7 results
Medical cannabis use among patients with Post-Traumatic Stress Disorder (PTSD): A nationwide database study
- N. Yakirevich Amir, N. Treves, E. Davidson, O. Bonne, I. Matok
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S111-S112
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Introduction
In recent years, cannabis use among PTSD patients has become more common than ever. However, data available today regarding the effectiveness and safety of medical cannabis in PTSD treatment is limited, based on cross sectional studies, self-report surveys and a few clinical studies with small sample size.
ObjectivesTo characterize patterns of use and adverse effects over time in patients with PTSD using medical cannabis in real life setting.
MethodsData were acquired from the Israeli national database of all patients licensed to use medical cannabis from January 2014 to December 2021. A license for medical cannabis is given to patients with PTSD of at least moderate intensity after treatment failure of at least two drugs and two psychological interventions. Comparative statistics were used to evaluate patterns of use and adverse effects.
Results12,977 patients were licensed to use medical cannabis in the study period for PTSD (8.2% of all users; 70% men) during the above-mentioned time period. PTSD was the 3rd most common indication after chronic pain and symptoms related to oncological disease and chemotherapy treatment. Over time, the relative increase in use of medical cannabis among PTSD patients was higher than that found in non-PTSD patients. In 2021 36.2% of all PTSD patients using medical cannabis had their license issued that year compared to 28.1% of all non-PTSD patients. PTSD patients were significantly younger compared to non-PTSD patients (40.9 years vs. 52.9 years). PTSD patients consume slightly higher monthly amount at the beginning of treatment compared to non-PTSD patients (32.1gr vs. 30.6gr) with higher Tetrahydrocannabinol (THC) concentration (15.2% vs. 12.9%) and lower Cannabidiol (CBD) concentration (4.7% vs. 6.0%). Over two years of use, amount, and composition of cannabis among the two groups were comparable and showed an increase in total amount and THC concentration, reaching the maximal available THC concentration of 20%. Data regarding adverse effects were available for 6,242 PTSD patients (48.1%) and 39,497 non-PTSD patients (26.6%). PTSD patients reported more physical adverse effects (RR 1.45 [95%CI 1.34-1.56]), anxiety (RR 1.47 [95%CI 1.13-1.92]), and derealization (RR 3.44 [95%CI 2.42-4.89]).
ConclusionsPTSD is one of the leading indications for medical cannabis use in Israel, despite scarcity in good quality data supporting its effectiveness and safety. The increased risk of mental adverse effects among PTSD patients emphasizes the need for cautious use in cannabis in this population. Expanding the knowledge regarding patterns of use and risks in medical cannabis use among PTSD patients is important for understanding the role of cannabis in PTSD treatment and to ensure an effective and safe treatment.
Disclosure of InterestNone Declared
Sex-related differences in medical cannabis use: A nation-wide database study
- N. Yakirevich Amir, N. Treves, I. Reuveni, E. Davidson, O. Bonne, I. Matok
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S82
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Introduction
Cannabis use is associated with mental illness among men and women, especially induction or exacerbation of psychosis, anxiety, and depression. Although safety and efficacy of cannabis in most medical conditions have not been established, use of medical cannabis is growing exponentially. In particular, albeit sex-related differences in the activity of the endocannabinoid system in animals and humans, differential effects of cannabis on men and women have rarely been sought.
ObjectivesTo characterize patterns of use and adverse effects experienced by men and women using medical cannabis.
MethodsData from the Israeli national database of patients licensed to use medical cannabis in Israel from January 2014 to December 2021 was analyzed. The database includes indications for cannabis use, monthly cannabis quantities, Tetrahydrocannabinol (THC) and Cannabidiol (CBD) concentrations, and reports of adverse effects. Comparative statistics were used to evaluate the sex related differences.
Results161,644 persons (62% men) were issued a license to use medical cannabis during the study period. Men are significantly younger than women (50.5±19.1 vs. 56.5±18.4). The leading indications among both men and women are chronic pain (58% of men, 57% of women), symptoms related to oncological disease and chemotherapy treatment (21% of men, 24% of women) and post-traumatic stress disorder (9% of men, 6% of women). Men consume significantly higher monthly quantities at the beginning of treatment compared to women (31.6 gram vs. 29.3 gram) with a higher THC concentration (13.9% vs. 11.6%) and lower CBD concentration (5.3% vs. 6.7%). Over two years of use, there is an increase among both men and women in the amount and THC concentration, and a decrease in the CBD concentration. The differences between men and women remain significant throughout the whole period. Data on adverse effects are available for 28,629 men and 17,204 women (28.6% of men, 28.0% of women). Women report significantly more physical adverse effects (RR 1.48 [95%CI 1.39-1.57]), anxiety (RR 1.45 [95%CI 1.35-1.56]), depression (RR 1.36 [95%CI 0.95-1.96]) and derealization (RR 3.44 [95%CI 2.42-4.89]).
