTRN12619000932167; https://www.anzctr.org.au) [ABSTRACT FROM AUTHOR]

Cannabis use may increase the risk of self-harm, but whether legalization of cannabis is associated with changes in self-harm is unknown. We examined changes in cannabis-involvement in emergency department (ED) visits for self-harm after the liberalization of medical and legalization of non-medical cannabis in Canada. This repeated cross-sectional study used health administrative data to identify all ED visits for self-harm in individuals aged ten and older between January 2010 and December 2021. We identified self-harm ED visits with a co-diagnosis of cannabis (main exposure) or alcohol (control condition) and examined changes in rates of visits over four distinct policy periods (pre-legalization, medical liberalization, non-medical legalization with restrictions, and non-medical commercialization/COVID-19) using Poisson models. The study included 158,912 individuals with one or more self-harm ED visits, of which 7810 (4.9 %) individuals had a co-diagnosis of cannabis use and 24,761 (15.6 %) had a co-diagnosis of alcohol use. Between 2010 and 2021, the annual rate of ED visits for self-harm injuries involving cannabis per 100,000 individuals increased by 90.1 % (3.6 in 2010 to 6.9 in 2021 per 100,000 individuals), while the annual rate of self-harm injuries involving alcohol decreased by 17.3 % (168.1 in 2010 to 153.1 in 2021 per 100,000 individuals). The entire increase in visits relative to pre-legalization occurred after medical liberalization (seasonally adjusted Risk Ratio [a s RR] 1.71 95 % CI 1.09–1.15) with no further increases during the legalization with restrictions (a s RR 1.77 95%CI 1.62–1.93) or commercialization/COVID-19 periods (a s RR 1.63 95%CI 1.50–176). Cannabis-involvement in self-harm ED visits almost doubled over 12 years and may have accelerated after medical cannabis liberalization. While the results cannot determine whether cannabis is increasingly causing self-harm ED visits or whether cannabis is increasingly being used by individuals at high risk of self-harm, greater detection for cannabis use in this population and intervention may be indicated. • Of the 158,912 self-harm ED visits in Ontario, Canada between 2010 and 2021, 4.9 % involved cannabis. • The annual rate of self-harm ED visits with cannabis involvement increased by 90.1 %. • Medical cannabis liberalization was associated with these increases. [ABSTRACT FROM AUTHOR]

Children receiving palliative care have life-limiting or life-threatening conditions, which include symptoms ranging from unpleasant to intolerable suffering. We describe three diverse cases of medical marijuana within ambulatory pediatric palliative care, highlighting use for spasticity, refractory seizures, and cancer-related symptoms. Included are caregiver perspectives of their child's experience with medical marijuana. This population has high potential for positive effects from medical marijuana therapy, particularly for maximizing quality of life. [ABSTRACT FROM AUTHOR]

Despite evidence showing that recreational cannabis use is associated with a higher risk of psychotic disorders, this risk has not been well characterized for patients using medical cannabis. Therefore, this study assessed the risk of emergency department (ED) visits and hospitalization for psychotic disorders (the study outcome) among adult patients authorized to use medical cannabis. We performed a retrospective cohort study on patients authorized to use medical cannabis in a group of Ontario cannabis clinics between 2014 and 2019. Using clinical and health administrative data, each patient was matched by propensity scores to up to 3 population-based controls. Conditional Cox proportional hazards regressions were used to assess the risk. Among 54,006 cannabis patients matched to 161,265 controls, 39 % were aged ≤50 years, and 54 % were female. Incidence rates for psychotic disorders were 3.00/1000 person-years (95%CI: 2.72–3.32) in the cannabis group and 1.88/1000 person-years (1.75–2.03) in the control group. A significant association was observed, with an adjusted hazard ratio of 1.38 (95%CI: 1.19–1.60) in the total sample and 1.63 (1.40–1.91) in patients without previous psychotic disorders. The results suggest that cannabis authorization should include a benefit-risk assessment of psychotic disorders to minimize the risk of events requiring emergency attention. [ABSTRACT FROM AUTHOR]

Cannabis use for medical purposes is legalized across 39 states and the District of Columbia in the U.S. The objective of this study was to evaluate temporal trends and correlates of cannabis use for medical purposes in the U.S. Data from the 2013−2020 National Survey on Drug Use and Health were used. Since 2013, medical cannabis use has been assessed using a dichotomous question asking whether any medical cannabis use was recommended by a doctor among those who used cannabis in the past 12 months. A modified Poisson model was used to estimate the average annual percentage change in medical cannabis use from 2013 to 2020. The analyses were repeated for key sociodemographic and clinical subgroups. Data were analyzed from September to November 2022. The prevalence of U.S. residents using cannabis for medical purposes increased significantly from 1.2% in 2013–2014 to 2.5% in 2019–2020, with an average annual percentage change of 12.9% (95% CI=10.4, 15.5), and many of sociodemographic and clinical subgroups showed similar significant increases in cannabis use for medical purposes. In the multivariable-adjusted model, living in a state that legalized medical cannabis remained significantly associated with medical cannabis use (AOR=4.10; 95% CI=3.68, 4.56). The study documents a continued nationwide increase in the use of cannabis for diverse medical purposes between 2013 and 2020, two decades after the first state passed legalizing legislation. [ABSTRACT FROM AUTHOR]

• Almost half the sample reported driving immediately after consuming cannabis. • 26.8% of participants reported waiting a sufficient time to avoid drug driving. • 173,455 drug driving events were anticipated by the sample in the next year. • Medically prescribed users were willing to wait longer before driving. • Offending behaviours stem from a history of drug use, and a lack of perceived risk. This study aimed to explore the length of time cannabis users typically wait between drug consumption and driving a vehicle, and what factors influence such decisions. A total of 839 Australian cannabis users participated in an online survey (26.3% had a prescription for cannabis). Participants ranged in age between 18 years and 75 years (M = 43.3) and 38.2% were female. Driving immediately after consuming cannabis was reported by 41.6% of the sample and waiting 1 h was the next most common response (17%). About one-quarter of participants reported that they waited at least 4 h, thus driving at a time they may no longer be impaired (26.8%). Factors that predicted waiting less time included: a greater frequency of drug consumption (times per day and per month), earlier age of cannabis use onset, using cannabis without a prescription, reporting past-year driving within four hours of consuming cannabis with an illegal drug, and lower perceptions of risk related to driving after consuming cannabis. Participants were asked to report how many days in the next year they would drive within four hours of cannabis consumption, with the most common response being 365 days (37.9% of sample). Given cannabis use is likely to increase through impending decriminalisation and expansion of prescription access, identifying ways to educate cannabis users and extend the length of time they wait between consumption and driving is critical for road safety. [ABSTRACT FROM AUTHOR]

• Prospective study of 3554 patients starting cannabis treatment. • Patient characteristics failed to accurately predict the 6-month dose following the titration. • Higher THC doses was associated with improvements in pain and quality of life. • Sublingual therapy was associated with more side effects and less improvement in pain. • Higher CBD doses was associated with more side effects in the inhalation method. Medical cannabis is an increasingly prevalent treatment for a wide variety of indications, yet there is still no uniformly accepted protocol for the titration of cannabinoid doses. We aimed to develop a model to predict the stable THC and CBD dosages after six months of treatment using available baseline patient characteristics. In this prospective study, we included all consecutive adult patients (age 18 and above) who exclusively used a single method of cannabis delivery. Telephone interviews were conducted six months post-treatment initiation to assess changes in symptoms and side effects. We prospectively analyzed THC and CBD dosages with respect to demographic variables and patient characteristics in two main groups divided according to cannabis administration method – inhalation or sublingual oil. A total of 3,554 patients were included in the study (2,724 exclusively inhaled cannabis and 830 exclusively consumed cannabis as sublingual oil). The daily THC and CBD doses were significantly higher in the inhalation group than in the sublingual group (p <.001). None of the four models predicting THC and CBD doses in the two groups had satisfactory prediction ability (adjusted R-squared between 0.007 and 0.09). Male gender, unemployed status, tobacco smoking and a lack of concern about cannabis treatment were associated with a higher inhaled THC dose (p <.001). Models based on patient characteristics failed to accurately predict the final titration doses of CBD and THC for both inhalation and sublingual administration. Clinical guidelines should maintain a highly individual approach for cannabinoid dosing. [ABSTRACT FROM AUTHOR]

