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Introduction: In the wake of continued consumer demand despite increasing regulatory scrutiny, there is a need to develop systematic methods for identifying the harm profile of new psychoactive substances derived from hemp. Tetrahydrocannabinol-O (THC-O)-acetate, colloquially known as THCO, is the acetate ester of the principal psychoactive compound in cannabis. The heating of THCO can create ketene gas, which is harmful to the lungs. Materials and Methods: The research team used a multidisciplinary, iterative process to develop a survey to incorporate consumers' perspectives of semisynthetic cannabinoids. The survey was then distributed across the social media platform Reddit to learn about delivery device preferences and associated use styles when consuming THCO. Results: Most participants (74.9%) vaped THCO and one-quarter of participants (24.3%) dabbed THCO and tended to report higher temperatures for dabbing than vaping THCO. A small portion (12.0%) of participants reported concerns regarding ketene risk. Conclusion: As there are multiple variables associated with the formation of ketene, and consumer responses indicate temperatures use that might enable ketene formation, more research is needed to understand the risk profile of hemp-derived substances like THCO. Further studies are needed to understand the how various routes of administration and delivery devices used with THCO may exacerbate the risk of ketene formation and other potential harms.

Feedstock variability represents a challenge in lignocellulosic biorefineries, as it can influence both lignocellulose deconstruction and microbial conversion processes for biofuels and biochemicals production. The impact of feedstock variability on microbial performance remains underexplored, and predictive tools for microbial behaviour are needed to mitigate risks in biorefinery scale-up. Here, twelve batches of corn stover were deconstructed via deacetylation, mechanical refining, and enzymatic hydrolysis to generate lignin-rich and sugar streams. These batches and their derived streams were characterised to identify their chemical components, and the streams were used as substrates for producing muconate and butyrate by engineered Pseudomonas putida and wildtype Clostridium tyrobutyricum, respectively. Bacterial performance (growth, product titers, yields, and productivities) differed among the batches, but no strong correlations were identified between feedstock composition and performance. To provide metabolic insights into the origin of these differences, we evaluated the effect of twenty-three isolated chemical components on these microbes, including three components in relevant bioprocess settings in bioreactors, and we found that growth-inhibitory concentrations were outside the ranges observed in the streams. Overall, this study generates a foundational dataset on P. putida and C. tyrobutyricum performance to enable future predictive models and underscores their resilience in effectively converting fluctuating lignocellulose-derived streams into bioproducts., (© 2024 The Author(s). Microbial Biotechnology published by John Wiley & Sons Ltd.)

There is a growing interest in semi-synthetic cannabinoids, including THC-O-acetate (THC-Oac). Some cannabis marketers and users have claimed that THC-Oac produces psychedelic effects; the current study is the first to examine this claim. Researchers developed an online survey for THC-Oac consumers based on previous cannabis and psychedelic use surveys and in consultation with the moderator of an online forum. The survey assessed the experiential profile of THC-Oac and included items from the Mystical Experience Questionnaire (MEQ), an instrument for assessing psychedelic experiences. Participants reported a low to moderate level of cognitive distortions (altered sense of time, difficulties concentrating, difficulties with short-term memory) and few visuals or hallucinations. Participants' responses were significantly below the threshold for a complete mystical experience on all four MEQ dimensions. Participants who had used classic (5-HT 2A agonist) psychedelics had lower scores on all MEQ dimensions. When asked directly, 79% responded that using THC-Oac is "not at all" or "a little" of a psychedelic experience. Some reports of psychedelic experiences may be due to expectations or contaminants. Those having prior experience with classic psychedelics had lower ratings of mystical experiences.

