Research coauthored by a University of Miami Business School professor links more frequent cannabis use to fewer days of good mental health, particularly among men.
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More frequent cannabis use is associated with fewer days of good mental health among adults, particularly men, according to a study coauthored by a University of Miami Business School professor.
Michael T. French, professor and chair of the Department of Health Management and Policy, and Weiwei Chen, an economist at Kennesaw State University, examined how cannabis use relates to self-reported overall, physical and mental health. Their study was published in Medical Care Research and Review.
“People have some preconceived notions about alcohol and other drug use, including how they affect individuals, society and governments,” said French. “I believe this paper is another example of how our preconceived notions aren’t always correct, especially when it comes to cannabis use and related policies.”
The study examined the relationship between cannabis use and overall physical and mental health, added French, who has spent much of his career studying substance use policies and risky behaviours.
Cannabis use has become more prevalent as additional states pass medical and recreational cannabis laws. In April, FDA-approved cannabis medications and cannabis sold under state medical licences were moved out of the Schedule I classification they shared with heroin and into Schedule III, a category for drugs with accepted medical uses and a moderate risk of dependence, such as ketamine and Tylenol with codeine.
French and Chen applied statistical techniques to data on cannabis use, health status and other individual characteristics from the 2016–2023 Behavioral Risk Factor Surveillance System. The analysis included adults from 38 states and found that more days of cannabis use were associated with fewer days of good mental health among younger adults, particularly men. Results for adults 65 and older were mixed and often not statistically significant.
The main analyses did not find a consistent relationship between cannabis use and physical health in either age group. The authors caution that this does not mean cannabis use carries no physical health risks.
“Although medical use of marijuana has numerous benefits, the cannabis industry, just like the pharmaceutical industry or the medical-device industry, tends to emphasize all the advantages of their products without a full assessment of the potential consequences,” said French. “Objective academic researchers and other scientists without a predetermined agenda can provide unbiased analyses of the true costs and benefits.
“As articulated in the paper, we are presenting our findings without advocating for a particular policy or law. Policymakers can use our results to formulate more informed initiatives that consider the full spectrum of pros and cons associated with cannabis use.”
For generations, corporate South Africa treated water like as an abundant utility. Facility managers turned on the tap, paid the monthly municipal bill, and gave the resource little further consideration. That luxury is gone. Today, deteriorating municipal infrastructure, frequent water cuts, and declining water quality have transformed water security from an operational concern into a strategic business risk. It is no longer an issue confined to factory floors or facilities departments, but it demands attention at board level. For modern companies, water stewardship is no longer a corporate social responsibility initiative. It is a core leadership duty that directly affects business survival, legal compliance, and long-term success.
Caught between strategic expectations and operational reality
Business leaders are under pressure from both ends of the value chain. From the top down, investors, banks, and strict environmental standards demand complete openness about how much water companies use and how they protect the environment. From the ground up, operational teams face mounting challenges as unreliable municipal supply, infrastructure failures, and water quality concerns disrupt daily activities.
When poor municipal water supply stops production lines or dirty wastewater breaks environmental laws, the financial hit is immediate. Businesses are constantly forced to choose between paying massive fines or spending large sums of money on emergency repairs. Because of this constant pressure, water has permanently shifted from a minor monthly expense into a top business risk.
Knowing your true water footprint
One of the biggest challenges for large organisations is the lack of accurate, consolidated water data. Many organisations operate without a comprehensive understanding, unified view of how much water they consume, where losses occur, how water quality changes across facilities, or what is ultimately discharged into the environment. Without this basic information, setting realistic reduction goals or meeting modern Environmental, Social and Governance (ESG) reporting requirements becomes exceptionally difficult.
To take back control, boards need to know exactly which of their facilities sit in water-stressed areas or depend on fragile local water supplies. Executive leaders must connect with site managers to truly understand how water shortages impact everything from daily manufacturing output to employee health and community relations.
Testing business resilience for a drier future
Protecting a business for the future requires serious planning at the executive level. Boards can no longer assume that municipal water services will remain reliable. Leadership teams must prepare for a range of scenarios, including long municipal outages, water quality that drops below safe working levels, and sharp increases in water tariffs and fines. As South Africa works to fix its national water infrastructure, factoring these rising costs and risks into financial planning is a basic duty for any director.
Forward-thinking companies are discovering that active water stewardship creates real business advantages beyond just avoiding risks. Moving toward a circular water model allows businesses to grow without relying entirely on fresh water. Investing in on-site water recycling, greywater systems, and advanced treatment technology is what enables companies to insulate themselves from municipal supply problems while turning environmental responsibility into operational strength.
