In the USA, there are more than 5.5 million registered patients in state-regulated medicinal cannabis programs and many people use hemp products (sourced from cannabis containing <0.3% delta-9-tetrahydrocannabinol (THC) by dry weight) for therapeutic purposes. However, clinical research on non-pharmaceutical cannabis products remains limited1, healthcare providers feel inadequately trained on integrating medicinal cannabis into their practice2, and medicinal cannabis use is poorly documented in electronic medical records (EMRs)3. These issues highlight the need for patient-level data on the impacts of medicinal cannabis use4.
With legalization of retail cannabis sales in some US states, the diversity of cannabis products available to consumers has substantially increased5. Products vary in chemical composition6, dose and intended route of administration, all of which can affect clinical effect, safety and abuse liability, and should be considered in clinical decision making. The diversity in cannabis products and the use of poorly defined nomenclature contributes to difficulty in assessing the health effects of medicinal cannabis.
Transcranial direct current stimulation (tDCS) has been proposed as a new treatment in major depressive disorder (MDD). This is a fully remote, multisite, double-blind, placebo-controlled, randomized superiority trial of 10-week home-based tDCS in MDD. Participants were 18 years or older, with MDD in current depressive episode of at least moderate severity as measured using the Hamilton Depression Rating Scale (mean = 19.07 ± 2.73). A total of 174 participants (120 women, 54 men) were randomized to active (n = 87, mean age = 37.09 ± 11.14 years) or sham (n = 87, mean age = 38.32 ± 10.92 years) treatment. tDCS consisted of five sessions per week for 3 weeks then three sessions per week for 7 weeks in a 10-week trial, followed by a 10-week open-label phase. Each session lasted 30 min; the anode was placed over the left dorsolateral prefrontal cortex and the cathode over the right dorsolateral prefrontal cortex (active tDCS 2 mA and sham tDCS 0 mA, with brief ramp up and down to mimic active stimulation). As the primary outcome, depressive symptoms showed significant improvement when measured using the Hamilton Depression Rating Scale: active 9.41 ± 6.25 point improvement (10-week mean = 9.58 ± 6.02) and sham 7.14 ± 6.10 point improvement (10-week mean = 11.66 ± 5.96) (95% confidence interval = 0.51–4.01, P = 0.012). There were no differences in discontinuation rates. In summary, a 10-week home-based tDCS treatment with remote supervision in MDD showed high efficacy, acceptability and safety. ClinicalTrials.gov registration: NCT05202119
In recent years, there has been growing concern about waning interest in science, as despite advances in research and technology, fewer young people seem to be pursuing careers in these fields1. This decline can be attributed to various factors, including a lack of early engagement, inadequate integration of practical experience and insufficient alignment between educational stages. To address this issue, the National Academy of Scientist Education (NASE) and Academia Europaea (AE) propose the concept of ‘multigenerational systems education’, a comprehensive approach that draws inspiration from systems biology and systems medicine.
The traditional methods of teaching science have failed to keep pace with the rapid advancements of the twenty-first century. Evidence of declining interest is reflected in the decreasing number of students enrolling in science courses at both the high school level and the university level1. According to recent studies, fewer students are choosing to specialize in life sciences, with many perceiving these fields as inaccessible or irrelevant to real-world applications2,3.
Correction to: Nature Medicine https://doi.org/10.1038/s41591-024-03282-2, published online 1 October 2024.