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Cannabis policy is rapidly changing and more individuals are using cannabis nationally. Despite increased use and known adverse outcomes to cannabis use, there is a lack of understanding of health care utilization for cannabis-related conditions. The objectives of this study were: (1) To understand the change in the incidence of cannabis-related diagnoses from 2012 to 2015 nationally and (2) to describe the relationship between regional cannabis policies and changes in the incidence of cannabis-related diagnoses from 2012 to 2015. National Inpatient Sample (NIS) data from the Healthcare Cost and Utilization Project for 2012 and 2015 were analyzed using SPSS software for incidence of cannabis diagnoses. Previously defined NIS regions were assigned a policy status related to medical and recreational cannabis laws. Comparisons were made at the national and regional levels to better understand change in incidence of diagnoses. From 2012 to 2015, there was a 26.7% increase in cannabis-related diagnoses in the inpatient setting nationally. All 9 regions showed increases in the incidence of cannabis-related diagnoses ranging from 15.5% to 41.9% regardless of cannabis policy. As cannabis policy increased legal access, cannabis-related diagnoses increased nationally and regionally across the United States from 2012 to 2015 regardless of cannabis policy. Continued tracking of cannabis-related diagnoses is needed to identify where interventions are necessary to reduce negative impacts of increased cannabis use.

Hepatic steatosis associated with high fat diets, obesity and type 2 diabetes is thought to be the major driver of severe liver inflammation, fibrosis, and cirrhosis. Cytosolic acetyl-coenzyme A (AcCoA), a central metabolite and substrate for de novo lipogenesis (DNL), is produced from citrate by ATP-citrate lyase (ACLY) and from acetate through AcCoA synthase short chain family member 2 (ACSS2). However, the relative contributions of these two enzymes to hepatic AcCoA pools and DNL rates in response to high fat feeding is unknown. We report here that hepatocyte-selective depletion of either ACSS2 or ACLY caused similar 50% decreases in liver AcCoA levels in obese mice, showing that both pathways contribute to generation of this DNL substrate. Unexpectedly however, the hepatocyte ACLY depletion in obese mice paradoxically increased total DNL flux measured by D2O incorporation into palmitate, while in contrast ACSS2 depletion had no effect. The increase in liver DNL upon ACLY depletion was associated with increased expression of nuclear sterol regulatory element-binding protein 1c (SREBP1c) and of its target DNL enzymes. This upregulated DNL enzyme expression explains the increased rate of palmitate synthesis in ACLY depleted livers. Furthermore, this increased flux through DNL may also contribute to the observed depletion of AcCoA levels due to its increased conversion to Malonyl CoA (MalCoA) and palmitate. Together, these data indicate that in HFD fed obese mice, hepatic DNL is not limited by its immediate substrates AcCoA or MalCoA, but rather by activities of DNL enzymes.

Hepatic steatosis associated with high-fat diet, obesity, and type 2 diabetes is thought to be the major driver of severe liver inflammation, fibrosis, and cirrhosis. Cytosolic acetyl CoA (AcCoA), a central metabolite and substrate for de novo lipogenesis (DNL), is produced from citrate by ATP-citrate lyase (ACLY) and from acetate through AcCoA synthase short chain family member 2 (ACSS2). However, the relative contributions of these two enzymes to hepatic AcCoA pools and DNL rates in response to high-fat feeding are unknown. We report here that hepatocyte-selective depletion of either ACSS2 or ACLY caused similar 50% decreases in liver AcCoA levels in obese mice, showing that both pathways contribute to the generation of this DNL substrate. Unexpectedly however, the hepatocyte ACLY depletion in obese mice paradoxically increased total DNL flux measured by D

The full issue of WPLCLE, volume 3 (2014).

This chapter is drawn from a qualitative case study of one alternative high school English class, tracing students' engagement and resistance with digital media and school-based literacy practices, exploring how each student's use of literacy and digital media led to the formation of particular identities in the social sphere of the classroom. In this chapter the authors focus on two students, Callie--loud and socially dominant-- and Nina, quiet, reserved, outside the social circle. The authors trace the students' respective discursive practices in two composition units-- a multimodal children's book unit and a Theater of the Oppressed unit. The chapter argues that both young women have strong literacy skills and are strategic in using them, thereby creating particular identities as they produced texts.