Bridging the gap between policy and practice
Protecting a company’s right to operate means connecting high-level company goals with everyday actions on the ground. Effective water stewardship takes a holistic view of the entire water cycle, examining how water enters a facility, how efficiently it is used, how losses are managed, and how responsibly wastewater is treated and discharged.
Partnerships with specialised environmental service providers can help organisations implement advanced filtration systems, optimise treatment processes, improve wastewater management, and deploy innovative water-efficiency solutions. When the private sector takes responsibility for its water use, the benefits go far beyond individual company profits and reputations.
By taking stress off municipal systems, businesses actively help secure water for the surrounding community. Water stewardship is no longer an act of corporate philanthropy. It is a fundamental requirement for organisations seeking to remain competitive, resilient, and sustainable in an increasingly resource-constrained world.
Researchers at The University of Texas MD Anderson Cancer Center found new evidence that BRAF, a protein commonly involved in cancer, plays a key role in developing, amplifying and maintaining chronic pain caused by nerve damage. Using BRAF inhibitors reduced pain sensitivity in preclinical models, suggesting the therapeutic potential of this approach for treating chronic nerve pain.
“Our findings identify the cancer-promoting protein BRAF as a key driver of pathological pain signaling following nerve injury,” Pan said. “Because BRAF inhibitors are already approved for cancer treatment, this discovery raises the possibility of rapidly repurposing existing therapies to reduce the level of pain signals entering the spinal cord and improve patient quality of life.”
How does nerve injury cause chronic pain?
Chronic nerve pain, or neuropathic pain, can come from injury, disease or even life-saving cancer treatments. This pain can be intense and persistent, and it responds poorly to conventional pain medications, negatively affecting patient quality of life.
Protein channels in the brain and spinal cord, known as NMDA receptors, help nerve cells communicate. After nerve injury, these NMDA receptors can become hyperactive, amplifying pain signals. To identify potential mechanisms, the researchers explored the role of BRAF on NMDA receptor activity.
What did the researchers find in this study?
Using preclinical models of nerve injury, the researchers discovered that BRAF moved from peripheral sensory nerve cells to their terminals inside the spinal cord, where it activated molecular signals to increase NMDA receptor activity. They also found a correlation between BRAF signaling proteins and NMDA receptors in human spinal cord samples.
These initial results suggested that targeting BRAF could help reduce activity in the NMDA receptors to reduce pain.
Does targeting BRAF reduce pain?
In the preclinical models, the BRAF inhibitor vemurafenib and the MEK inhibitor selumetinib reduced sensitivity to touch, pressure and heat but did not change normal response in models without nerve injury.
Deleting the Braf gene also resulted in less persistent pain sensitivity. Conversely, activating BRAF directly caused pain sensitivity in models that did not have nerve injury, highlighting the key role of BRAF in starting and maintaining neuropathic pain.
What does this mean for patients who have nerve injury and chronic pain?
These results are preclinical, and researchers will need to further examine the appropriate dosing, delivery methods and possible side effects of BRAF inhibitors prior to clinical trials in humans. The researchers also hope to understand how nerve injury triggers the translocation of BRAF from the nerves to the spinal cord.
However, these results suggest that BRAF signalling is associated with NMDA receptor activation in the spinal cord and that currently available BRAF inhibitors have therapeutic potential to treat neuropathic pain.
Emergency diagnosis occurred in more than 20% of patients across multiple conditions, including Parkinson’s disease, schizophrenia, and coronary heart disease
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Patients diagnosed with conditions after an emergency hospital admission or an emergency room visit face a higher risk of death than those diagnosed in non-emergency settings, according to a large population-based study by Emma Whitfield and colleagues from University College London, UK, published August 25th in the open access journal PLOS Medicine.
Cancer diagnoses following emergency hospital care are known to be associated with advanced disease and poor prognosis. However, less is known about the frequency and prognostic outcomes of emergency diagnosis in other conditions.
Using linked primary care, hospital, and mortality records from England for 1.7 million patients diagnosed with one of 13 conditions between 1999 and 2019, the researchers assessed how often patients received a diagnosis following emergency hospital care and compared subsequent outcomes with those of patients diagnosed through non-emergency routes. Conditions included chronic obstructive pulmonary disease (COPD), inflammatory bowel disease (IBD), Parkinson’s disease, multiple sclerosis (MS), rheumatoid arthritis, celiac disease, and schizophrenia.