Objective: A severe staff shortage and a dearth of professionals from underrepresented backgrounds in the public health workforce are contributing to poor health outcomes in the United States. Schools and programs can mitigate these problems by admitting more graduate public health students overall and from underrepresented backgrounds. We identified predictors of foundational graduate public health course grades and graduate grade point average (GPA), sharing evidence to remove application factors that are admission barriers and do not predict student outcomes., Methods: We conducted a linear regression analysis on demographic and academic factors from 564 graduate public health applications for students at the University at Buffalo who received their degree from January 1, 2016, to February 1, 2021, analyzing age, race and ethnicity, sex, income, undergraduate degree, verbal and quantitative Graduate Record Examination (GRE) percentiles, and undergraduate GPA. Outcomes were grades in foundational public health courses and cumulative graduate GPA., Results: Undergraduate GPA was the best predictor of graduate public health student success, explaining nearly 7% of foundational public health course grades and 29% of graduate GPA. Higher undergraduate GPA contributed to higher course grades and graduate GPA. GRE scores explained <1% of student outcomes., Conclusions: Our findings add to the growing body of research showing that standardized test scores may not predict graduate student outcomes and provide further evidence for the field of public health to consider removing this admission barrier. By doing so, institutions could admit more students to graduate public health programs who can bring needed skills to the market, further diversifying the workforce and public health faculty, to better meet population health needs., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: Medical misinformation, which contributes to vaccine hesitancy, poses challenges to health professionals. Health professions students, while capable of addressing and advocating for vaccination, may lack the confidence to engage with vaccine-hesitant individuals influenced by medical misinformation., Methods: An interprofessional in-person simulation activity (90 minutes) using standardized patients was developed and instituted for students in medicine, nursing, pharmacy, and public health programs. Student volunteers were recruited from classes approximately halfway through their respective degree programs (i.e., second or third year of a 4-year program). Online simulation was used as a method to prepare for in-person simulation. Impact on students was assessed primarily through a postprogram student self-assessment., Results: A total of 220 students participated in the program; 206 (94%) had paired data available to analyze. Following program participation, self-assessed abilities increased from pre to post, from 2.8 out of 5 (good) to 3.9 out of 5 (very good; p < .001). Ninety-eight percent of students felt that their ability to address medical misinformation was somewhat/much better after the activity, compared to before, and that their ability to address vaccine hesitancy was somewhat/much better. The overall program was rated highly, with mean scores for each program evaluation item >4 out of 5 (very good)., Discussion: An interprofessional cohort of students demonstrated improvement in self-assessed skills to participate in a conversation with an individual with hesitancy to receive vaccines and/or beliefs informed by misinformation. Students felt that this program was relevant and important to their professional development., (© 2024 Fusco et al.)

Introduction: Medical cannabis users tend not to trust or rely on health care providers regarding cannabis advice. Previous surveys of physicians have focused on favorability toward medical cannabis. The current study assesses how physicians interact with patients regarding cannabis in their day-to-day practice, and whether and how they address important topics such as use patterns and substituting cannabis for medications. We predicted that physicians would generally perceive cannabis dispensary staff and caretakers as not competent in addressing patient health needs and would not be likely to use their recommendations. Methods: Physicians in a university-affiliated health system completed an anonymous online survey. The survey assessed physicians' cannabis related education experiences, perceptions of their knowledge of and competence regarding medical cannabis, and the content of cannabis related discussions with patients. We also examined perceptions of the sources of influence on patients regarding cannabis and physicians' attitudes toward medical cannabis dispensary staff and medical cannabis caregivers (MCCs). Results: A few physicians (10%) had ever signed a medical cannabis authorization form for their patients, consistent with their perceptions of low knowledge and competence in this area. Discussions on cannabis primarily focus on risks (63%) rather than dosage (6%) and harm reduction (25%). Physicians see their influence on patients as weak compared with other information sources and have generally unfavorable attitudes toward medical cannabis dispensary staff and MCCs. Conclusion: Greater integration of medical cannabis knowledge is needed at all levels of medical and clinical education to address the potential harm to patients if they receive no guidance. Continued research is needed to provide a strong scientific basis for developing treatment guidelines and standardized medical education for medical cannabis use.

Purpose: The American Dental Association advocates for dentists' education on therapeutic and legal issues related to medical cannabis. It is important to understand current knowledge of cannabis and cannabinoids and to have a practical knowledge assessment instrument. This exploratory study is the first of its kind to assess dental students' knowledge of cannabis and aims to determine if there is a need for more instruction regarding cannabis in a dental school's curriculum., Methods: Predoctoral dental students at the University at Buffalo School of Dental Medicine were recruited to participate. A validated, anonymous 22-item online survey was adapted and administered to students in all 4 years of the dental program. There was a total of 56 knowledge points., Results: The average knowledge score was 21.6 points (SD = 5.2, range: 7-34), corresponding to 38.5% (SD = 9.2) of the answers correct. There were no overall differences in knowledge by gender, years in dental school, or by any reported source of formal education on cannabis. Those who reported doing their own research had higher knowledge scores. Most participants knew that there is an endogenous cannabinoid system (72.3%) and that Tetrahydrocannabinol (THC) is responsible for the "high" experienced with cannabis (76.6%). Most participants reported that they did not know the effective doses of THC (58.2%) and Cannabidiol (CBD) (66.7%); few provided an answer for THC (34%) or CBD (17%) in the acceptable range of 2-10 mg., Conclusion: Dental students did not have adequate knowledge on cannabis and cannabinoids. Given the rapid expansion of cannabis legalization, additional efforts are needed to integrate cannabis topics into coursework and learning experiences., (© 2024 American Dental Education Association.)

Valorization of algal biomass to fuels and chemicals frequently requires pretreatment to lyse cells and extract lipids, leaving behind an extracted solid residue as an underutilized intermediate. Mild oxidative treatment (MOT) is a promising route to simultaneously convert nitrogen contained in these residues to easily recyclable ammonium and to convert carbon in the same fraction to biofuel precursor carboxylates. We show that for a Nannochloropsis algae under certain oxidation conditions, nearly all the nitrogen in the residues can be converted to ammonium and recovered by cation exchange, while up to ∼20% of the carbon can be converted to short chain carboxylates. At the same time, we also show that soluble phosphorus in the form of phosphate can be selectively recovered by anion exchange, leaving a clean aqueous carbon stream for further upgrading., Competing Interests: The authors declare no competing financial interest., (© 2024 The Authors. Published by American Chemical Society.)