• Examined risk perceptions of driving under the influence of cannabis (DUIC) and alcohol (DUIA). • Compared perceptions of non-medical (ie. recreational) to medical or dual-purpose cannabis users. • Medical or dual-purpose users were more likely to agree that DUIC is safer than DUIA. • No difference found in perception that DUIC increases collision risk. • No difference found in perception that risk of police enforcement is higher for DUIA than DUIC. Reduced perception of potential harm resulting from cannabis use is associated with greater risk of driving under the influence of cannabis (DUIC). Understanding risk perceptions of DUIC among subgroups of users will positively inform targeting and content of anti-DUIC driver education and public awareness campaigns. The current study compared DUIC-related risk perceptions among individuals who use cannabis exclusively for non-medical purposes versus those who use cannabis for exclusively medical or for both medical and non-medical purposes (i.e., dual-purpose users). Data were drawn from a regionally stratified cross-sectional general population telephone survey of adults (18 + years) in Ontario, Canada conducted in 2017. Respondents who reported past-year use of cannabis and answered questions regarding DUIC risk perceptions were selected (weighted N = 343). Modified Poisson regression models with robust standard error estimation were conducted for three attitudes: disagree that DUIC increases motor vehicle collision risk, agree that DUIC is safer than driving under the influence of alcohol (DUIA), agree that chances of being caught by police for DUIA higher than DUIC. In addition to type of cannabis user (non-medical only versus medical or dual-purpose), covariates included demographic characteristics and past-year alcohol and cannabis use frequency. Adjusting for other covariates, regression analyses indicated that medical or dual-purpose cannabis users were 45 % more likely than non-medical users to agree that DUIC is safer than DUIA (Adjusted Prevalence Ratio = 1.45, 95 %CI = 1.10, 1.91, p = 0.007). No other differences in risk perception between medical or dual-purpose and non-medical cannabis users were found. Although no difference between medical or dual-purpose and non-medical cannabis users was found in perceptions of collision risk associated with DUIC or risk of police enforcement, the perception that DUIC is safer than DUIA was stronger among medical or dual-purpose than non-medical users. Recognizing that the shift in public perception of DUIA as a high-risk behaviour contributed to reductions in incidence of DUIA, results of the current study support education and awareness campaigns that target medical or dual-purpose users and emphasize that, like DUIA, DUIC is also a high-risk behaviour. [ABSTRACT FROM AUTHOR]

Many states have legalized medical cannabis with various reported therapeutic benefits. However, there is little data assessing the effects of cannabis on surgical outcomes. We sought to compare post-operative pancreatic resection complications between cannabis users and non-users. This is a single-center, retrospective review of patients who underwent Whipple or distal pancreatectomy from 1/2017-12/2020. The primary outcome was any in-hospital complication, using Clavien-Dindo. Multivariable regression analysis was performed. There were 486 patients who underwent Whipple (n=346, 71.2%) or distal pancreatectomy (n=140, 28.8%). Overall, 21.4% (n=104) reported cannabis use, of whom 80.8% were current users. Cannabis users were younger (60 vs. 66 years, p < 0.001), and more likely to have smoked tobacco (p=0.04), but otherwise had similar demographics as non-users. There were 288 (59.3%) patients who developed an in-hospital complication (grade 1–2, 75.3%; grade 3–5, 24.7%). A trend towards increased complications was observed with tobacco smoking (OR 1.33, 95% CI 0.91–1.94, p=0.14), but no association of cannabis use with complications was observed (OR 0.93, 95% CI 0.58–1.47 , p=0.74). A significant proportion of patients undergoing pancreatic resection report cannabis use. These results suggest that there was no association between cannabis use and post-operative complications, future prospective evaluation is warranted. [Display omitted] [ABSTRACT FROM AUTHOR]

• In the United States, hemp and marijuana are both Cannabis sativa, differentiated only by whether the plant on dry weight basis is above or below 0.3% Δ9-tetrahydrocannabinol (Δ9-THC). • Pod-based vaping products were devised for discreet vaping and originated in the cannabis industry. • Cannabis vaping is correlated with younger age, higher education, and higher income. • Thorough and transparent labelling of chemicals present in cannabis vaping products is not widespread industry practice. • A federally unregulated cannabis industry and variable state-to-state regulations has enabled low quality products to enter the marketplace which can lead to adverse events and consumer confusion. • Unified and enforced state regulations or federal regulations supported by quality testing and robust research are needed for consumer confidence and safety in cannabis vaping products. [ABSTRACT FROM AUTHOR]

The use of medical cannabis has rapidly increased among cancer patients worldwide. Cannabis is often administered concomitantly with cancer medications, including immune checkpoint inhibitors (ICIs). As the cannabinoid receptors are abundantly expressed and modulate immune cells, it has been hypothesised that cannabis may attenuate the activity of ICIs. We aimed to assess the effect of cannabis on ICIs' efficiency in patients having non-small cell lung cancer (NSCLC). The murine model of CT26 tumour-bearing mice treated with an anti-PD-1 antibody and Δ9-tetrahydrocannabinol (THC) was used to evaluate the interaction between THC and ICIs in vivo. Correlation between use of medical cannabis and clinical outcome was evaluated in a cohort of 201 consecutive metastatic NSCLC patients treated with monotherapy pembrolizumab as a first-line treatment. Median overall survival (OS) of the mice receiving a control vehicle, THC, anti-PD-1 antibody or their combination was 21, 24, 31 and 54 days, respectively (p < 0.05 for the combination treatment compared to a control vehicle), indicating that THC did not reduce the efficacy of anti-PD-1 therapy. Of 201 NSCLC patients treated with first-line monotherapy pembrolizumab for metastatic disease, 102 (50.7%) patients received licence for cannabis within the first month of treatment. Cannabis-treated patients were younger compared to the cannabis naïve patients (median age 68 versus 74, p = 0.003), with female predominance (62, 60.8% versus 34, 34.3%, p = 0.002) and with more prevailing brain metastasis (15.7% versus 5%, p = 0.013). Similar distribution of histology, smoking status, ECOG (Eastern Cooperative Oncology Group) and programmed death-ligand 1 expression was noted between the groups. Liver metastases were marginally significant (19.6% versus 10.1%, p = 0.058). The most common indication for cannabis was pain (71%) followed by loss of appetite (34.3%). Time to tumour progression was similar for cannabis-naive and cannabis-treated patients (6.1 versus 5.6 months, respectively, 95% confidence interval, 0.82 to 1.38, p = 0.386), while OS was numerically higher in the cannabis-naive group (54.9 versus 23.6 months) but did not reach statistical significance (95% confidence interval 0.99 to 2.51, p = 0.08). In multivariate analyses, we did not identify cannabis use as an independent predictor factor for mortality. Preclinical and clinical data suggest no deleterious effect of cannabis on the activity of pembrolizumab as first-line monotherapy for advanced NSCLC. The differences in OS can most likely be attributed to higher disease burden and more symptomatic disease in the cannabis-treated group. These data provide reassurance regarding the absence of a deleterious effect of cannabis in this clinical setting. • Cannabis might alter tumour's microenvironment and, hence, reduce the immune checkpoint inhibitors efficacy. • We investigate this theory in murine models and real-world data. • We found no determinantal effect of this combination in clinic or laboratory. • This conclusion has a great reassuring impact on our patients having non-small cell lung cancer. [ABSTRACT FROM AUTHOR]

Cannabis is increasingly accepted by medical organizations for medicinal and research purposes. A traceability system is required for monitoring and controlling the use of cannabis. This work aimed to investigate the relationship between critical success factors (CSFs) for creating the innovation framework that affects the implementation of the cannabis traceability system. These factors are identified based on the digital supply chain by structural modeling. Additionally, the issue of patients' safety is a crucial factor that needs to be considered. Total Interpretive Structural Modeling (TISM) and fuzzy MICMAC analysis techniques were applied to investigate the relationship between CSFs. Finally, the 14 CSFs affecting cannabis traceability systems were determined. The research results discovered that system reliability is the most significant key factor with the greatest influence and contribution to the achievement. The five CSFs based on TISM comprise harmonized strategic orientation, inter-organization collaboration, standardization, government regulations, and customer awareness. According to the conclusive dependence–driving power diagram, they have the most driving power in the implementation and operation traceability system. The innovation framework helps to establish the traceability system in a way that works well. This will build trust in the supply chain and prevent abuse and substandard products. [ABSTRACT FROM AUTHOR]

Context: Palliative care aims to improve the quality of life in patients with incurable illness. Medicinal cannabis (MC) has been used in the palliative care setting to address multiple symptoms in patients.Objectives: To evaluate the full scope of available literature investigating the effects and potential harms of MC on symptom management and quality of life in palliative care.Methods: PubMed, Embase, The Cochrane Library and clinicaltrials.gov were searched for eligible articles, published between 1960 and September 9, 2021. Quality of the evidence was assessed in accordance with Grading of Recommendations, Assessment, Development and Evaluations. Risk of bias was assessed using the RoB 2 tool for randomised controlled trials and the Risk of Bias in Non-randomized Studies-of Interventions (ROBINS-I) tool for non-randomized trials.Results: Fifty-two studies (20 randomised; 32 non-randomised) with 4786 participants diagnosed with cancer (n = 4491), dementia (n = 43), AIDS (n = 235), spasticity (n = 16), NORSE syndrome (n = 1) were included. The quality of evidence was 'very low' or 'low' for all studies, and low for only two randomised controlled trials. Positive treatment effects (statistical significance with P < 0.05) were seen for some MC products in pain, nausea and vomiting, appetite, sleep, fatigue, chemosensory perception and paraneoplastic night sweats in patients with cancer, appetite and agitation in patients with dementia and appetite, nausea and vomiting in patients with AIDS. Meta-analysis was unable to be performed due to the wide range of cannabis products used and the heterogeneity of the study outcomes.Conclusion: While positive treatment effects have been reported for some MC products in the palliative care setting, further high quality evidence is needed to support recommendations for its use in clinical practice. [ABSTRACT FROM AUTHOR]