ConclusionsAlthough the prevalence of medical conditions for which medical cannabis is indicated are similar for both genders, approximately 60% more men consume medical cannabis. While consuming lower cannabis amount and THC concentration, women report more physical and psychiatric adverse effects than men. Understanding the differences in usage patterns and adverse effects between men and women will enable more accurate policy determinations and more effective and safer treatment strategies.
Disclosure of InterestNone Declared
The Association between Mood, Inhibitory Control and Depressive Symptoms: An Ecological Momentary Assessment Study
- M. Nahum, N. Yitzhak, O. Shimony-Mazar, N. Oved, O. Bonne
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S418-S419
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Introduction
Cognitive models of depression highlight the role of inhibitory control - the cognitive control ability which supports our goal directed behavior – as key and even causal feature of the disorder. According to these models, deficits in inhibitory control prevent the exclusion of irrelevant negative information, leading to rumination and sustained negative mood which result in depressive episodes. However, the scientific evidence linking deficits in inhibitory control to depression is thus far mixed. Moreover, although one’s inhibitory control ability may fluctuate, it is often assessed using a single-time measurement in the lab.
ObjectivesHere we aimed to assess the association between intra-individual fluctuations in inhibitory control measured in ecological settings, daily mood states, and depressive symptoms.
MethodsN=106 participants (Mean age: 38 ± 10 years; range: 19-62 years; 68% female) reported their depressive symptoms (using the PHQ-9 scale) and completed a mobile version of the Go-NoGo inhibition task at baseline. They then completed a 5-day ecological-momentary-assessment (EMA) protocol, in which they reported their current mood (using the IMS-12 scale) and performed a shortened version of the Go-NoGo task twice/day using a mobile application. Depressive symptoms were assessed again following the 5-day EMA. Hierarchical-linear-modeling (HLM) was applied to examine the association between momentary IC and mood, with post-EMA depressive symptoms as a moderator. Inhibitory control was included as a time-varying predictor for mood in the 1st step, and depressive symptoms post-EMA and their interaction with inhibition were included in the 2nd step.
ResultsAt baseline, there were no correlations between depressive symptoms and inhibitory control (rp = .035, n.s). However, individuals with elevated depressive symptoms demonstrated worse and more variable inhibition performance over time (rp = .29, p = .002), as captured in the EMA measures. In addition, participants with more variable inhibitory control performance over time also reported more depressive symptoms at the end of the 5-day period (rp = .27, p = .006). Finally, post-EMA depressive symptoms moderated the association between momentary inhibitory control and daily mood, such that reduced inhibition was associated with more negative mood only for those with lower, but not with higher, depressive symptoms (Figure 1).
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ConclusionsVariable, rather than mere reduced inhibitory control is related to depressive symptoms. Moreover, the role of inhibition in modulating mood differs in non-depressed vs. depressed individuals. These findings contribute to our understanding of inhibition and mood in real life and help account for some of the discrepant findings related to cognitive control models of depression. Future investigations should examine the validity of these outcomes in other, clinical samples.
Disclosure of InterestNone Declared
Sprays from droplets impacting a mesh
- S. A. Kooij, A. M. Moqaddam, T. C. de Goede, D. Derome, J. Carmeliet, N. Shahidzadeh, D. Bonn
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- Journal:
- Journal of Fluid Mechanics / Volume 871 / 25 July 2019
- Published online by Cambridge University Press:
- 22 May 2019, pp. 489-509
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In liquid spray applications, the sprays are often created by the formation and destabilization of a liquid sheet or jet. The disadvantage of such atomization processes is that the breakup is often highly irregular, causing a broad distribution of droplet sizes. As these sizes are controlled by the ligament corrugation and size, a monodisperse spray should consist of ligaments that are both smooth and of equal size. A straightforward way of creating smooth and equally sized ligaments is by droplet impact on a mesh. In this work we show that this approach does however not produce monodisperse droplets, but instead the droplet size distribution is very broad, with a large number of small satellite drops. We demonstrate that the fragmentation is controlled by a jet instability, where initial perturbations caused by the injection process result in long-wavelength disturbances that determine the final ligament breakup. During destabilization the crests of these disturbances are connected by thin ligaments which are the leading cause of the large number of small droplets. A secondary coalescence process, due to small relative velocities between droplets, partly masks this effect by reducing the amount of small droplets. Of the many parameters in this system, we describe the effect of varying the mesh size, mesh rigidity, impact velocity and wetting properties, keeping the liquid properties the same by focusing on water droplets only. We further perform lattice Boltzmann modelling of the impact process that reproduces key features seen in the experimental data.