Conversion of microalgae to renewable fuels and chemical co-products by pretreating and fractionation holds promise as an algal biorefinery concept, but a better understanding of the pretreatment performance as a function of algae strain and composition is necessary to de-risk algae conversion operations. Similarly, there are few examples of algae pretreatment at scales larger than the bench scale. This work aims to de-risk algal biorefinery operations by evaluating the pretreatment performance across nine different microalgae samples and five different pretreatment methods at small (5 mL) scale and further de-risk the operation by scaling pretreatment for one species to the 80 L scale. The pretreatment performance was evaluated by solubilization of feedstock carbon and nitrogen [as total organic carbon (TOC) and total nitrogen (TN)] into the aqueous hydrolysate and extractability of lipids [as fatty acid methyl esters (FAMEs)] from the pretreated solids. A range of responses was noted among the algae samples across pretreatments, with the current dilute Brønsted acid pretreatment using H 2 SO 4 being the most consistent and robust. This pretreatment produced TOC yields to the hydrolysate ranging from 27.7 to 51.1%, TN yields ranging from 12.3 to 76.2%, and FAME yields ranging from 57.9 to 89.9%. In contrast, the other explored pretreatments (other dilute acid pretreatments, dilute alkali pretreatment with NaOH, enzymatic pretreatment, and flash hydrolysis) produced lower or more variable yields across the three metrics. In light of the greater consistency across samples for dilute acid pretreatment, this method was scaled to 80 L to demonstrate scalability with microalgae feedstocks., Competing Interests: The authors declare no competing financial interest., (© 2024 The Authors. Published by American Chemical Society.)

Introduction: Graphical representations of a case study can help learners recognize how systems and institutions impact health. The impact of the social determinants of health (SDoH) on individual and community health is well established, yet it may be challenging for students to visualize the impact of these components within a case study., Purpose: This study explored the use of ecomaps in an interprofessional forum and examined the perceptions from students and faculty regarding use of this educational tool., Methods: This tool was assessed over two semesters, Fall 2021 (n=968) and Fall 2022 (n= 835) to evaluate student and faculty perceptions of the use of the tool along with faculty's assessment of student completion of the tool within a rubric., Results: Nearly all students (99%) came prepared to the forum and presented their ecomaps to others during the small group discussion to facilitate conversation as they explored the role of SDoH related to the case study. Both students and faculty rated the use of this tool favorably., Discussion: In conclusion, ecomaps were viewed favorably by both students and faculty. This visual exploration of SDoH helps students to visualize both positive and negative factors that impact a patient's experience.

Purpose: The Consortium of Student-Led Eye Clinics (CSLEC), founded in 2021, administered a comprehensive survey to document the types of services, most common diagnoses, and follow-up care protocols offered by student-led free vision screening programs (SLFVSP) in the United States., Methods: An 81-question institutional review board (IRB)-approved survey was administered to student-led vision screening eye clinics from October 1, 2022 to February 24, 2023., Results: Sixteen SLFVSPs were included in the final analysis, of which 81% (n = 13) conducted variations of fundoscopic examinations and 75% (n = 12) measured intraocular pressure. Cataracts and diabetic retinopathy were reported as the most frequent diagnoses by the majority of SLFVSPs (n = 9, 56%); non-mobile SLFVSPs more commonly reported cataract as a frequent diagnosis (P < 0.05). Most patients screened at participating programs were uninsured or met federal poverty guidelines. Prescription glasses were offered by 56% of the programs (n = 9). SLFVSPs that directly scheduled follow-up appointments reported higher attendance rates (66.5%) than those that only sent referrals (20%). Transportation was the most cited barrier for follow-up appointment attendance., Conclusions: SLFVSPs, one community vision screening initiative subtype, vary significantly in scope and capabilities of identifying vision threatening disease. The follow-up infrastructure is not uniformly robust and represents a key target for improving care delivery to at-risk populations., Translational Relevance: The CSLEC aims to develop a consensus-based standardization for the scope of screening services, offer guidelines for diagnostic criteria, promote real-time data stewardship, and identify means to improve follow-up care mechanisms in member communities.