Acute coronary syndrome (ACS) is the usual clinical entry point for coronary heart disease. France is the European country with the highest prevalence of cannabis use and an increase in serious cardiovascular complications, including infarction, related to cannabis. The main objective was to compare the clinical and cardiological profile of patients with ACS according to exposure to cannabis use. We conducted a retrospective, single-centre, exposure-non-exposure cohort study of all adult patients (> 18 years) admitted for ACS in the ICU between January 1, 2012 and December 31, 2021 at the Centre Hospitalier de Troyes, with mention of cannabis use in the medical record. A matching was performed so that each patient identified in the exposed group was associated with a comparable unexposed patient on age, sex, period of hospitalisation and cardiovascular event typology (type of ACS and topography for ST+). 2745 patients admitted to the ICU and the coronary angiography room presented an ST+ or ST− ACS from 01/01/2012 to 31/12/2021 at the CHT. For 31 patients of them (1.1%), we noted cannabis consumption, which concern 7,9% of SCA ST+ aged under 50. The link between cannabis use and ACS is established, but studies concerning the place of cannabis in the ACS pathway of an ICU are few in France. Our results show the interest of developing a specific pathway focused on the needs of patients and their specificities in post ACS management. [ABSTRACT FROM AUTHOR]

Introduction: On the basis of both scientific progress and popular lore, there is growing optimism in the therapeutic potential of cannabis (marijuana) and cannabinoid-based chemicals for movement disorders. There is also notable skepticism regarding the scientific basis for this therapeutic optimism and significant concerns regarding the safety and regulation of cannabinoid products, particularly those available without prescription.Methods: In recognition of the high interest and controversial nature of this subject, the meeting committee of the International Parkinson and Movement Disorders Society arranged for a talk on cannabis at the 2019 annual meeting's Controversies in Movement Disorders plenary session. This paper summarizes the highlights of this session.Results: The endocannabinoid system is strongly tied to motor function and dysfunction, with basic research suggesting several promising therapeutic targets related to cannabinoids for movement disorders. Clinical research on cannabinoids for motor and nonmotor symptoms in Parkinson's disease, Huntington's disease, Tourette's syndrome, dystonia, and other movement disorders to date are promising at best and inconclusive or negative at worst. Research in other populations suggest efficacy for common symptoms like pain. While social campaigns against recreational cannabinoid use focus on cognitive changes in adolescents, the long-term sequelae of regulated medical use in older adults with movement disorders is unknown. The overall risks of cannabinoids may be similar to other commonly used medications and include falls and apathy.Conclusion: Further research is greatly needed to better understand the actual clinical benefits and long-term side effects of medical cannabis products for movement disorders indications and populations. [ABSTRACT FROM AUTHOR]

Anacardium occidentale (cashew) tree gum is being used in several sectors, including the pharmaceutical sector. This gum has been explored more in the medical field by many previous researchers, but there is a big research gap regarding its thermal and mechanical properties. Therefore, this research is intended to reveal the thermal, chemical, and mechanical characteristics of Anacardium occidentale tree gum. The results obtained in this regard are then compared with certain properties of artificial resins. Thermal analysis is carried out using a thermogravimetric analyzer, and differential scanning calorimeter, elemental analysis is carried out using a scanning electron microscope and a micro-X-ray fluorescence analyzer; and mechanical tests are carried out using a nano-indentation tester and a universal testing machine. The pH of 4.76 shows that the gum is acidic in nature, and the peaks obtained from thermal analysis demonstrate that it doesn't have a melting point. The microhardness value, tensile strength, flexural strength, and compressive strength of cashew gum are 218.39 MPa, 1.667 MPa, 3.64 MPa, and 2.667 MPa, respectively. The obtained results show that, Anacardium occidentale tree gum has comparable thermal properties to those of artificial resins and other natural gums. • Cashew gum doesn't have a melting point according to STA analysis. • Micro X-ray Fluorescence Test can be considered as a complementary test for SEM/EDX. • Electrical resistivity and viscosity of cashew gum reduce with increasing temperature. • Cashew gum can be used in many applications due to its valuable mechanical properties. [ABSTRACT FROM AUTHOR]

Post-traumatic stress disorder (PTSD) refers to a chronic impairing psychiatric disorder occurring after exposure to the severe traumatic event. Studies have demonstrated that medicinal cannabis oil plays an important role in neuroprotection, but the mechanism by which it exerts anti-PTSD effects remains unclear. The chronic complex stress (CCS) simulating the conditions of long voyage stress for 4 weeks was used to establish the PTSD mice model. After that, behavioral tests were used to evaluate PTSD-like behaviors in mice. Mouse brain tissue index was detected and hematoxylin-eosin staining was used to assess pathological changes in the hippocampus. The indicators of cell apoptosis and the BDNF/TRPC6 signaling activation in the mice hippocampus were detected by western blotting or real-time quantitative reverse transcription PCR experiments. We established the PTSD mice model induced by CCS, which exhibited significant PTSD-like phenotypes, including increased anxiety-like and depression-like behaviors. Medicinal cannabis oil treatment significantly ameliorated PTSD-like behaviors and improved brain histomorphological abnormalities in CCS mice. Mechanistically, medicinal cannabis oil reduced CCS-induced cell apoptosis and enhanced the activation of BDNF/TRPC6 signaling pathway. We constructed a PTSD model with CCS and medicinal cannabis oil that significantly improved anxiety-like and depressive-like behaviors in CCS mice, which may play an anti-PTSD role by stimulating the BDNF/TRPC6 signaling pathway. [ABSTRACT FROM AUTHOR]

Medical cannabis is increasingly considered for palliation of pain, nausea/vomiting, anorexia, and other symptoms. We aimed to determine whether training in hospice and palliative medicine (HPM) adequately prepares fellows to counsel patients about medical cannabis. A previously validated questionnaire was adapted for HPM fellows. Domains included fellows' practices recommending cannabis and their knowledge of its effectiveness and risks compared with standard treatments. U.S. HPM fellowships were sent surveys in 2022 and 2023. Forty six programs participated, 123 fellows responded (response rate of 42%) including 69% female; 55% White, and 28% Asian. Of respondents, 65% reported receiving formal training regarding medical cannabis; 57% reported discussing medical cannabis with over five patients; 23% recommended medical cannabis to more than five patients in the preceding year. Only 19%, however, felt sufficiently informed to issue cannabis-related recommendations. HPM fellows with prior training were not more likely to feel sufficiently informed to discuss cannabis (RR: 1.17; 95% CI: 0.82–1.66) or to recommend cannabis to patients (RR: 2.05, 95% CI: 0.89–4.71). Fellows rate cannabis as equally or more effective than conventional treatments for the following symptoms: anorexia/cachexia (63%), nausea/vomiting (43%), pain (25%), and neuropathic pain (21%). Most HPM fellows report formal training in the use of medical cannabis. Over half of trainees reported discussing medical cannabis with patients, but few considered themselves sufficiently informed to make cannabis-related clinical recommendations. These results suggest both a need for expanded high-quality evidence for medical cannabis in palliative care and for improved formal education for HPM fellows. [ABSTRACT FROM AUTHOR]

The phytocomplex of Cannabis is made up of approximately 500 substances: terpeno-phenols metabolites, including Δ-9-tetrahydrocannabinol and cannabidiol, exhibit pharmacological activity. Medical Cannabis has several pharmacological potential applications, in particular in the management of chronic and neuropathic pain. In the literature, a few data are available concerning cannabis pharmacokinetics, efficacy and safety. Thus, aim of the present study was the evaluation of cannabinoid pharmacokinetics in a cohort of patients, with chronic and neuropathic pain, treated with inhaled medical cannabis and decoction, as a galenic preparation. In this study, 67 patients were enrolled. Dried flower tops with different THC and CBD concentrations were used: Bedrocan® medical cannabis with THC level standardized at 19% and with a CBD level below 1%, Bediol® medical cannabis with THC and CBD level standardized at similar concentration of 6.5% and 8%, respectively. Cannabis was administered as a decoction in 47 patients and inhaled in 11 patients. The blood withdrawn was obtained before the new dose administration at the steady state and metabolites plasma concentrations were measured with an UHPLC-MS/MS method. Statistically significant differences were found in cannabinoids plasma exposure between inhaled and oral administration of medical cannabis , between male and female and cigarette smokers. For the first time, differences in cannabinoid metabolites exposures between different galenic formulations were suggested in patients. Therapeutic drug monitoring could be useful to allow for dose adjustment, but further studies in larger cohorts of patients are required in order to confirm these data. [Display omitted] • Cannabis shows different pharmacological applications, in particular in the management of pain. • Cannabinoids pharmacokinetics description in patients with chronic and neuropathic pain. • Differences in cannabinoids plasma exposure between route of administration. [ABSTRACT FROM AUTHOR]

In vivo solid-phase microextraction (SPME) is a minimally invasive, non-exhaustive sample-preparation technique that facilitates the direct isolation of low molecular weight compounds from biological matrices in living systems. This technique is especially useful for the analysis of phytocannabinoids (PCs) in plant material, both for forensic purposes and for monitoring the PC content in growing Cannabis spp. plants. In contrast to traditional extraction techniques, in vivo SPME enables continuous tracking of the changes in the level of PCs during plant growth without the need for plant material collection. In this study, in vivo SPME utilizing biocompatible C18 probes and liquid-chromatography coupled to quadrupole time-of flight mass spectrometry (LC-Q-TOF-MS) is proposed as a novel strategy for the extraction and analysis of the acidic forms of five PCs in growing medicinal cannabis plants. The SPME method was optimized by testing various parameters, including the extraction phase (coating), extraction and desorption times, and the extraction temperature. The proposed method was validated with satisfactory analytical performance regarding linearity (10–3000 ng/mL), limits of quantification, and precision (relative standard deviations below 5.5 %). The proposed method was then successfully applied for the isolation of five acidic forms of PCs, which are main components of growing medicinal cannabis plants. As a proof-of-concept, SPME probes were statically inserted into the inflorescences of two varieties of Cannabis spp. plants (i.e., CBD-dominant and Δ9-THC-dominant) cultivated under controlled conditions for 30 min extraction of tetrahydrocannabinolic acid (Δ9-THCA), cannabidiolic acid (CBDA), cannabigerolic acid (CBGA), cannabiviarinic acid (CBVA), and tetrahydrocannabivarinic acid (THCVA). The results confirmed that the developed SPME-LC-Q-TOF-MS method is a precise and efficient tool that enables direct and rapid isolation and analysis of PCs under in vivo conditions. The proposed methodology is highly appealing option for monitoring the metabolic pathways and compositions of multiple PCs in medicinal cannabis at different stages of plant growth. [Display omitted] • An analytical method to determine phytocannabinoids in Cannabis spp. is presented. • In vivo SPME allows direct isolation of acidic forms of phytocannabinoids from growing plants. • Precise tool for analysis of the composition of phytocannabinoids in in vivo conditions. • SPME-LC-Q-TOF-MS protocol for resolution and analysis of acidic forms of phytocannabinoids. • Monitoring of multiple phytocannabinoids at different stages of medicinal cannabis plant growth. [ABSTRACT FROM AUTHOR]