Analysis of the two-dimensional dynamics of a Mach 1.6 shock wave/transitional boundary layer interaction using a RANS based resolvent approach
- N. Bonne, V. Brion, E. Garnier, R. Bur, P. Molton, D. Sipp, L. Jacquin
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- Journal:
- Journal of Fluid Mechanics / Volume 862 / 10 March 2019
- Published online by Cambridge University Press:
- 16 January 2019, pp. 1166-1202
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A two-dimensional analysis of the resolvent spectrum of a Mach 1.6 transitional boundary layer impacted by an oblique shock wave is carried out. The investigation is based on a two-dimensional mean flow obtained by a RANS model that includes a transition criterion. The goal is to evaluate whether such a low cost RANS based resolvent approach is capable of describing the frequencies and physics involved in this transitional boundary layer/shock-wave interaction. Data from an experiment and a companion large eddy simulation (LES) are utilized as reference for the validation of the method. The flow is characterized by a laminar boundary layer upstream, a laminar separation bubble (LSB) in the interaction region and a turbulent boundary layer downstream. The flow exhibits low amplitude unsteadiness in the LSB and at the reflected shock wave with three particular oscillation frequencies, qualified as low, medium and high in reference to their range in Strouhal number, here based on free stream velocity and LSB length ($S_{t}=0.03{-}0.11$, 0.3–0.4 and 2–3 respectively). Through the resolvent analysis this dynamics is found to correspond to an amplifier behaviour of the flow. The resolvent responses match the averaged Fourier mode of the time dependent flow field, here described by the LES, with a close agreement in frequency and spatial distribution, thereby validating the resolvent approach. The low frequency dynamics relates to a pseudo-resonance process that sequentially implies the amplification in the separated shear layer of the LSB, an excitation of the shock foot and a backward travelling density wave. As this wave hits back the separation point the amplification in the shear layer starts again and loops. The medium and high frequency modes relate to the periodic expansion/reduction of the bubble and to the turbulent fluctuations at the reattachment point of the bubble, respectively.
Universal rescaling of drop impact on smooth and rough surfaces
- J. B. Lee, N. Laan, K. G. de Bruin, G. Skantzaris, N. Shahidzadeh, D. Derome, J. Carmeliet, D. Bonn
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- Journal:
- Journal of Fluid Mechanics / Volume 786 / 10 January 2016
- Published online by Cambridge University Press:
- 30 November 2015, R4
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The maximum spreading of drops impacting on smooth and rough surfaces is measured from low to high impact velocity for liquids with different surface tensions and viscosities. We demonstrate that dynamic wetting plays an important role in the spreading at low velocity, characterized by the dynamic contact angle at maximum spreading. In the energy balance, we account for the dynamic wettability by introducing the capillary energy at zero impact velocity, which relates to the spreading ratio at zero impact velocity. Correcting the measured spreading ratio by the spreading ratio at zero velocity, we find a correct scaling behaviour for low and high impact velocity and, by interpolation between the two, we find a universal scaling curve. The influence of the liquid as well as the nature and roughness of the surface are taken into account properly by rescaling with the spreading ratio at zero velocity, which, as demonstrated, is equivalent to accounting for the dynamic contact angle.
Multiple coexisting states of liquid rope coiling
- N. M. RIBE, H. E. HUPPERT, M. A. HALLWORTH, M. HABIBI, DANIEL BONN
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- Journal:
- Journal of Fluid Mechanics / Volume 555 / 25 May 2006
- Published online by Cambridge University Press:
- 11 May 2006, pp. 275-297
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A thin ‘rope’ of viscous fluid falling from a sufficient height onto a surface forms a series of regular coils. Here we investigate theoretically and experimentally a curious feature of this instability: the existence of multiple states with different frequencies at a fixed value of the fall height. Using a numerical model based on asymptotic ‘thin rope’ theory, we determine curves of coiling frequency $\Omega$vs. fall height $H$ as functions of the fluid viscosity $\nu$, the diameter $d$ of the injection hole, the volumetric injection rate $Q$, and the acceleration due to gravity $g$. In addition to the three coiling modes previously identified (viscous, gravitational and inertial), we find a new multivalued ‘inertio-gravitational’ mode that occurs at heights intermediate between gravitational and inertial coiling. In the limit when the rope is strongly stretched by gravity and $\Pi_1\,{\equiv}\, (\nu^5/g Q^3)^{1/5}\,{\gg}\, 1$, inertio-gravititational coiling occurs in the height range $O(\Pi_1^{-1/6})\,{\leq}\, H(g/\nu^2)^{1/3}\,{\leq}\, O(\Pi_1^{-5/48})$. The frequencies of the individual branches are proportional to $(g/H)^{1/2}$, and agree closely with the eigenfrequencies of a whirling liquid string with negligible resistance to bending and twisting. The number of coexisting branches scales as $\Pi_1^{5/32}$. The predictions of the numerical model are in excellent agreement with laboratory experiments performed by two independent groups using different apparatus and working fluids. The experiments further show that interbranch transitions in the inertio-gravitational regime occur via an intermediate state with a ‘figure of eight’ geometry that changes the sense of rotation of the coiling.