Establishing the effectiveness of IPE experiences is essential, and current assessment measures may be subject to various types of bias. The Interprofessional Collaborative Competency Attainment Survey (ICCAS) is administered after the learning experience as retrospective pretest and posttest measures of perceived collaborative practice skills. Because the ICCAS does not have an actual pretest, there are potential risks of recall bias and social desirability bias. To address these concerns, Jackson (2017) proposed conducting a true ICCAS pretest before the learning experience and examining the differences between the true and retrospective pretest scores and the differences between these pretest and posttest scores. This study design was implemented for two in-person Interprofessional forums conducted in the Fall ( N  = 745) and following Spring ( N  = 599) semesters. Students from 11 (Fall) and 12 (Spring) health professions education programs were included. True ICCAS pretest scores did not significantly differ from the retrospective pretest scores in either sample, although the effect sizes for pretest to posttest gains were slightly smaller for the true pretest scores. These results support and provide confidence for using the standard ICCAS administration methodology by demonstrating the administration methodology is not adversely impacted by recall or social desirability biases.

Objective: To assess the regulations on Cannabis advertising across U.S. states for variation and compare with Canadian federal policies, for the purpose of identifying opportunities to protect the public, especially the youth and other vulnerable populations, from health risks. Methods: We reviewed Health Canada's Cannabis Act and Cannabis Regulations to identify prohibited marketing and advertising activities for cannabis products. The Canadian guidelines (where cannabis is legal for both medical and nonmedical use) were compared with regulations in the 36 U.S. states where cannabis is legalized for medical and/or adult (e.g., recreational) use. Results: Cannabis advertising regulations vary greatly and have little consistency across the U.S. states. Most states do not address many of the cannabis advertising activities that are prohibited in Canada. Among the 31 states that do allow some form of cannabis advertising, 74% explicitly prohibit targeting or appealing to minors and 68% prohibit making false or misleading claims. There are 11 illegal advertising tactics in Canada, such as glamorization and testimonials, that were not specifically discussed in any of the U.S. state policies. Conclusion: The lack of consistent marketing guidelines could expose youth and vulnerable populations to cannabis advertisements; more widespread or federal guidance is needed.

Introduction: Cannabis products containing delta-8-THC became widely available in most of the United States in late 2020 and rapidly became a significant source of revenue for hemp processing companies, especially in states where use of delta-9-THC remains illegal or requires professional authorization for medical use. Scientific research on the use of delta-8-THC is scarce, previous clinical studies included a combined total of 14 participants, leading some state governments to prohibit it until its properties and effects are better understood. Methods: Researchers developed an online survey for delta-8-THC consumers addressing a broad range of issues regarding delta-8-THC, including use for the treatment of health and medical conditions. Previous survey studies on the medical use of cannabis and cannabis products informed survey components. Results: Patterns of delta-8-THC use had both similarities with and differences from the use of delta-9-THC cannabis and products. Administration methods were primarily edibles (64%) and vaping concentrates (48%). About half of the participants (51%) used delta-8-THC to treat a range of health and medical conditions, primarily anxiety or panic attacks (69%), stress (52%), depression or bipolar disorder (46%), and chronic pain (41%). Participants compared delta-8-THC very favorably with both delta-9-THC and pharmaceutical drugs and reported substantial levels of substitution for both. Most participants did not inform their primary care provider of their delta-8-THC use (78%) and were not confident of their primary care provider's ability to integrate medical cannabis into their treatment (70%). Knowledge of effective dosages was low, and participants' knowledge of delta-8-THC was primarily from the Internet and their own experiences. Conclusion: Harm reduction is a central component of public health. Although the legal environment is becoming more restrictive for delta-8-THC in comparison to delta-9-THC, results suggest that delta-8-THC may be equally effective for desired purposes of cannabis use and lower in undesirable or adverse effects. All policies and practices should be informed by empirical evidence. Considerable research will be needed to systematically verify the patterns reported by participants, and collaborations among academic researchers, government, and the cannabis industry may be valuable in developing the knowledge base for delta-8-THC and other cannabinoids.

Objective. Innovation sprints are a novel pedagogy where small groups of students find creative solutions to problems. The purpose of this study was to extend our understanding of innovation sprint pedagogical design by investigating the impact of an innovation sprint on Doctor of Pharmacy (PharmD) students' and Master of Public Health (MPH) students' interprofessional collaboration and problem-solving skills. We hypothesized that the innovation sprint would increase student self-efficacy and that interprofessional collaborative behaviors would be demonstrated by individuals on a team. Methods. MPH and third-year PharmD students were assigned to teams and participated in a required two-hour innovation sprint. Faculty observed student teams and evaluated their interprofessional collaboration skills using a rubric modeled after the Modified McMaster-Ottawa Scale. Students completed a postprogram survey assessing their interprofessional collaborative behaviors and attitudes toward the innovation sprint. Results. Of the 133 students participating in the innovation sprint, 127 completed the postprogram survey (response rate=95%). Faculty determined that 123 students (92%) met the interprofessional collaboration competencies. The mean interprofessional collaborative competencies attainment survey scores increased for both PharmD and MPH students. Qualitative analyses highlighted themes of interprofessional collaboration and problem-solving skills that students valued. Overall, students enjoyed working with each other and engaging in creative problem-solving. Conclusion. An interprofessional innovation sprint involving PharmD and MPH students demonstrated a positive impact on student self-assessed interprofessional collaboration and problem-solving skills. Further, faculty observed a high rate of interprofessional behaviors within student teams. Based on these findings, an innovation sprint may be an effective pedagogical tool to enhance students' skills in these areas., (© 2023 American Association of Colleges of Pharmacy.)