• There is insufficient evidence to determine whether medicinal cannabis might have a role in supporting the mental health of people with cancer. • Medicinal cannabis might improve and maintain appetite. • High-dose tetrahydrocannabinol (THC) might increase the incidence of side-effects, including anxiety. • No studies had mental health as the primary outcome or therapeutic target. • Confidence in findings was limited by risk of bias and imprecise pooled estimates. Medicinal cannabis might have a role in supporting the mental health of people with cancer. This systematic review and meta-analysis examined the efficacy and safety of medicinal cannabis, compared with any control, as an intervention for depression, anxiety, and stress symptoms in people living with cancer. A secondary aim was to examine the effect of low versus high Δ9-tetrahydrocannabinol (THC) dose on these outcomes. Five databases were systematically searched, and complemented with a snowball search from inception to May 2023, for any type of interventional study that included humans of any age with any cancer type. Primary outcomes were incidence and severity of depression, anxiety, and stress symptoms. Secondary outcomes were mood, cognition, quality of life, appetite, nutrition status, gastrointestinal symptoms, and adverse events. Data were pooled using Review Manager. Evidence was appraised using Cochrane risk of bias tools. Confidence in the estimated effect of pooled outcomes was assessed using Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Fifteen studies (n = 11 randomized trials, n = 4 non-randomized trials) of 18 interventions (N = 1898 total participants; 100 % ≥18 years of age) were included. Ten studies examined THC (70 % synthetic), two synthetic cannabidiol with or without THC, and six whole-plant extracts. No clinically significant effects of medicinal cannabis were found on primary outcomes. The likelihood of anxiety events increased with higher-dose synthetic THC compared with a lower dose (OR: 2.0; 95 % CI: 1.4, 2.9; p < 0.001; Confidence: very low). Medicinal cannabis (THC, cannabidiol, and whole-plant extract) increased the likelihood of improved appetite (OR: 12.3; 95 % CI: 3.5, 45.5; p < 0.001; n = 3 interventions; Confidence: moderate) and reduced severity of appetite loss (SMD: −0.4; 95 % CI: −0.8, −0.1; p = 0.009; Confidence: very low). There was very low confidence that higher doses of synthetic THC increased the likelihood of any adverse event (OR: 0.5; 95 % CI: 0.3, 0.7; p < 0.001). Medicinal cannabis had no effect on emotional functioning, mood changes, confusion, disorientation, quality of life, and gastrointestinal symptoms. Confidence in findings was limited by some studies having high or unclear risk of bias and imprecise pooled estimates. There was insufficient evidence to determine the efficacy and safety of medicinal cannabis as a therapeutic intervention for depression, anxiety, or stress in people with active cancer. Further research should explore whether medicinal cannabis might improve and maintain appetite and if high-dose synthetic THC might increase the incidence of side-effects, including anxiety. To inform clinical practice, well-powered and rigorously designed trials are warranted that evaluate the effects of medicinal cannabis prescribed to target anxiety, depression, and stress. [ABSTRACT FROM AUTHOR]

Conventional cannabis drying is time-consuming and energy intensive. A quick and dependable drying of cannabis is essential to ensure high-quality products to meet increasing demands. This study explored a combined microwave and infrared (MI) drying on cannabis comparing with control environmental (CE) drying. MI was very efficient with a short drying time of 16–200 min, high moisture diffusivity of 7.95×10−09-8.70×10−08 m2/s, and low energy consumption of 390.49–1611.42 kJ. The Page and Modified Page drying models fitted well to describe and predict the MI drying characteristics of cannabis. Microstructural images identified shrinkage in glandular trichomes of cannabis, whereas colorimetric assessment resulted in alteration of color attributes due to MI drying. It also facilitated the conversion of acidic cannabinoids to their neutral forms by decreasing tetrahydrocannabinolic acid (THCA) in g/g of dry matter from 20.15% to 7.57% and increasing tetrahydrocannabinol (THC) from 6.31% to 16.65% that insignificantly (p ≥0.05) affected the total THC level. MI drying resulted in a total terpenes concentration (%g/g of dry matters) of 0.541–0.730, insignificantly lower than CE drying (0.768). Overall, the study highlights MI as a rapid and energy-efficient drying for obtaining high quality cannabis, particularly for medicinal applications. [Display omitted] • The effects of microwave-infrared drying on medicinal cannabis were investigated. • Microwave-infrared drying was quite faster and saved 95.54–98.92% energy. • Scanning electron microscopy shows shrinkage and damage of cannabis trichomes. • Tetrahydrocannabinol content increased from 6.31% to 16.65%. • Total terpenes of dried samples were statistically similar but lower than fresh. [ABSTRACT FROM AUTHOR]

The prevalence of cannabis use disorders (CUDs) in people who use cannabis recreationally has been estimated at 22%, yet there is a dearth of literature exploring CUDs among people who use medicinal cannabis. We aimed to systematically review the prevalence of CUDs in people who use medicinal cannabis. In our systematic review and meta-analysis, we followed PRISMA guidelines and searched three databases (PsychInfo, Embase and PubMed) to identify studies examining the prevalence of CUDs in people who use medicinal cannabis. Meta-analyses were calculated on the prevalence of CUDs. Prevalence estimates were pooled across different prevalence periods using the DSM-IV and DSM-5. We conducted a systematic review of 14 eligible publications, assessing the prevalence of CUDs, providing data for 3681 participants from five different countries. The systematic review demonstrated that demographic factors, mental health disorders and the management of chronic pain with medicinal cannabis were associated with an elevated risk of CUDs. Meta-analyses were conducted on the prevalence of CUDs. For individuals using medicinal cannabis in the past 6–12 months, the prevalence of CUDs was 29% (95% CI: 21-38%) as per DSM-5 criteria. Similar prevalence was observed using DSM-IV (24%, CI: 14–38%) for the same period. When including all prevalence periods and using the DSM-5, the prevalence of CUDs in people who use medicinal cannabis was estimated at 25% (CI: 18-33%). The prevalence of CUDs in people who use medicinal cannabis is substantial and comparable to people who use cannabis for recreational reasons, emphasizing the need for ongoing research to monitor the prevalence of CUDs in people who use medicinal cannabis. • The prevalence of cannabis use disorders in people who use medicinal cannabis is estimated at 25% (CI: 18-33%). • People with chronic non-cancer pain, mental health or substance use disorders may have a higher risk of cannabis use disorder. • The study highlights the need to carefully consider the risk of cannabis use disorder when prescribing medicinal cannabis. [ABSTRACT FROM AUTHOR]

Cannabis use disorder (CUD) treatment prevalence decreased in the US between 2002 and 2019, yet structural mechanisms for this decrease are poorly understood. We tested associations between cannabis laws becoming effective and self-reported CUD treatment. Restricted-use 2004–2019 National Surveys on Drug Use and Health included people ages 12+ classified as needing CUD treatment (i.e., past-year DSM-5-proxy CUD or last/current specialty treatment for cannabis). Time-varying indicators of medical cannabis laws (MCL) with/without cannabis dispensary provisions differentiated state-years before/after laws using effective dates. Multi-level logistic regressions with random state intercepts estimated individual- and state-adjusted CUD treatment odds by MCLs and model-based changes in specialty CUD treatment state-level prevalence. Secondary analyses tested associations between CUD treatment and MCL or recreational cannabis laws (RCL). Using a broad treatment need sample definition in 2004–2014, specialty CUD treatment prevalence decreased by 1.35 (95 % CI = −2.51, −0.18) points after MCL without dispensaries and by 2.15 points (95 % CI = −3.29, −1.00) after MCL with dispensaries provisions became effective, compared to before MCL. Among people with CUD in 2004–2014, specialty treatment decreased only in MCL states with dispensary provisions (aPD = −0.91, 95 % CI = −1.68, −0.13). MCL were not associated with CUD treatment use in 2015–2019. RCL were associated with lower CUD treatment among people classified as needing CUD treatment, but not among people with past-year CUD. Policy-related reductions in specialty CUD treatment were concentrated in states with cannabis dispensary provisions in 2004–2014, but not 2015–2019, and partly driven by reductions among people without past-year CUD. Other mechanisms (e.g., CUD symptom identification, criminal-legal referrals) could contribute to decreasing treatment trends. • Specialty CUD treatment decreased in MCL states with dispensary provisions. • RCLs were associated with lower treatment among people needing CUD treatment. • Reductions were concentrated in 2004–2014, with lagged associations in 2015–2019. • CUD treatment remained low across the United States in 2004–2019. [ABSTRACT FROM AUTHOR]

