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ObjectiveCannabis use may reduce the effectiveness of antipsychotic medication and treatment adherence in schizophrenia patients. This study examined the impact of cannabis legalization on cannabis-related acute care among schizophrenia patients. MethodsUsing health administrative data in Ontario, 119,848 individuals who were diagnosed with schizophrenia prior to legalization were identified. An interrupted time-series model was used to study the effect of cannabis-related policy on hospitalizations in individuals diagnosed with schizophrenia.ResultsWe found that legalization of cannabis flower and herb sales was associated with an immediate increase in hospitalization by 233.6% (95%CI 1.59-3.414) for men and 216.1% (95%CI 1.59-3.390) for women with schizophrenia. ConclusionsOther jurisdictions seeking to legalize recreational cannabis should consider preventive strategies to reduce unintended consequences among vulnerable patients.

Introduction: Recreational cannabis policies are being considered in many jurisdictions internationally. Given that cannabis use is more prevalent among people with depression, legalisation may lead to more adverse events in this population. Cannabis legalisation in Canada included the legalisation of flower and herbs (Phase 1) in October 2018, and the deregulation of cannabis edibles one year later (Phase 2). This study investigated disparities in cannabis-related emergency department (ED) visits in depressed and non-depressed individuals in each phase.Methods: Using administrative data in Ontario, we identified all adults diagnosed with depression 60 months prior to legalisation (n=929,844). A non-depressed comparison group was identified using propensity score matching. We compared the pre-post policy differences in cannabis-related ED-visits in depressed individuals versus matched (and unmatched) non-depressed individuals. Results: In the matched sample (i.e. comparison with non-depressed people similar to the depressed group), people with depression had approximately 4 times higher risk of cannabis-related ED-visits relative to the non-depressed over the entire period. Phases 1&2 were not associated with any changes in the matched depressed and non-depressed groups. In the unmatched sample (i.e. comparison with the non-depressed general population), the disparity between individuals with and without depression is greater. While Phase 1 was associated with an immediate increase in ED-visits among the general population, Phase 2 was not associated with any changes.Conclusion: Depression is a risk factor for cannabis-related ED-visits. Cannabis legalisation did not further elevate the risk among individuals diagnosed with depression. However, the elevated risk of cannabis misuse among individuals with depression should be addressed.

BackgroundThere have been no studies examining how neighbourhood deprivation modifies the effects of sexual minority status on suicide-related behaviours (SRB). Sexual minority individuals in deprived areas may face unique challenges and stressors that exacerbate their risk of SRB. This study aims to investigate the association between sexual minority status and clinical SRB, and examine whether the effect of neighbourhood deprivation differs across sexual orientation. MethodsA population-representative survey sample (weighted n= 8,778,120) was linked to administrative health data in Ontario, Canada to measure SRB-related events (emergency department visits, hospitalizations, and deaths) from 2007 to 2017. Neighbourhood-level deprivation was measured using the Ontario Marginalisation index measure of material deprivation at the dissemination area level. Discrete-time survival analysis models, stratified by sex, tested the effects of neighbourhood deprivation and sexual minority status, while controlling for individual-level covariates. ResultsSexual minority men had 2.79 times higher odds of SRB compared to their heterosexual counterparts (95% CI 1.66 to 4.71), while sexual minority women had 2.14 time higher odds (95% CI 1.54 to 2.98). Additionally, neighbourhood deprivation was associated with higher odds of SRB: men in the most deprived neighbourhoods (Q5) had 2.01 times higher odds (95% CI 1.38 to 2.92) of SRB compared to those in the least deprived (Q1), while women had 1.75 times higher odds (95% CI 1.28 to 2.40). No significant interactions were observed between sexual minority status and neighbourhood deprivation levels. ConclusionIn both men and women, sexual minority status and neighbourhood deprivation are independent risk factors for SRB. Despite the lack of effect modification, sexual minorities living in the most deprived neighbourhoods have the highest chances of SRB. Future investigations should evaluate interventions and policies to improve sexual minority mental health and address neighbourhood deprivation.

Objective: To quantify suicide-related behaviour (SRB) leading to acute care or deaths across heterosexual, homosexual, and bisexual individuals using population-representative sample and health administrative data.Methods: We linked data from a population-based survey (n=123,995) to health administrative data (2002-2019), and examined differences in time-to-SRB events across sexual orientations using Cox proportional hazards regression.Results: The crude incidence rates for heterosexuals was 224.67 SRB events/100,000 person-years, while the rates for homosexuals was 664.74, and bisexuals was 5911.88.In fully adjusted (gender-combined) models, bisexual individuals were 2.98 times (95% CI, 2.08-4.27) more likely to have a SRB event, and gay men and lesbians were 2.10 times (95% CI, 1.18-3.71) more likely, compared to heterosexual individuals.Conclusions: In a large, population-based sample of Ontario residents using clinically relevant outcomes, LGB individuals were at elevated risk of SRB events. Increased education among psychiatric professionals is needed to improve awareness and sensitivity towards the elevated risk of LGB SRB events. Further funding and research on interventions to reduce sexual minority SRB is required.

Rural sexual minorities may experience unique stressors due to stigma and a lack of sexual minority-specific social and health services. We examine whether rural and sexual minority status are associated with suicide-related behaviour (SRB) risks, using a nationally representative survey linked to administrative health data of Ontario individuals from 2007-2017. Our study provides evidence that rural and sexual minority status both independently contribute to an elevated likelihood of SRB; however, sexual orientation did not appear to modify the SRB risk by rurality. Evaluations of interventions to reduce SRB in both rural and sexual minority populations are required.

In order to understand the state and evolution of the entirety of open source software we need to get a handle on the set of distinct software projects. Most of open source projects presently utilize Git, which is a distributed version control system allowing easy creation of clones and resulting in numerous repositories that are almost entirely based on some parent repository from which they were cloned. Git commits are based on Merkle Tree and two commits are highly unlikely to be produced independently. Shared commits, therefore, appear like an excellent way to group cloned repositories and obtain an accurate map for such repositories. We use World of Code infrastructure containing approximately 2B commits and 100M repositories to create and share such a map. We discover that the largest group contains almost 14M repositories most of which are unrelated to each other. As it turns out, the developers can push git object to an arbitrary repository or pull objects from unrelated repositories, thus linking unrelated repositories. To address this, we apply Louvain community detection algorithm to this very large graph consisting of links between commits and projects. The approach successfully reduces the size of the megacluster with the largest group of highly interconnected projects containing under 100K repositories. We expect the tools that the resulting map of related projects as well as tools and methods to handle the very large graph will serve as a reference set for mining software projects and other applications. Further work is needed to determine different types of relationships among projects induced by shared commits and other relationships, for example, by shared source code or similar filenames., 5 pages