Purpose: This study evaluates third-year dental medicine students' perceived competencies related to interprofessional collaborative practice (IPCP) after completing two exposure level experiences with students from other professions across a large academic health center., Methods: Two cohorts of D3 dental medicine students (2018-2019 and 2019-2020) completed the Interprofessional Collaborative Competencies Attainment Survey (ICCAS) after participating in in-person 2.5-h Interprofessional (IP) Forums in the Fall and Spring semesters. Self-reported competencies were compared between pre-and post-IP Forum ratings and between Fall and Spring., Results: Prior to the IP Forums, dental medicine students (n = 185) reported perceived skill in the interprofessional competencies to be from Good to Very Good using the ICCAS. After participation in the Fall IP Forum, students' ICCAS scores increased in all ICCAS subscales with large effect sizes. Students reported a perceived decline in these skills in the four months between Fall and Spring IP Forums and restoration of IP skill levels after participating in a second IP Forum (Spring)., Conclusions: Participation in IP Forums has a positive impact on students' IPCP skill perception. Our data suggest that perceived skill level requires repeated IP learning experiences. If dental medicine students are expected to embrace collaborative practice to enhance patient outcomes, then dental school educators must provide opportunities for students to engage in collaborative practice experiences at all levels of their training., (© 2021 American Dental Education Association.)

Introduction: As more states allow for medical and nonregistered adult cannabis (i.e., marijuana) use, ensuring proper utilization should be a priority. Standardized labeling for foods and pharmaceutical drugs promotes consumer safety. This study investigated cannabis product labeling requirements in the United States. Materials and Methods: Researchers compiled the requirements for cannabis product labeling across 31 U.S. states with medical cannabis programs from state regulatory publications. Results: Information requirements ranged considerably by U.S. state. All states required delta-9-tetrahydrocannabinol content and manufacturer contact information, >80% of states required the batch number, health risks, production tracking, a cannabis symbol, cannabidiol content, children disclaimer, and an impairment disclaimer. There appeared to be a random pattern in requirements for other specific items. The relationships between the extent of cannabis product labeling requirements and the number of years that a state had a medical cannabis program or whether states allowed nonregistered adult use cannabis were not significant, although there was a trend for nonregistered adult use states to require more recommended label attributes. Conclusion: A comprehensive framework for cannabis use is needed to protect the public, maximize benefits, and minimize harms and risks. Standardization of cannabis product labeling requirements would benefit consumers and promote safer and more effective usage of cannabis products.

Background: Products containing delta-8-THC became widely available in most of the USA following the 2018 Farm Bill and by late 2020 were core products of hemp processing companies, especially where delta-9-THC use remained illegal or required medical authorization. Research on experiences with delta-8-THC is scarce, some state governments have prohibited it because of this lack of knowledge., Objective: We conducted an exploratory study addressing a broad range of issues regarding delta-8-THC to inform policy discussions and provide directions for future systematic research., Methods: We developed an online survey for delta-8-THC consumers, including qualities of delta-8-THC experiences, comparisons with delta-9-THC, and open-ended feedback. The survey included quantitative and qualitative aspects to provide a rich description and content for future hypothesis testing. Invitations to participate were distributed by a manufacturer of delta-8-THC products via social media accounts, email contact list, and the Delta8 Reddit.com discussion board. Participants (N = 521) mostly identified as White/European American (90%) and male (57%). Pairwise t tests compared delta-8-THC effect rating items; one-sample t tests examined responses to delta-9-THC comparison items., Results: Most delta-8-THC users experienced a lot or a great deal of relaxation (71%); euphoria (68%) and pain relief (55%); a moderate amount or a lot of cognitive distortions such as difficulty concentrating (81%), difficulties with short-term memory (80%), and alerted sense of time (74%); and did not experience anxiety (74%) or paranoia (83%). Participants generally compared delta-8-THC favorably with both delta-9-THC and pharmaceutical drugs, with most participants reporting substitution for delta-9-THC (57%) and pharmaceutical drugs (59%). Participant concerns regarding delta-8-THC were generally focused on continued legal access., Conclusions: Delta-8-THC may provide much of the experiential benefits of delta-9-THC with lesser adverse effects. Future systematic research is needed to confirm participant reports, although these studies are hindered by the legal statuses of both delta-8-THC and delta-9-THC. Cross-sector collaborations among academics, government officials, and representatives from the cannabis industry may accelerate the generation of knowledge regarding delta-8-THC and other cannabinoids. A strength of this study is that it is the first large survey of delta-8 users, limitations include self-report data from a self-selected convenience sample., (© 2022. The Author(s).)