Introduction: Little is known about the possible impacts of recreational marijuana legalization on alcohol and marijuana co-use among underage youth. This study examines the association between recreational marijuana legalization in California in 2016 and alcohol and marijuana co-use among adolescents. Additional analyses investigate the associations between recreational marijuana legalization and co-use among past 30-day drinkers and marijuana users and the frequency of alcohol and marijuana use among co-users.Methods: This study used annual cross-sectional data from 7th, 9th, and 11th graders (N=3,319,329) who participated in the California Healthy Kids Survey from 2010-2011 to 2018-2019. Measures included past 30-day alcohol and marijuana use and student demographic characteristics, survey year, pre-post recreational marijuana legalization, and urbanicity. Multilevel regression analyses were conducted in 2021.Results: Recreational marijuana legalization was associated with greater odds of past 30-day alcohol and marijuana co-use in the total sample (OR=1.06, 95% CI=1.05, 1.07). Recreational marijuana legalization was more strongly associated with co-use among adolescents who reported past 30-day alcohol use (OR=1.58, 95% CI=1.52, 1.62) and heavy drinking (OR=1.25, 95% CI=1.21, 1.29) but was inversely related to co-use among past 30-day marijuana users (OR=0.76, 95% CI=0.74, 0.78). Among past 30-day co-users, there was a positive association with the frequency of marijuana use (β=0.36, SE=0.07).Conclusions: Recreational marijuana legalization may increase the risk of alcohol and marijuana co-use among adolescents. Greater restrictions on the numbers of alcohol and marijuana retail outlets and hours of operation and advertising and higher taxes on alcohol and marijuana products may help reduce the availability of these substances to adolescents. [ABSTRACT FROM AUTHOR]

• We ran a cross-sectional population study on the changes in cannabis-related attitudes of Australian parents from 2016 to 2019. • The estimated proportion of parents who supported legalisation and approved regular cannabis use increased significantly. • Parents who would try cannabis if it was legal grew from 5.9 % (95 %CI: 5.2, 6.7) to 8.1 % (95 %CI: 7.2, 9.0). • Parents who said they would use cannabis more often increased 81% over the three years. • The strongest associations were observed between high levels of psychological distress and regular smoking and drinking. With recent policy changes around medicinal cannabis in Australia, there is concern about the influence of changing norms of cannabis use on adults who are actively parenting. This repeated cross-sectional population study used National and Drug Strategy and Household Surveys to estimate the changes and correlates of cannabis-related attitudes (support of legalisation, approve of regular use, would try or use if legal) among Australian parents from 2016 to 2019. The estimated proportion of parents who supported legalisation and approved regular cannabis use increased significantly. Parents who would try cannabis if it was legal grew from 5.9% (95 %CI: 5.2, 6.7) to 8.1% (95 %CI: 7.2, 9.0). Parents who said they would use cannabis more often increased from 1.6 (95 % CI: 1.2, 1.9) to 2.9 (95 %CI: 2.4, 3.4), an 81% jump in the three years. The strongest associations were observed between a very high level of psychological distress and regular smoking and drinking. For example, people with a very high level of psychological distress were 2.16 times (95 %CI: 1.42, 3.28) and 2.48 times (95 %CI: 1.61, 3.83) more likely to approve legalisation and regular cannabis use, respectively. Daily drinking was associated with higher odds of trying cannabis (OR = 1.66; CI: 1.25–2.20). The proportion of parents who would try or use cannabis more often represents a sizeable pool of potential new and frequent users. This highlights the need for education and intervention strategies for parents who use cannabis and care for young children. The associations between mental health and substance use suggest that more research is needed to understand the impact of legalisation on vulnerable groups. [ABSTRACT FROM AUTHOR]

Medical cannabis is increasingly used as an alternative therapy for various conditions, including chronic pain, multiple sclerosis, epilepsy, and cancer-related symptoms. However, it is crucial to ensure that patients receive the intended dose of tetrahydrocannabinol (THC) from inhaled cannabis for optimal therapeutic effect without overdose risk. This requires a comprehensive understanding of the factors that influence the pharmacokinetics (PKs) of THC in the respiratory system. However, accurate estimation of lung dosimetry and blood concentration of inhaled THC remains challenging partially because the influence of diversified patient-specific puff patterns on inhaled THC transport, deposition, and translocation is still not well quantified. To address the knowledge gap mentioned above, this study employed a hybrid computational fluid-particle dynamics (CFPD) and PK model to evaluate factors that influence delivered doses of THC to the human respiratory system and the resultant THC-plasma concentration-time profile. Specifically, this study compared multiple puff waveforms for inhalation-holding-exhalation (IHE) with total puff volumes from 55 to 82 ml for 2 or 3 s, hold durations from 0 to 5 s, and three puff waveforms (i.e., square, sinusoidal, and realistic). THC deposition in the airways was recorded during all phases for each case using either 452,849 particles per second for the 1.128-μm monodisperse cases or 399,866 particles per second for the polydisperse cases, with the mass median aerodynamic diameter (MMAD) of 1.128 μm. Pulmonary air-THC particle flow transport dynamics, THC particle deposition data, and THC vapor absorption were predicted using CFPD for four airway regions, then scaled by region-specific bioavailability factors. The deposited THC mass in airway regions represents the initial mass entering a 3-compartment PK model, to predict the THC-plasma concentration-time profiles. The CFPD-PK results revealed significant variability in THC transport, deposition, and plasma concentration based on IHE factors. Specifically, larger puff volumes and longer holding times enhanced THC deposition in deeper airways and increased THC-plasma concentrations. Realistic transient puff waveforms predicted higher particle deposition and THC-plasma concentrations than simplified square waveforms. Polydisperse particle distributions show more realistic deposition patterns than monodisperse particle simulations. This study provides insights into the complexity of THC inhalation therapy, emphasizing the importance of considering individualized puff patterns and realistic particle size distributions in accurately predicting therapeutic outcomes, which is highly related to THC deposition in the lung and THC plasma concentration. These findings and the CFPD-PK modeling framework offer guidance for clinicians in prescribing personalized THC dosages, support regulatory science in evaluating inhalation devices, and contribute to ongoing research aimed at optimizing THC delivery for maximum therapeutic effectiveness while minimizing potential overdose risks. • A CFPD-PK model is used to investigate puff waveform influence on THC transport and translocation. • Longer hold times enhance THC lung deposition and increase THC blood levels. • Larger puff volumes and longer puff duration boost THC blood levels and respiratory deposition. • Realistic puff waveforms outperform square ones in predicting THC transport and effects. • Polydisperse particles show more accurate THC deposition patterns than monodisperse. [ABSTRACT FROM AUTHOR]

Cannabis is a genus of plants in the Cannabaceae family that contains tetrahydrocannabinolic acid. When heated or burned, the acid decarboxylates to form tetrahydrocannabinol (THC). Its (-)-trans-Δ9-THC isomer is a psychoactive substance that has been used as a drug for centuries. In most countries, both the private sale of cannabis products and their use for non-medical purposes are still prohibited by law. However, for some time now there has been societal and political pressure to at least partially legalize cannabis products. It can be expected that such a measure will lead to a significant increase in the consumption of cannabis. However, this also increases the possibility of involuntary passive exposure to THC and contamination of the indoor environment. In indoor sciences, THC is still a largely unknown or underrepresented substance. In this perspective paper, THC will therefore first be presented on the basis of its physical properties. Then, the distribution of THC in different indoor compartments and potential routes of passive exposure are discussed. Finally, an assessment of the future importance of THC for indoor use is made. Previous experience has shown that early monitoring is always advantageous so that preventive and protective measures can be taken quickly if necessary. [Display omitted] • The psychoactive tetrahydrocannabinol is released from cannabis smoke and vapor. • THC is a typical SVOC and accumulates in the indoor environment. • THC has been found in indoor air, house dust and on surfaces. • The planned legalization of cannabis is likely to increase passive exposure to THC. • There is a need to monitor THC indoors for preventative and protective reasons. [ABSTRACT FROM AUTHOR]

• Adding far-red to red:blue or sole red promoted rooting in one of two experiments. • Adding far-red only in the initial stage improved rooting without stem elongation. • The presence or absence of blue did not significantly affect rooting. • IAA and carbohydrate concentrations did not correlate with rooting. Stem cuttings are used in the commercial cultivation of many crops, including medicinal cannabis, to produce large numbers of uniform and genetically identical plants. Light is an important environmental factor determining the success of the rooting of stem cuttings. The aim of this study was to investigate the influence of different fractions of far-red and blue during the adventitious rooting phase of medicinal cannabis stem cuttings on rooting and whether these effects are related to changes in endogenous auxin and/or carbohydrates. Two experiments were conducted in climate chambers with sole LED lighting (blue, red, far-red) using two cannabis cultivars. In Experiment 1, four light treatments were applied: 100 µmol m−2s−1 red:blue (88:12) with additional 0, 50 or 100 µmol m−2s−1 far-red and a fourth treatment with 100 µmol m−2s−1 sole red with additional 50 µmol m−2s−1 far-red. In Experiment 2, the following four light treatments were applied: 90 µmol m−2s−1 red:blue (45:45) with additional 0 or 45 µmol m−2s−1 far-red, a third treatment with 45 µmol m−2s−1 sole red with additional 45 µmol m−2s−1 far-red, and a fourth dynamic treatment which was 45 µmol m−2s−1 sole red with additional 45 µmol m−2s−1 far-red for 7 days followed by 90 µmol m−2s−1 red:blue (45:45) for 14 days. The effects on rooting in both experiments were measured after 21 days of light treatments. In Experiment 2, periodic measurements of auxin and carbohydrates were performed. Far-red improved adventitious rooting only in Experiment 2, where both cultivars responded similarly. Adding far-red only during the initial stage (7 days) of rooting was sufficient to improve rooting, while it did not result in excessive stem elongation. The presence or absence of blue did not significantly affect rooting. Although the positive effects of far-red on auxin and carbohydrate concentrations in stem cuttings are a likely explanation for the observed effects of far-red on rooting, we did not find a correlation between auxin or carbohydrates and rooting. [ABSTRACT FROM AUTHOR]

