In der Reihe werden herausragende monographische Untersuchungen und Sammelbände zu allen Aspekten der Philosophie Kants veröffentlicht, ebenso zum systematischen Verhältnis seiner Philosophie zu ...anderen philosophischen Ansätzen in Geschichte und Gegenwart. Veröffentlicht werden Studien, die einen innovativen Charakter haben und ausdrückliche Desiderate der Forschung erfüllen. Die Publikationen repräsentieren damit den aktuellsten Stand der Forschung.
Wild relatives and unadapted forms of crop plants are important reservoirs of allelic variation that can be accessed through wide crosses for improvement of crop plants. In this paper, we describe ...insights and innovations from the use of wide crosses to transfer favorable alleles from wild or unadapted forms of two crops: canola (oilseed Brassica napus L.) and tomato (Lycopersicon esculentum Mill.). The canola research involves the use of unadapted forms (winter types and resynthesized B. napus) in wide crosses to spring-seeded types to increase seed yield of hybrids. The tomato research involves the use of wild tomato relatives to improve several traits, including disease resistance and fruit quality. These two crop plants provide a broad range of insights and innovations that have been gained from wide crosses in plant breeding research, including the impact of chromosomal rearrangements on allelic variation among unadapted forms of B. napus, and innovations that can be achieved from stacking elite alleles in tomato. The examples presented in this paper highlight the value of using DNA markers for understanding and applying the results of wide crosses.
US rates of overdose deaths involving stimulants (e.g., cocaine or methamphetamine) have increased, but little is known about non-fatal stimulant overdoses, particularly among vulnerable populations. ...We characterized rates of non-fatal stimulant overdose identified outside of health care settings among women at high risk.
Homeless and unstably housed women in San Francisco, California using stimulants were administered questionnaires on drug use and outcomes (stimulant overdose, health care utilization) monthly for six months. Based on pilot interviews, stimulant overdose during follow-up was defined as acute toxicity from stimulant use (“over-amping”) resulting in “feeling sick, really scared, or like one’s life may be in danger”. Poisson regression estimated unadjusted incidence rate ratio (IRR) comparing participant characteristics.
We included 160 women (41% Black, 26% White, 15% Latina, median age 54 years) using crack cocaine (81%), methamphetamine (48%), and powdered cocaine (36%). Participants reported 67 non-fatal stimulant overdoses over 685 person-months of observation, a rate of 117.4 per 100 person-years (95% CI 85.8–160.5). Rates were higher among participants who were Latina vs. White (IRR 4.18 1.60–10.94), used methamphetamine (IRR 1.80 0.96–3.38), or used any stimulant daily/almost daily (IRR 2.63 1.41–4.91). Among women reporting stimulant overdose, 4% received emergency and 3% inpatient care for overdose of any drug.
Women in this setting, particularly those who used stimulants frequently or used methamphetamine, experienced high non-fatal stimulant overdose and rarely received health care for these events. Efforts should be made to increase awareness and reduce harms of stimulant toxicity in vulnerable populations.
•Unstably housed women had high rates of non-fatal stimulant overdose.•Rates were higher for women who used stimulants frequently or used methamphetamine.•Rates were also higher for women who identified as Latina vs. White.•Few women reporting stimulant overdoses received health care for these events.
•The large drops in emergency department use observed in the general population during the COVID-19 pandemic were not observed among homeless and unstably housed women who participated in this ...study.•Homeless and unstably housed women who reported difficulties accessing drug treatment were eight times more likely to report emergency department use during the COVID-19 pandemic.•It is critical to ensure access to housing and to maintain low-barrier health and substance use services, including drug use treatment, during public health crises.
The COVID-19 pandemic created a major public health crisis that disrupted economic systems, social networks and individual behaviors, which led to changes in patterns of health care use. Factors associated with emergency department (ED) visits during the pandemic among especially high-risk individuals are unknown. We used a “Big Events” approach, which considers major disruptions that create social instability, to investigate ED use in people experiencing homelessness or housing instability, many of whom use drugs.
Between July and December 2020, we conducted a community-based San Francisco study to compare homeless and unstably housed (HUH) women who did and did not use an ED during the first 10 months of the pandemic.