Reductive catalytic fractionation (RCF) is a promising approach to fractionate lignocellulose and convert lignin to a narrow product slate. To guide research towards commercialization, cost and sustainability must be considered. Here we report a techno-economic analysis (TEA), life cycle assessment (LCA), and air emission analysis of the RCF process, wherein biomass carbohydrates are converted to ethanol and the RCF oil is the lignin-derived product. The base-case process, using a feedstock supply of 2000 dry metric tons per day, methanol as a solvent, and H 2 gas as a hydrogen source, predicts a minimum selling price (MSP) of crude RCF oil of $1.13 per kg when ethanol is sold at $2.50 per gallon of gasoline-equivalent ($0.66 per liter of gasoline-equivalent). We estimate that the RCF process accounts for 57% of biorefinery installed capital costs, 77% of positive life cycle global warming potential (GWP) (excluding carbon uptake), and 43% of positive cumulative energy demand (CED). Of $563.7 MM total installed capital costs, the RCF area accounts for $323.5 MM, driven by high-pressure reactors. Solvent recycle and water removal via distillation incur a process heat demand equivalent to 73% of the biomass energy content, and accounts for 35% of total operating costs. In contrast, H 2 cost and catalyst recycle are relatively minor contributors to operating costs and environmental impacts. In the carbohydrate-rich pulps, polysaccharide retention is predicted not to substantially affect the RCF oil MSP. Analysis of cases using different solvents and hemicellulose as an in situ hydrogen donor reveals that reducing reactor pressure and the use of low vapor pressure solvents could reduce both capital costs and environmental impacts. Processes that reduce the energy demand for solvent separation also improve GWP, CED, and air emissions. Additionally, despite requiring natural gas imports, converting lignin as a biorefinery co-product could significantly reduce non-greenhouse gas air emissions compared to burning lignin. Overall, this study suggests that research should prioritize ways to lower RCF operating pressure to reduce capital expenses associated with high-pressure reactors, minimize solvent loading to reduce reactor size and energy required for solvent recovery, implement condensed-phase separations for solvent recovery, and utilize the entirety of RCF oil to maximize value-added product revenues., Competing Interests: None to declare., (This journal is © The Royal Society of Chemistry.)

We examined knowledge and practice of harm reduction strategies among people who use cannabis attending an annual public cannabis advocacy event. We also assessed the sources from which they glean information about cannabis. Participants ( n = 472) completed a brief survey assessing cannabis use, sources for information on cannabis, and harm reduction strategies. Participants' knowledge of cannabis was based mostly on their own experiments and experiences rather than on information from health professionals. Participants generally had low accuracy in identifying effective harm reduction techniques and low rates of utilizing effective harm reduction techniques, using them at the same rate overall as techniques without empirical support. Results from this survey will be useful to public health professionals developing and implementing harm reduction educational strategies related to cannabis use.

Objective: To examine the feasibility of taste testing and point-of-purchase prompting to promote healthier food choices at a food truck event., Design: A pre-/post-study was conducted where food trucks provided samples of healthy food items to patrons and implemented point-of-purchase prompting (promotional signage; verbal cues). Implementation fidelity, acceptability and initial effectiveness were assessed via observation, patron surveys and sales data. A linear mixed model with a random effect for subject (food truck) and fixed effect for time point (baseline, intervention and post-intervention) was used to assess changes in relative sales of promoted healthy items as a percentage of food items sold., Setting: Weekly food truck event in Buffalo, New York., Participants: Seven food trucks; 179 patrons., Results: Implementation fidelity data illustrated that all food trucks complied with manualised procedures. Approximately one-third of surveyed patrons accepted a healthy sample, with the majority rating the sample positively. There was no main effect of time when examining changes in relative sales of promoted healthy items across all periods (P = 0·32); however, effect sizes representing changes between individual time points are consistent with an increase from baseline to intervention (d = 0·51), which was maintained through post-intervention (d = 0·03). The change from baseline to post-intervention corresponded to a medium effect size (d = 0·55)., Conclusions: Findings generally support the feasibility of implementing taste testing and point-of-purchase prompting to increase the selection of healthy food items from food trucks; implications for future research in this novel setting are discussed.