Objectives: Although there is a growing body of evidence suggesting that cannabinoids may relieve symptoms of some illnesses, they are relatively high-cost therapies compared with illicit growth and supply. This article aimed to comprehensively review economic evaluations of medicinal cannabis for alleviating refractory symptoms associated with chronic conditions.Methods: Seven electronic databases were searched for articles published up to September 6, 2020. The quality of reporting of economic evaluations was assessed using the Consolidated Health Economic Evaluation Reporting Standards checklist. The extracted data were grouped into subcategories according to types of medical conditions, organized into tables, and reported narratively.Results: This review identified 12 cost-utility analyses conducted across a variety of diseases including multiple sclerosis (MS) (N = 8), pediatric drug-resistant epilepsies (N = 2), and chronic pain (N = 2). The incremental cost-effectiveness ratio varied widely from cost saving to more than US$451 800 per quality-adjusted life-year depending on the setting, perspectives, types of medicinal cannabis, and indications. Nabiximols is a cost-effective intervention for MS spasticity in multiple European settings. Cannabidiol was found to be a cost-effective for Dravet syndrome in a Canadian setting whereas a cost-utility analysis conducted in a US setting deemed cannabidiol to be not cost-effective for Lennox-Gastaut syndrome. Overall study quality was good, with publications meeting 70% to 100% (median 83%) of the Consolidated Health Economic Evaluation Reporting Standards checklist criteria.Conclusions: Medicinal cannabis-based products may be cost-effective treatment options for MS spasticity, Dravet syndrome, and neuropathic pain, although the literature is nascent. Well-designed clinical trials and health economic evaluations are needed to generate adequate clinical and cost-effectiveness evidence to assist in resource allocation. [ABSTRACT FROM AUTHOR]

The public and health care providers are increasingly curious about the potential medical benefits of Cannabis. In vitro and in vivo studies of Cannabis have suggested it has favorable effects on regulating pain, pruritus, and inflammation, making it a potentially attractive therapeutic agent for many dermatologic conditions. The body of literature reporting on the role of cannabinoids in dermatology is in its infancy but growing. We review the current research, possible cutaneous adverse effects, and future directions for cannabinoids and their use in skin cancer, acne, psoriasis, pruritus, dermatitis, scleroderma, dermatomyositis, cutaneous lupus erythematous, epidermolysis bullosa, pain, and wound healing. [ABSTRACT FROM AUTHOR]

Introduction: Psychoactive substance use may be risky for adults with functional impairments. This study investigates cannabis use and prescription opioid and tranquilizer/sedative (mis)use among adults aged ≥50 years reporting functional impairments in the U.S.Methods: This cross-sectional analysis of adults aged ≥50 years from the 2015-2019 cohorts of the National Survey on Drug Use and Health estimates the prevalence of past-year medical and nonmedical cannabis use and prescription opioid and tranquilizer/sedative use and misuse according to the number of functional impairments reported. The adjusted odds of medical and nonmedical use or misuse of each substance in relation to any impairment, the number of impairments, and specific impairments were estimated using logistic regression. Analyses were conducted in December 2020.Results: Compared with those reporting no impairments, those reporting any impairment were more likely to report the use of cannabis and the (mis)use of prescription opioids and tranquilizers/sedatives (all p<0.05). Prevalence of (mis)use increased for each drug as the number of impairments increased (all p<0.001). Having any impairment was associated with increased odds for medical cannabis use (AOR=2.28, 95% CI=1.57, 3.30) but not for nonmedical use and with increased odds for misuse of prescription opioids (AOR=1.62, 95% CI=1.38, 1.91) and tranquilizers/sedatives (AOR=1.59, 95% CI=1.20, 2.11). Impaired thinking was associated with increased odds for the use and misuse of each substance, and impaired ability to do errands was associated with increased odds for prescription opioid misuse (AOR=1.34, 95% CI=1.01, 1.78).Conclusions: Prescription drug misuse is linked to functional impairments among adults aged ≥50 years and may pose a potential risk for this vulnerable population. [ABSTRACT FROM AUTHOR]

• A safety-focused approach is necessary in each step of patient's cannabis journey. • Prior to initiation, screen for precautions, contraindications & drug interactions. • Patient risk factors guides choice of chemovar and route of administration. • Initiate cannabis using a low dose, slow titration method. • Set monitoring frequency, and adjust for adverse events or medication changes. Medical cannabis use is increasing worldwide. Clinicians are commonly asked by patients to provide guidance on its safety and efficacy. Although there has been an increase in research on the role of medical cannabis for a number of different conditions, we found that there was a paucity of clear safety guidance on its use. We aim to address this issue by answering two pertinent clinician safety questions: 1 Can medical cannabis be safely used in this patient? 2. What strategies can be used to ensure that any harms from medical cannabis are mitigated? To address these questions, we reviewed available evidence and provided expert clinical opinion to summarize the fundamental components for evaluating medical cannabis safety and strategies to reduce risk from its use. Our review resulted in a safety-focused framework for medical cannabis initiation and utilization. We provide clear recommendations for patients being considered for cannabis (e.g. precautions, contraindications and drug interactions). Risk mitigation strategies such as appropriate chemovar (strain) selection, routes of administration, and dosing are reviewed. As with any other pharmacotherapy, we review the key components of monitoring and address potential issues that may arise while using medical cannabis. We propose a structured assessment and monitoring strategy that can be used by clinicians recommending cannabis (CRC) to guide patients through each step of their cannabis journey. This framework can be used to ensure that medical cannabis utilization is associated with the lowest possible risk to the patient. [ABSTRACT FROM AUTHOR]

Although cannabis use during adolescence has been consistently linked to adverse health effects, the extent, nature, and cause of these effects remain widely debated in the public domain.1 Results from longitudinal studies conducted in North American, Europe, Australia, and New Zealand and meta-analytic reports suggest that exposure to cannabis during adolescence is associated with cognitive impairment, increased risk for psychiatric disorders, and academic and vocational failure.2,3 Recently, the rigor of some of these studies has been questioned, as a few of the studies have not found relationships between cannabis and adverse health outcomes or have shown nonsignificant effects after controlling for premorbid factors such as psychopathology or low IQ prior to cannabis exposure. Although adolescent cannabis users are at increased risk for developing a cannabis use disorder (CUD) compared to adults, not all adolescents who try cannabis develop problems related to its use. In fact, there is significant heterogeneity in how adolescents respond to cannabis exposure at the individual level.4 Some adolescents experiment with cannabis, use it sporadically and for a limited duration of time, and experience few negative consequences related to their cannabis use. Others, particularly those who use it frequently and for prolonged periods of time, go on to develop significant impairment related to their use. Cannabis use patterns among US adolescents and young adults are changing following 2 decades of legislative changes and expanding normalization of recreational and medical cannabis use.1 To improve prevention and early-intervention efforts during this time of societal change, it is critical that we identify which vulnerable populations are at greatest risk for experiencing negative outcomes related to cannabis use, and which features/aspects of adolescent cannabis use are most predictive of cannabis-associated adverse health outcomes. [ABSTRACT FROM AUTHOR]

Adequate evidence exists in the literature indicating a relatively positive shift with regards to the legal acceptance of cannabis and cannabis-derived products for medicinal purposes in some countries. Concomitantly, scientists are showing renewed interest in cannabis-related research work. Over the years, clinical and preclinical studies have demonstrated the therapeutic significance of cannabinoids for diverse indications. Additionally, efforts are being made to develop cannabis-related products into acceptable prescription products. FDA authorization for the commercial use of four cannabinoid-derived products, available as oral dosage forms is a significant progress already. However, there are certain drawbacks associated with the conventional delivery forms of cannabinoids. These include low oral bioavailability due to hepatic degradation, gastric instability, poor water solubility, and the side effects experienced upon the use of high doses of psychotropic cannabinoids associated with heightened plasma concentrations of the drug. These are however, limitable with the aid of transcutaneous drug delivery. Emerging topical and transdermal strategies could be exploited for the successful development of highly effective delivery systems for cannabinoids. This review discusses the feasibility of delivering therapeutic cannabinoids via skin and provides a comprehensive account of the supporting research studies that have been reported in the literature till date. [Display omitted] • Cannabis research is gaining renewed interest given favorable policy changes. • Delivery via the transcutaneous route is quite promising for cannabinoids. • Decrease in psychotropic side effects is anticipated with topical delivery. • Oleic acid, and ethanol alone or in solvents identify as good chemical enhancers. • Ethosomes, nanocryogel are viable controlled release strategies for cannabinoids. • Potential of microneedles and other active strategies is under utilized. [ABSTRACT FROM AUTHOR]