Among 128 study participants, 34% had ≥1 ED visit during the pandemic. In adjusted analysis, factors significantly associated with ED use included experiencing homelessness, cocaine use and increased difficulties receiving drug use treatment during the pandemic.
These findings build on the “Big Events” approach to considering risk pathways among people who use drugs. They suggest the importance of ensuring access to housing and low-barrier non-COVID health services, including drug treatment, alongside crisis management activities, to reduce the health impacts of public health crises.
•Cocaethylene and fentanyl are associated with higher levels of hsTnI in poly-drug using women.•Counseling to avoid using cocaine and alcohol in the same two hour period may reduce cardiovascular ...events.•Including substance use in cardiac risk stratification tools may be warranted.
The use of controlled substances like cocaine increases the risk of cardiovascular disease (CVD) and myocardial infarction (MI). However, outside of alcohol and tobacco, substance use is not included in CVD risk assessment tools. We identified the effects of using multiple substances (nicotine/cotinine, cannabis, alcohol, cocaine, methamphetamine, heroin and other opioids) on cardiac injury measured by high-sensitivity troponin (hsTnI) in homeless and unstably housed women.
We recruited 245 homeless and unstably housed women from shelters, free meal programs and street encampments. Participants completed six monthly study visits. Adjusting for traditional CVD risk factors, we examined longitudinal associations between substance use and hsTnI.
Median participant age was 53 years and 74 % were ethnic minority women. At baseline, 76 % of participants had hypertension, 31 % were HIV-positive, 8% had a history of a prior MI and 12 % of prior stroke. The most commonly used substances were cotinine/nicotine (80 %), cannabis (68 %) and cocaine (66 %). HsTnI exceeding the 99th percentile (14.7 ng/L) – a level high enough to signal possible MI – was observed in 14 participants during >1 study visit (6%). In adjusted analysis, cocaethylene and fentanyl were significantly associated with higher hsTnI levels.
Fentanyl use and the co-use of cocaine and alcohol are associated with myocardial injury, suggesting that the use of these substances may act as long-term cardiac insults. Whether risk counseling on these specific substances and/or including their use in CVD risk stratification would improve CVD outcomes in populations where substance use is high merits further investigation.
Cardiovascular disease (CVD) and heart failure (HF) are disproportionately high in people living with HIV and differ by sex. Few CVD-related studies focus on drug use, yet it is common in low-income ...women living with HIV (WLWH) and increases cardiac dysfunction.
We recruited unsheltered and unstably housed WLWH from San Francisco community venues to participate in a six-month cohort study investigating linkages between drug use, inflammation, and cardiac dysfunction.
Adjusting for CVD risk factors, co-infections, medications, and menopause, we examined the effects of toxicology-confirmed drug use and inflammation (C-reactive protein, sCD14, sCD163 and sTNFR2) on levels of NT-proBNP, a biomarker of cardiac stretch and HF.
Among 74 WLWH, the median age was 53 years and 45 % were Black. At baseline, 72 % of participants had hypertension. Substances used included tobacco (65 %), cannabis (53 %), cocaine (49 %), methamphetamine (31 %), alcohol (28 %), and opioids (20 %). Factors significantly associated with NT-proBNP included cannabis use (Adjusted Relative Effect ARE: −39.6 %) and sTNFR2 (ARE: 65.5 %). Adjusting for heart failure and restricting analyses to virally suppressed persons did not diminish effects appreciably. Cannabis use was not significantly associated with sTNFR2 and did not change the association between sTNFR2 and NT-proBNP.
Among polysubstance-using WLWH, NT-proBNP levels signaling cardiac stretch were positively associated with sTNFR2, but 40 % lower in people who used cannabis. Whether results suggest that cardiovascular pathways associated with cannabis use mitigate cardiac stress and dysfunction independent of inflammation in WLWH who use multiple substances merits further investigation.
•Cannabis use is negatively associated with NT-proBNP in women living with HIV.•The cannabis effect is retained after adjusting for viral suppression and heart failure.•sTNFR2 is positively associated with NT-proBNP in women living with HIV.•Cannabis use is not significantly associated with sTNFR2 in women living with HIV.
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