Purpose: To compare cannabis enthusiasts' knowledge about cannabis risks and effectiveness in treating medical conditions with existing empirical evidence., Design: A brief survey assessed cannabis use, information sources, and knowledge about risks and effectiveness., Setting: A cannabis advocacy event in April 2019 in a state with legal medical and recreational cannabis., Participants: Demographically diverse adults (N = 472) who frequently used cannabis; 85% used cannabis for health or medical purposes., Measures: Participants reported the sources of their cannabis information, health conditions they thought cannabis was effective in treating (n = 10), and health risks increased by cannabis (n = 6). Conditions and risks were based on ratings of evidence (ie, from substantial to insufficient) for therapeutic effects and risks identified in a review by The National Academies of Sciences, Engineering, and Medicine (NASEM, 2017)., Analyses: Chi-square tests examined the correspondence between participants' knowledge and NASEM conclusions., Results: Most participants' (95% confidence interval [CI]: 74%-81%) knowledge of cannabis was from their own experiences; 18% (95% CI: 14%-21%) received information from primary care providers. On average, participants' beliefs matched NASEM conclusions for half of effectiveness (95% CI: 50%-53%) and risk items (95% CI: 55%-57%). Many (95% CI: 38%-42%) thought that cannabis use did not increase any risk. Contrary to NASEM conclusions, many thought cannabis was effective in treating cancer (76%), depressive symptoms (72%), and epilepsy (68%). Those who received cannabis information from their primary care providers had better knowledge of medical effectiveness. Medicinal cannabis use frequency inversely predicted knowledge of medical effectiveness and increased risks of adverse events., Conclusion: There were considerable discrepancies between cannabis users' knowledge and available evidence, highlighting the need for more research and education (by physicians, caregivers, and dispensaries) on effectiveness and health risks, especially for users with specific health issues such as pregnant women and people with depression.

An evidence-based approach is needed to shape policies and practices regarding medical cannabis, thereby reducing harm and maximizing benefits to individuals and society. This project assesses attitudes towards and utilization of medical cannabis and the mainstream healthcare system among medical cannabis users. The research team administered brief hard copy surveys to 450 adults attending an annual public event advocating for cannabis law reform. Among usable responses (N = 392), the majority (78%) reported using cannabis to help treat a medical or health condition. Medical cannabis users reported a greater degree of use of medical cannabis and a greater degree of trust in medical cannabis compared to mainstream healthcare. In comparison to pharmaceutical drugs, medical cannabis users rated cannabis better on effectiveness, side effects, safety, addictiveness, availability, and cost. Due to the medical use of cannabis, 42% stopped taking a pharmaceutical drug and 38% used less of a pharmaceutical drug. A substantial proportion (30%) reported that their mainstream healthcare provider did not know that they used medical cannabis. Other issues identified included lack of access to mainstream healthcare, self-initiated treatment of health issues, little knowledge of psychoactive content, and heavy cannabis use.

Renewed interest in production of 1,3-butadiene from non-petroleum sources has motivated research into novel production routes. In this study, we investigated an integrated process comprising 1-butanol dehydration over a γ-Al 2 O 3 catalyst to produce a mixture of linear butenes, coupled with a downstream K-doped Cr 2 O 3 /Al 2 O 3 catalyst to convert the butenes into butadiene. Linear butene yields greater than 90% are achievable at 360 °C in the dehydration step, and single-pass 1,3-butadiene yields greater than 40% are achieved from 1-butene in a N 2 atmosphere in the dehydrogenation step. In the integrated process, 1,3-butadiene yields are 10-15%. In all cases, linear C4 selectivity is greater than 90%, suggesting that 1,3-butadiene yields could be significantly improved in a recycle reactor. Doping the Cr 2 O 3 catalyst with different metals to promote H 2 consumption in a CO 2 atmosphere did not have a large effect on catalyst performance compared to an undoped Cr 2 O 3 catalyst, although doping with K in an N 2 -diluted atmosphere and with Ni in a CO 2 -enriched atmosphere showed slight improvement. In contrast, doping with K and Ca in a CO 2 -enriched atmosphere showed slightly decreased performance. Similarly, employing a CO 2 -enriched atmosphere in general did not improve 1,3-butadiene yield or selectivity compared to reactions performed in N 2 . Overall, this study suggests that an integrated dehydration/dehydrogenation process to convert 1-butanol into 1,3-butadiene could be feasible with further catalyst and process development., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Objective: To identify barriers to children's access to dental care., Basic Research Design: A cross-sectional health survey., Setting: All residential census tracts in Genesee County, Michigan, USA., Participants: 498 adults who reported having children in their households, extracted from 2,932 randomly selected adult participants in the 2009 and 2011 surveys., Main Measures: Stepwise logistic regression was used to predict two dependent variables: children's lack of any visits to dentists' offices and unmet dental care needs (defined as needing dental care but not receiving it due to cost) in the previous year as reported by the adults. Independent variables included gender, age, education, race/ethnicity, financial planning, financial distress, fear of crime, stress, depressive symptoms, experiences of discrimination, and neighbourhood social capital., Results: Of the 498 adults, 29.9% reported that they had children who had not visited a dentist in the past 12 months and 13% reported that they had household children with unmet dental care needs in the past year. Adults who reported higher depressive symptoms, lower neighbourhood social capital, greater financial distress, and who were younger were more likely to have household children who did not visit a dentist in the past year. Financial distress was the only significant predictor when controlling for other variables to predict unmet dental care needs., Conclusions: Factors beyond financial distress affect children's dental care; these include parental depressive symptoms and lower neighbourhood social capital. Interventions promoting parental mental health and social integration may increase dental care among children.