Determination of pesticides in cannabis facilities is increasingly important as medicinal and recreational uses of cannabis products expand rapidly. We report a method involving wipe sampling, liquid chromatography separation, and tandem mass spectrometry, which enables determination of 82 pesticides out of the 96 regulated by Health Canada. To demonstrate an application of the method, we sampled and measured pesticides in two cannabis growing facilities, representing a non-certified and a certified site. We detected 41 pesticides in surface wipe samples at the non-certified site and 6 at the certified site. This study provides the first evidence showing pesticide occurrence on common surfaces in cannabis growing facilities and points to a need for routine monitoring and strict control of pesticide use in cannabis facilities. [Display omitted] [ABSTRACT FROM AUTHOR]

Background: Legalization of medical and recreational cannabis is a major contributor to pediatric cannabis exposures. The trends and magnitude of pediatric cannabis exposures in Michigan after medical cannabis legalization in 2008 have not been assessed.Objective: To describe the temporal trends of pediatric cannabis exposures reported to the Michigan Poison Center (MiPC) after medical cannabis was legalized in 2008 and 1 year after legalization of recreational cannabis in 2018.Methods: Retrospective electronic chart review of pediatric (<18 years old) single-substance cannabis exposures reported to the MiPC from January 1, 2008 to December 31, 2019. Routes of cannabis exposure were reported as ingestion, inhalation, and unknown. Types of ingested cannabis products were also documented.Results: Between 2008 and 2019, 426 pediatric cannabis single exposures were reported. The median patient age was 6.0 years (interquartile range 2-15 years). Age distribution was bimodal. A total of 327 (76.8%) exposures were from cannabis ingestion, 79 (18.5%) from inhalation, 2 (0.5%) from both ingestion and inhalation, and 18 (4.2%) from unknown route. The doubling time for number of cases was 2.1 years, and the total number of annual reported cases increased after 2016. Teenagers (13-17 years) had the highest number of inhalational exposures, whereas young children (0-5 years) had the highest number of ingestions.Conclusion: Single-substance pediatric cannabis exposures reported to the Michigan Poison Center increased after medical cannabis was legalized in 2008 through recreational legalization in 2018. [ABSTRACT FROM AUTHOR]

Background: Medical cannabis use is increasing rapidly in the past several years, with older adults being the fastest growing group. Nevertheless, the evidence for cardiovascular safety of cannabis use is scarce. The aim of this study was to assess the effect of cannabis on blood pressure, heart rate, and metabolic parameters in older adults with hypertension. Methods: We conducted a prospective study of patients aged 60 years or more with hypertension and a new prescription of cannabis. We have performed the following assessments: 24-hours ambulatory blood pressure monitoring, ECG, blood tests, and anthropometric measurements prior to the initiation of cannabis therapy and 3 months afterward. The primary outcome was change in mean 24-h blood pressure at 3 months. Results: Twenty-six patients with a mean age of 70.42 ± 5.37 years, 53.8% females completed the study. At 3 months follow-up, the mean 24-hours systolic and diastolic blood pressures were reduced by 5.0 mmHg and 4.5 mmHg, respectively (p<0.001 for both). The nadir for the blood pressure and heart rate was achieved at 3 hours post-administration. The proportion of normal dippers changed from 27.3% before treatment to 45.5% afterward. No significant changes were seen in the different metabolic parameters assessed by blood tests, anthropometric measurements, or ECG exam. Conclusion: amongst older adults with hypertension, cannabis treatment for 3 months was associated with a reduction in 24-hours systolic and diastolic blood pressure values with a nadir at 3 hours after cannabis administration. [ABSTRACT FROM AUTHOR]

Background: Little is known about the the acute effects of cannabis on symptoms of OCD in humans. Therefore, this study sought to: 1) examine whether symptoms of OCD are significantly reduced after inhaling cannabis, 2) examine predictors (gender, dose, cannabis constituents, time) of these symptom changes and 3) explore potential long-term consequences of repeatedly using cannabis to self-medicate for OCD symptoms, including changes in dose and baseline symptom severity over time.Method: Data were analyzed from the app Strainprint® which provides medical cannabis patients a means of tracking changes in symptoms as a function of different doses and strains of cannabis across time. Specifically, data were analyzed from 87 individuals self-identifying with OCD who tracked the severity of their intrusions, compulsions, and/or anxiety immediately before and after 1,810 cannabis use sessions spanning a period of 31 months.Results: Patients reported a 60% reduction in compulsions, a 49% reduction in intrusions, and a 52% reduction in anxiety from before to after inhaling cannabis. Higher concentrations of CBD and higher doses predicted larger reductions in compulsions. The number of cannabis use sessions across time predicted changes in intrusions, such that later cannabis use sessions were associated with smaller reductions in intrusions. Baseline symptom severity and dose remained fairly constant over time.Limitations: The sample was self-selected, self-identified as having OCD, and there was no placebo control group.Conclusions: Inhaled cannabis appears to have short-term beneficial effects on symptoms of OCD. However, tolerance to the effects on intrusions may develop over time. [ABSTRACT FROM AUTHOR]

• UK law changed in 2018 to permit cannabis prescribing. Cannabis remains otherwise criminalised. Participants experienced benefits from cannabis across a broad range of conditions. • Most people who need a cannabis prescription in the UK still cannot access one. • Poor implementation of cannabis prescribing policy creates heath inequalities. • Intractable prohibition policy context continues to create social harms. This paper reports on the first qualitative study to interview people prescribed cannabis in the UK. Cannabis is a class B controlled substance under the 1971 Misuse of Drugs (MoD) Act, but a 2018 change to UK regulations provided for the prescription of cannabis for medical purposes. Relatively few people have been able to access a prescription, despite this policy change. This paper examines their experiences. Qualitative, semi-structured interviews were conducted with 24 people with a prescription for cannabis, or their carers. Data was analysed using a reflextive thematic analysis approach. The findings are discussed using a zemiology (social harms) perspective which provides a language for critical reflection on the current cannabis policy context. All participants reported that cannabis had significantly improved their mental and/or physical health, across a broad range of conditions. Many had been able to reduce their use of conventional medicines and reported that cannabis had relatively few side effects. Despite the potentially life-enhancing benefits of cannabis medicine, patients in the UK face multiple barriers to access. These include a lack of funding streams, bureaucratic supply problems, and a lack of training for doctors and police. Even for the few people able to obtain a prescription, the ongoing criminalisation of cannabis in the UK contributed to their experiences of stigmatisation. This often made it difficult and anxiety-inducing to take their medicine in public spaces. The UK government's lack of implementation of medical cannabis legalisation, combined with their ongoing prohibition position, is producing multiple harms to people who need cannabis medicine. The policy context is perpetuating stigmatising attitudes to cannabis which, as we demonstrate, contribute to social harms. We make recommendations on equality of patient access, and highlight the importance of education and policy change as means of combatting stigma. [ABSTRACT FROM AUTHOR]

In 2016, the Australian Government legislated to allow cannabis to be prescribed to patients as an unapproved medicine under the special access provisions of the Therapeutic Goods Act. This paper compares the Australian regulatory approach with other national approaches, outlines the main provisions of the Special Access Scheme for medical cannabis, describes how the program has evolved since 2017, includes an analysis of adverse events reported to the Therapeutic Goods Administration, and discusses the barriers that remain for patients who wish to access medical cannabis. It assesses how well the Australian program has addressed the challenges of providing patients with easier access to medical cannabis while ensuring that high-quality products are used safely and effectively under medical guidance. [ABSTRACT FROM AUTHOR]

Cannabis cultivation has been growing worldwide due to the legalization for either or both medicinal and recreational uses. Therefore, the amount of agriculture residues for this crop has the potential to become a promising feedstock for biofuels. This study aimed to demonstrate the complete valorization of cannabis biomass residues for biofuel production. Through the optimization of acid hydrolysis operation parameters (2:1 acid-to-biomass ratio, 60 min of swelling and 60 min of post-hydrolysis), it was possible to keep high glucose yields and low inhibitor formation. The use of CaCO 3 to neutralize the cannabis hydrolysate allowed the fermentation with a final ethanol concentration of 30 g EtOH /100 g biomass. After distillation, the vinasse was used to produce biogas (270 L CH 4 /kg VS). Therefore, a two-step acid hydrolysis can be considered as an efficient pretreatment for cannabis biomass to be used for the combined production of bioethanol and biogas. • Decreasing the acid-to-biomass ratio did not reduced sugars extraction. • CaCO 3 neutralized and detoxified acid hydrolysate, allowing > 90% on fermentation efficiency. • The use of antifoaming agent improved the process and did not harmer CaCO 3 action. • Cannabis vinasse produce high rate of biogas production (270 L CH 4 /kg VS). [ABSTRACT FROM AUTHOR]

Environmental exposure to lead (Pb) and cannabis use are two of the largest public health issues facing modern society in the United States and around the world. Exposure to Pb in early life has been unequivocally shown to have negative impacts on development, and recent research is mounting showing that it may also predispose individuals for risk of developing substance use disorders (SUD). At the same time, societal and legal attitudes towards cannabis (the main psychoactive component of which is delta-9-tetrahydrocannabinol) have been shifting, and many American states have legalized the recreational use of cannabis. It is also the 3rd most widely used drug of abuse in the US, and rates of cannabis use disorder are on the rise. Here we establish a link between early life Pb exposure and later THC-related behavior in C57BL6/J mice, as has been demonstrated for other drugs of abuse. The study seeks to answer whether Pb exposure affects physiological/behavioral THC sensitivity (as measured by the cannabinoid-induced tetrad). It was hypothesized that Pb exposure would decrease THC sensitivity and that sex-dependent effects of Pb-exposure and THC would be observed. Interestingly, results showed that THC sensitivity was increased by Pb exposure, but only in female mice. Future research will fully explore the implications of these findings, namely how these effects impact THC self-administration and the mechanism(s) by which developmental Pb exposure produces these effects. • This article adds to a growing literature surrounding early-life lead(Pb) exposure and substance use. • Early-life Pb exposure affects basal THC sensitivity in adulthood in female, but not male mice. • Cannabinoid-induced tetrad is used to measure THC sensitivity. [ABSTRACT FROM AUTHOR]