Emergency diagnosis was common across multiple conditions. More than one in five patients were diagnosed following an emergency presentation in nine of the 13 conditions examined, including more than 30% of patients with Parkinson’s disease and 35% of those with COPD. Across most conditions, patients diagnosed as an emergency experienced substantially poorer outcomes, including higher mortality and longer hospital stays during the year after diagnosis.
After accounting for factors such as age, year of diagnosis, socioeconomic deprivation, comorbidities, and healthcare setting, emergency diagnosis remained strongly associated with an increased risk of death within one year. This association was evident even in conditions that generally have a favourable prognosis, including celiac disease and IBD.
The study shows that emergency diagnosis is a common phenomenon across diverse diseases and is consistently associated with worse outcomes. Future research is needed to understand disease-specific and broader health system factors that contribute to emergency diagnosis as well as whether reducing emergency diagnoses or improving care for patients diagnosed through emergency pathways can lead to better outcomes.
Dr Emma Whitfield, first author, states, “We showed that emergency diagnosis occurred across a wide range of conditions and was consistently associated with a greater risk of death and more time in hospital in the year after diagnosis. Often emergency diagnosis will represent the best standard of care, as illnesses can develop rapidly or have few warning signs. However, the scale of our findings suggest others may reflect difficulties obtaining timely assessment, investigation, or specialist care.
“Behind these figures are patients and families experiencing an unexpected hospital admission, a new diagnosis, and, sometimes, a much more difficult year afterwards.
“Understanding why emergency diagnosis happens could help us identify where earlier diagnosis may be possible or additional support might make a difference.”
Prof Georgios Lyratzopoulos, senior author, notes, “Our study was triggered by a concept initially developed in the field of cancer epidemiology which we have applied across a diverse range of other conditions. The consistency of the findings suggests that emergency diagnosis deserves greater attention by researchers and policymakers across disease areas, and a health system-wide approach.
“Cancer policy has shown the value of monitoring emergency diagnosis, but there is currently little comparable evidence for other conditions. Our study provides a starting point for understanding the scale of the issue beyond cancer, although further research is needed before emergency diagnosis can be used as a quality measure in other disease areas.”
Immunotherapies such as CAR T cell therapy are used primarily to treat cancer. In the future, these patient-specific therapies, manufactured from patients’ own immune cells, could also help cure autoimmune diseases. Six patients with particularly severe rheumatoid arthritis have now received this treatment at Charité – Universitätsmedizin Berlin. In Nature Medicine, the researchers report the results from the world’s first clinical trial of its kind: Disease activity decreased substantially in all participants. By the end of the observation period, three of the patients no longer required any medication for rheumatoid arthritis.
Rheumatoid arthritis is a chronic disease in which the immune system mistakenly attacks the body’s own joints. This causes recurrent inflammation and joint swelling and, as the disease progresses, can lead to joint damage. Currently available treatments can usually keep the inflammation under control, but do not cure the disease. Patients therefore require lifelong medication, including anti-inflammatory drugs and medications that suppress the immune system, with all the associated side effects.
In some patients, even several of the newer treatments fail to produce an adequate response. Doctors then call the disease treatment-refractory. For those affected, this means persistent pain, restricted mobility and a substantial impact on quality of life. “One reason could be disease driving B cells – memory cells of the adaptive immune system that may survive in the lymph nodes, bone marrow or joint tissue after an infection, where they produce harmful antibodies directed against the body’s own tissues and repeatedly reignite the inflammation,” explains Prof. David Simon, who designed the trial for this patient group together with Prof. Gerhard Krönke at Charité’s Department of Rheumatology and Clinical Immunology.
The researchers hope that CAR T cells, patients’ own immune cells genetically modified in the laboratory, could selectively track down the disease driving B cells, even deep within tissues, reset the pathological B-cell memory as fully as possible and thereby effectively give the B-cell system a fresh start.
Cell therapy resets the immune system
Originally developed for cancer treatment, CAR T cells are now being used more widely. In cancer treatment, patients’ immune cells are given a kind of “training” to specifically recognise and eliminate tumour cells; in autoimmune diseases, the aim is instead to direct immune cells toward disease driving memory cells. “The identifying marker on many B cells, both abnormal B cells in cancers of the blood or lymphatic system and disease driving B cells in rheumatoid arthritis, is the surface molecule CD19. You could think of it as a kind of ‘name tag’” explains David Simon. “To enable CAR T cells to detect and eliminate the disease-causing cells, we equip patients’ own immune cells with a receptor that acts like a search sensor for CD19.”