Glycerol, a commodity by-product of the biodiesel industry, has value as a fuel feedstock and chemical intermediate. It is also a simple prototype of sugars and carbohydrates. Through catalytic partial oxidation (CPOx), glycerol can be converted into syngas without the addition of process heat. We explored the CPOx of glycerol using a nebulizer to mix droplets with air at room temperature for reactive flash volatilization. Introducing this mixture over a noble-metal catalyst oxidizes the glycerol at temperatures over 600 degrees C in 30-90 ms. Rhodium catalysts produce equilibrium selectivity to syngas, while platinum catalysts produce mainly autothermal non-equilibrium products. The addition of water to the glycerol increases the selectivity to H(2) by the water gas shift reaction and reduces non-equilibrium products. However, water also quenches the reaction, resulting in a maximum in H(2) production at a steam/carbon ratio of 2:3 over a Rh-Ce catalyst. Glycerol without water produces a variety of chemicals over Pt, including methylglyoxal, hydroxyacetone, acetone, acrolein, acetaldehyde, and olefins.

Elevated levels of epidermal growth factor receptor (EGFR) are predictive of increased invasion and metastasis in many human cancers. In the present study, we have shown that two distinct pathways regulate cell migration in EGFR-overexpressing invasive cells such as MDA 468 breast cancer cells: mitogen-activated protein kinase (MAPK or ERK 1 and 2) pathways play a major role in early stages to cell migration; and protein kinase C delta isoforms (PKC-delta) play a significant role in later stages of sustained cell migration. Inhibition of MAPK activity with MAP kinase kinase (MEK) inhibitor PD98059 blocks early stages of cell migration (up to 4 h); however, cells revert back to enhanced cell migration after 4 h. While inhibition of PKC-delta activity with rottlerin or dominant-negative PKC-delta expression blocks sustained cell migration after 4 h and up to 12 h, the combination of MAPK and PKC inhibitors completely blocked transforming growth factor alpha (TGF-alpha)-induced cell migration in EGFR-overexpressing breast cancer cells. However, inhibition of MAPK activity completely blocked cell migration in low EGFR-expressing non-invasive breast cancer cells such as MCF-7 cells. Forced overexpression of EGFR in MCF-7 cells (EGFR/MCF-7 cells) resulted in cell migration patterns seen in MDA 468 cells, that is, MAPK pathways play a major role in early stages to cell migration, and PKC-delta plays a major role in later stages of sustained cell migration. The above data demonstrate that EGFR-overexpressing invasive cells have the ability to compensate the loss of MAPK-mediated signaling through activation of PKC-delta signaling for cell migration, which plays a major role in invasion and metastasis. In addition, data suggest that inhibition of MAPK and PKC-delta signaling pathways should abrogate cell migration and invasion in EGFR-overexpressing human breast cancer cells.

The creation of an improved burn-care capability was a long-awaited dream at Kalafong Hospital, one of the two academic (tertiary referral) hospitals of the University of Pretoria. When this recently became a reality, a prospective analysis of cost-effective burn care was initiated. For patients with burns of less than 10% body surface area (BSA), hospital stay (healing time) was shortened from a mean of 4.1 d/% BSA burnt to 2.7 d/% BSA burnt (34% reduction; P = 0.01). For patients with burns greater than 10% BSA, hospital stay (healing time) decreased from 2.3 d/% BSA burnt to 1.4 d/% BSA burnt (39% reduction; P = 0.0095). The overall mortality rate declined from 16.2% to 11.2% over the 24-month period. Patients with the largest deep dermal burn injury to survive in our hospital improved from 35% BSA to 60%. It is concluded that the creation of better burn care facilities at our hospital has shortened the hospital stay of survivors by a mean of 35% and decreased the mortality rate by 30%. Hospital authorities should take note of the fact that better facilities not only improve cost-effective patient care but also survival figures.

Polyvinyl chloride tubing (ID, 1.27 mm; OD, 2.29 mm) was placed via the jugular vein into the right atrium of thirty-five 120- to 200-day-old gilts. Catheters remained patent for 14 to 88 days (mean, 41 days). The major cause of loss of function was damage inflicted by the gilt (20 catheters), whereas only 3 catheters lost patency because of blockage. Using a pulley and counterweight system the exteriorized end of the catheter was suspended above the gilt, facilitating blood collection and minimizing disturbance of the gilts.

Thermally induced focusing in a neodymium-doped yttrium aluminum garnet rod was measured for pulsed optical pumping conditions with low average pump powers (400 W or less). A transient defocusing and a quasi-steady-state equilibrium with positive focusing are identified. The equilibrium induced focusing is shown to depend only on the average pump power for pulse rates above about 5 Hz. The quantitative dependence of the equilibrium induced focusing power of the rod on average pump power was measured, and effects of this induced focusing on the parameters of a laser resonant cavity containing the rod were investigated. A technique for accurately measuring focal powers of the order of 0.02 diopter in systems with f-numbers as high as 8000 is described.