Knowledge on the impact of growing media (GM) composition and management on plant growth and quality parameters in the production of medical cannabis is still scarce. This study compared the most commonly used GM in the cannabis industry, namely rockwool (RW), peat-perlite (PP), and coconut-coir (CC), and their impact on plant growth, CBD yield, assimilate partitioning, and nitrogen (N) uptake of a chemotype III medical cannabis strain in pot cultivation, under GM-specific fertigation schedules. GM were tested in two experiments: i) over the whole cultivation cycle, including a flowering period (FP), and ii) an extended vegetative growth period (VP). In FP, common linear regressions were sufficient to describe the relation between dry inflorescence and CBD yield over growing degree days for all GM. Likewise, the effect of GM was negligible for CBD concentration. Comparisons of height, cumulative side shoot lengths, leaf area index (LAI) and biomass accumulation of leaves, stems and roots were based on parameter comparison of fitted growth functions over growing degree days. In FP, the fitted logistic growth functions indicated, that LAI and biomass accumulation of leaves and stems were impaired in PP when compared with RW and CC. In VP, the same parameters were described by expolinear growth functions, which, except for height, estimated consistently higher growth rates for plants grown in RW. Measured N concentrations in different plant organs were consistently at the upper end or above typical ranges, provided by previous studies. However, N uptake was further improved in RW, except in inflorescences, where this effect was not visible. The effect of GM on assimilate partitioning between vegetative plant organs was marginal but significant. We argue, that the reported differences could be mainly explained by the differences in water-holding capacities and irrigation management between GM. [Display omitted] • Differences in biomass accumulation are due to altered water availability. • Growing medium has impact on nitrogen uptake. • Growing medium has impact on biomass partitioning between plant organs. • Performance of growing media was compared by the use of fitted growth functions. • The effect of growing medium on cannabinoid concentration is negligible. [ABSTRACT FROM AUTHOR]

Rising temperatures, higher water consumption for irrigation, and the discharge of agricultural wastewater may soon adversely affect water resources across the entire planet and its people. Agriculture consumes large amounts of water, and there is a pressing need to explore possibilities for recirculation and reuse of nutrient solutions to reduce the associated environmental and economic costs of hydroponics. This study compared two different nutrient systems for hydroponic cultivation (recirculation, RS, and drain-to-waste system, DS), and assessed their effect on the growth and concentration of elements and secondary metabolites in medical cannabis (Cannabis sativa L.) plants. The dry decomposition method with flame atomic absorption spectroscopy (FAAS) and inductively coupled plasma optical emission spectroscopy (ICP-OES) were used for the elemental analysis of plant organs. Nitrogen content was measured using the Kjeldahl method. A high-performance liquid chromatograph equipped with a diode array detector (HPLC-DAD) was used to analyze the phytocannabinoid profile in ethanolic flower extracts. Gas chromatography with flame ionization detection (GC-FID) and gas chromatography with mass spectrometry (GC-MS) were employed to determine the content of terpenic compounds in hexane extracts. Cultivation of plants with the RS system, achieved an 87% higher maximum yield of the main cannabinoid of medical cannabis chemotype I, tetrahydrocannabinolic acid (THCA), with lower total water and nutrient consumption, but with a longer cultivation time and a lower concentration of the sesquiterpene, β-caryophyllene. In contrast, the DS system enabled better control over the nutrient solution with stable delivery of the exact concentrations of nutrients. DS accelerated plant maturation, but at the cost of higher water and fertilizer consumption and a significantly lower total yield of THCA and monoterpenes. [Display omitted] • Recirculation System and Drain-to-waste System compared. • Drain-to-waste System stably supplied nutrients and accelerated plant maturation. • Recirculation resulted in almost double the tetrahydrocannabinolic acid yield. • Plants in Drain-to-waste contained fewer monoterpenes but more β-caryophyllene. • Recirculation consumed less nutrients but possibly increased plant stress. [ABSTRACT FROM AUTHOR]

The primary and secondary metabolism of plants is closely connected to the resources supplied and obtained by the plant, including their mineral nutrition. We recently reported that nitrogen (N) deficiency enhances the production of terpenoids and cannabinoids, the unique biologically-active secondary metabolites in medical cannabis plants. Knowledge-gaps concerning effects of N supply on primary metabolism in cannabis hinder understanding of the interrelations between N inputs and biosynthesis of the therapeutic secondary metabolites. The present study therefore evaluated the hypothesis that a decrease in the plant's C (carbon): N ratio by N-limitation, induces a shift in the plant metabolism towards lower production of N-containing metabolites and higher production of metabolites that do not contain N. Effects of N input levels (30, 80, 160, 240, and 320 mg L−1) on total C and N concentrations and C: N ratio in leaves and inflorescences of medical cannabis plants were studied; and gas chromatography-mass spectrometry (GC-MS) analysis of primary metabolites added to the analyses of secondary metabolites. Elevation of N supply resulted in an increase in total N and N-containing compounds (chlorophylls and most amino acids), and decreased total C and compounds that do not contain N, such as sugars (fructose, glucose, and xylose), and phosphates (phosphate and glucose-6-phosphate) in both inflorescences and leaves. In the inflorescences, the elevation of N input also decreased total cannabinoids, phenols, and flavonoids, that do not contain N. Integrating the metabolic datasets revealed positive correlations between C sources (fructose and glucose) and most of the cannabinoids and terpenoids; the latter were negatively correlated with N-compounds (most amino acids). Taken together, these results suggest that elevated N supply induce a metabolic shift in the inflorescences towards increased production of N-compounds via deflecting the C sources from the biologically active compounds. In addition, the cannabis leaf was found to be more sensitive than the inflorescence to N supply, presenting greater changes in primary metabolism and more coordinated metabolic associations. These findings highlight the importance of adequate and precise N nutrition for standardization of the therapeutic-metabolite profile and for preventing undesirable metabolic repartitioning in medical cannabis plants. [Display omitted] • N supply increases N-containing compounds and decreases compounds that do not contain N. • Most cannabinoids and terpenoids positively correlated with C sources (fructose and glucose). • Most cannabinoids and terpenoids negatively correlated with N-compounds (most amino acids). • Cannabis leaf is more sensitive than inflorescences to N supply in primary metabolism. [ABSTRACT FROM AUTHOR]

The production of medical cannabis in compliance with the guidelines of Good Manufacturing Practice requires a science-based control strategy for the process. In this work, we hypothesized that industrial tray drying process of cannabis inflorescences can be achieved through an accurate selection and fitting of mechanistic models. In total, three industrial runs were measured and modeled from an initial moisture content of 70–72 wt% to a final content of ≤12 wt%. The temperature, relative humidity, and flow rate of convection air were kept constant at 20 °C, 50 %, and 9800 m 3 h − 1. A two-period model based on external resistance and intraparticle diffusion (FUMM+SPPM) was the best to describe the process, with a fitting error of 16.9 %. A control chart was conceived using FUMM+SPPM and a non-linear relation for the standard deviation along time. The suitability of the FUMM+SPPM was demonstrated with a validation run, resulting in a prediction error of 11.5 %; and where the upper and lower control limits of the control chart were respected. A sensitivity analysis showed that the initial moisture uncertainty can offset by 11.6 % the duration of the drying process. A deeper analysis on the fitted intraparticle diffusion coefficients points the migration of water to resemble osmotic movement. Globally, this study validates the adopted pathway to launch and improve a statistical process control for the tray drying of medical cannabis inflorescences. • Industrial tray drying process of medical cannabis. • Measurement and modeling of drying curves. • Screening of mass transfer mechanisms. • Intraparticle diffusion interpretation. • Implementation of statistical process control. [ABSTRACT FROM AUTHOR]

Microalgal biopolymers are studied mainly in terms of physico-chemical characterization, biological effects as well as possible biotechnological applications. Due to the significant antitussive, bronchodilator, anti-inflammatory and immunomodulatory effects of the previously isolated crude extracellular polysaccharide (EPS) produced by the cyanobacterium Nostoc sp., the purified biopolymer and its oligosaccharides, obtained after partial acid hydrolysis, were subjected to an in-depth NMR structural study. Analyses of the data obtained by chemical methods and NMR showed that the EPS backbone is composed of the repeating unit [→4)-β-D-Xyl p -(1 → 4)-β-D-Glc p -(1 → 4)-α-L-Ara p -(1 → 3)-β-D-Man p -(1→] n , in which about 60% of glucose units are substituted at C6 by uronic acids, in particular by the unusual unsaturated 3- O -lactyl-4-deoxy-α- erythro -hex-4-enopyranuronic acid, and to a lesser extent by β-D-glucuronic acid and 3- O -lactyl-β-D-glucuronic acid. These findings, structural features and identified biological effects, suggest the potential use of this biopolymer in the medical-pharmaceutical field. [ABSTRACT FROM AUTHOR]