Background: Reports of major limb defects after prenatal cannabis exposure (PCE) in animals and of human populations in Hawaii, Europe and Australia raise the question of whether the increasing use of cannabis in USA might be spatiotemporally associated with limb reduction rates (LRR) across USA.
Methods: Congenital anomaly data was from the National Birth Defects Prevention Network, drug use data was taken from the National Survey of Drug Use and Health (NSDUH), cannabinoid concentration was estimated from Federal seizure data and ethnicity and income data were from the US Census bureau. Geotemporospatial analysis was conducted in R.
Results: 436 LRR datapoints were obtained. LRR was significantly associated with cannabis use and tetrahydrocannabinol (THC) exposure and demonstrated prominent cannabis-use quintile effects. A sharp increase in LRR occurred from the fourth to fifth quintiles of cannabis exposure (mean ± S.E.M 3.78 ± 0.38 to 6.66 ± 0.56/10,000 live births, P = 5.22 × 10). In final lagged geospatial models adjusted for ethnicity and income interactive terms including cannabinoids were highly significant and robust to adjustment. States in which cannabis was not legalized had a lower LRR (4.28 v 5.01/10,000 live births, relative risk reduction = -0.15, (95%C.I. -0.25, -0.02), P = 0.021). Internationally 37-63% of cases are estimated to not be born alive. Their inclusion in these analyzes uniformly intensified the identified effects and the significance of the effect of the cannabis legalization paradigm rose from P = 0.0256 to P = 0.0146 to P = 0.0048 with silent factors of 0%, 36% and 63%, respectively.
Conclusion: Therefore a spatiotemporal and dose-dependent association between several cannabinoids including THC and cannabigerol and LRR is reported, is robust to adjustment, is consistent with pathophysiological and preclinical studies, accords with findings elsewhere, is markedly exacerbated in higher exposure quintiles, is exacerbated by cannabis legalization and evidences dose-related intergenerational sequaelae.
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http://dx.doi.org/10.1016/j.sste.2022.100480 | DOI Listing |
Foot Ankle Surg
December 2024
Dept of Orthopaedics, Kings College Hospital MTC, King's College Hospital NHS Foundation Trust, London, United Kingdom.
Background: Contemporary guidelines advocate for initial debridement and single-stage definitive fixation with immediate soft tissue reconstruction for open fractures. This study aims to evaluate the effectiveness of single-stage stabilization and immediate definitive soft tissue coverage in open ankle fractures compared to closed fractures.
Methods: We compared all isolated open ankle fractures (OF) treated between January 2017 and June 2019 to a control group of operatively managed closed ankle fractures (CF).
Introduction And Importance: Neglected posterior hip dislocations in adults are rare, particularly when untreated for years. In developing nations, patients often rely on traditional bone setters, leading to delayed diagnosis and increased complications. Adult hip dislocations carry a higher risk of avascular necrosis and require complex treatments.
View Article and Find Full Text PDFJ Neurosurg
January 2025
1Department of Neurosurgery, Inselspital, Bern University Hospital, University Bern, Switzerland.
Objective: The effectiveness and optimal stimulation site of deep brain stimulation (DBS) for central poststroke pain (CPSP) remain elusive. The objective of this retrospective international multicenter study was to assess clinical as well as neuroimaging-based predictors of long-term outcomes after DBS for CPSP.
Methods: The authors analyzed patient-based clinical and neuroimaging data of previously published and unpublished cohorts from 6 international DBS centers.
Sci Rep
January 2025
Department of Computer Science & Engineering, Galgotias University, Greater Noida, Uttar Pradesh, India.
A dual-stage model for classifying Parkinson's disease severity, through a detailed analysis of Gait signals using force sensors and machine learning approaches, is proposed in this study. Parkinson's disease is the primary neurodegenerative disorder that results in a gradual reduction in motor function. Early detection and monitoring of the disease progression is highly challenging due to the gradual progression of symptoms and the inadequacy of conventional methods in identifying subtle changes in mobility.
View Article and Find Full Text PDFSci Rep
January 2025
Biorobotics Laboratory, Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne (EPFL), CH-1015, Lausanne, Switzerland.
Despite their potential, exoskeletons have not reached widespread adoption in daily life, partly due to the challenge of seamlessly adapting assistance across various tasks and environments. Task-specific designs, reliance on complex sensing and extensive data-driven training often limit the practicality of the existing control strategies. To address this challenge, we introduce an adaptive control strategy for hip exoskeletons, emphasizing minimal sensing and ease of implementation.
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