For this type of CD19 CAR T-cell therapy, T cells are first collected from the patient’s blood. These are immune cells that normally recognize and eliminate infected or abnormal cells. In the laboratory, the cells are genetically modified and equipped with the key recognition feature: a chimeric, or artificial, antigen receptor, known as a CAR, that binds specifically to the CD19 molecule. Before the modified immune cells can be returned to the patient in a single infusion, a short course of preparatory chemotherapy is required to create space in the immune system. This temporarily reduces the number of certain immune cells so that the CAR T cells can then multiply effectively and carry out their function. Once returned to the body, the modified immune cells begin searching for the CD19 marker and specifically attack cells that carry it. In doing so, they temporarily eliminate all CD19-positive B cells, allowing the immune system to reset and helping to eliminate even long-lived disease-driving B cells in the joints that would otherwise be difficult to reach.
Will the approach work in difficult-to-treat rheumatoid arthritis?
For the world’s first clinical trial to evaluate the safety and efficacy of a CD19 CAR T-cell therapy in rheumatoid arthritis, the research team at Charité initially enrolled six patients with particularly severe disease. The three women and three men, aged 31 to 69, had received up to eight targeted or biologic therapies over the previous ten years, none of which had been sufficiently effective.
The key question was whether CAR T cells can track down the disease-driving B cells in the joints and whether the treatment is not only effective but also safe. For the researchers, the results from the first part of the COMPARE trial are highly encouraging: “Disease activity decreased markedly in all six patients. During follow-up of up to one year, three patients were in sustained remission without any medication for rheumatoid arthritis,” reports Gerhard Krönke, who leads the joint Clinical Rheumatology research group at Charité and the German Rheumatology Research Center (DRFZ), a Leibniz Institute. “This is particularly remarkable given that none of the established treatments had previously been able to relieve their symptoms adequately.”
The cell therapy appears to have done more than temporarily curb inflammation in the joints: the modified immune cells also tracked down and eliminated disease-promoting B cells in deeper reservoirs such as the bone marrow, lymph nodes and joint tissue. At regular follow-up visits over the subsequent twelve months, the research team found that levels of the autoantibodies characteristic of rheumatoid arthritis had declined sharply.
David Simon adds: “When the B-cell system later recovered, predominantly naïve B cells that had not yet been shaped by the disease returned. In contrast, the B cells directed against the body’s own tissues that had been present before treatment were no longer detectable in almost all patients, an indication that the treatment may indeed be able to reset the pathological immune memory.” Protective antibodies from previous vaccinations, for example against chickenpox or tetanus, remained detectable. Despite the profound depletion of B cells, protective antibody memory appears to be largely preserved. However, any longer-term effects of the therapy on the immune system still need to be investigated.
Early successes, but still some way to go
The trial shows that, in some patients, a single CAR T-cell treatment can lead to a sustained symptom-free period without medication – a state of disease inactivity known as remission. For selected patients with rheumatoid arthritis who have not responded adequately to treatment, it may in the future be possible to reset the pathological immune memory in a targeted way and thereby stop the persistent inflammation, instead of having to suppress it continuously with drugs.
Nevertheless, CAR T-cell therapy for autoimmune diseases, and for rheumatoid arthritis in particular, remains experimental. There is not yet any long-term experience with this treatment. In addition, responses to the therapy varied among patients in the current trial: some did not achieve a complete response, and in one case the disease returned after an initial medication-free period of remission. In contrast, the researchers consider the safety data obtained thus far to be encouraging. “After the participants received the CD19 CAR T cells, we observed only a temporary, mild-to-moderate cytokine release syndrome (CRS) in all participants, which was readily manageable. There were no severe neurological complications or other serious adverse events, and infections were rare,” explains Dr. Marie Luise Hütter-Krönke, Medical Director of the Hematology Early Clinical Trial Unit at Charité’s Department of Hematology, Oncology and Cancer Immunology.
In a second phase of the trial involving ten additional patients, the researchers will compare the new treatment approach with a drug already approved for rheumatoid arthritis that also targets B cells. In this way, they aim to determine whether CAR T cells have a stronger and longer-lasting effect and whether they can indeed reset immune memory. If the new concept is confirmed in this and other, larger trials, it could ultimately become an alternative for patients whose lives are severely affected and for whom no adequate treatment is currently available.
