Participation in mammography screening programs in Canada was associated with substantially reduced breast cancer mortality.

A genetic variation in fatty acid amide hydrolase (FAAH), C385A (P129T), has been previously associated with risk for problem street drug use. FAAH is a mammalian enzyme that inactivates neuromodulatory-signaling lipids including the endogenous cannabinoid 1 receptor agonist anandamide. We investigated in adult Caucasians (N = 749) whether this FAAH variant altered the risk for trying, regular use of or dependence on cannabis, alcohol or nicotine, traditional "gateway" drugs. Consistent with our knowledge that the A/A genotype results in reduced FAAH expression and activity in humans, subjects with the A/A genotype were less likely to be THC dependent than subjects with either a C/C or C/A genotype (11% vs. 26%, P < 0.05). No association was observed between the A/A genotype and risk for alcohol or tobacco regular use, or DSM IV dependence. Controlling for regular use of nicotine and sedatives, both identified as confounders, those with the A/A genotype were at significantly reduced risk for being THC dependent (OR 0.25, 95% CI: 0.07-0.88) as compared with those with the C/A or C/C genotype, supporting a link between alterations in the endocannabinoid system and THC dependence. Unexpectedly, we found an increased risk for regular use of sedatives among the A/A genotype group. The relationship between the FAAH A/A genotype and risk for drug dependence in this study was drug class specific, suggesting it is not part of a more general drug abuse effect. These results, particularly the observation of altered risk for sedative drug use, should be investigated further in multiple ethnic populations.

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Providing tools that make visualization authoring accessible to visualization non-experts is a major research challenge. Currently the most common approach to generating a visualization is to use software that quickly and automatically produces visualizations based on templates. However, it has recently been suggested that constructing a visualization with tangible tiles may be a more accessible method, especially for people without visualization expertise. There is still much to be learned about the differences between these two visualization authoring practices. To better understand how people author visualizations in these two conditions, we ran a qualitative study comparing the use of software to the use of tangible tiles, for the creation of bar charts. Close observation of authoring activities showed how each of the following varied according to the tool used: 1) sequences of action; 2) distribution of time spent on different aspects of the InfoVis pipeline; 3) pipeline task separation; and 4) freedom to manipulate visual variables. From these observations, we discuss the implications of the variations in activity sequences, noting tool design considerations and pointing to future research questions.

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Background: Guidelines aimed at improving care for lung cancer, the leading cause of cancer-related death in Canada and worldwide, require accurate knowledge of the diagnostic setting or pathway. We sought to determine how often lung cancer is initially diagnosed through the emergency department. Methods:We performed a descriptive study that included all cases of primary lung cancer diagnosed in residents of Nova Scotia in 2014. Cancer registry data included diagnostic data and date of death to Aug. 31, 2016. We reviewed linked hospital records, including laboratory and imaging results, to identify the first positive diagnostic study and the route of presentation (emergency department v. other). We evaluated time from diagnosis to death as a function of presentation route using Kaplan-Meier curves and Cox regression (hazard rate ratios [HRRs]).Results: Sufficient data were available for 946 of 951 cases identified, of which 336 (35.5%) were diagnosed through the emergency department. Cases diagnosed via the emergency department were more likely to be at an advanced stage (stage IV, 59.5% v. 43.4%), with patients experiencing shorter survival (1-yr survival, 28.4% v. 49.5%), including stage-specific survival. Mortality for cases diagnosed in the emergency department was 54% higher than for the non-emergency department group after adjusting for age and stage (HRR 1.54, 95% confidence interval 1.32-1.81). Few patients (7.1%, n = 24) who presented to the emergency department reported having no family physician. Interpretation:The emergency department is a common route of presentation for lung cancer and is associated with advanced stage at diagnosis and reduced survival time. Strategies are needed to encourage pre-emergent diagnosis and to ensure that emergency providers are supported in the initial care of patients with lung cancer. Abstract Research OPEN Research E118CMAJ OPEN, 7(1)Affiliations: Departments of Diagnostic Radiology (Suhail, Crocker, Payne, Manos), Psychiatry (Crocker) and Emergency Medicine (Das), Dalhousie University, Halifax, NS Contributors:All of the authors contributed to the design of the study and to the analysis and interpretation of the data. All of the authors were involved in drafting and revising the manuscript and gave final approval of the version to be published. All of the authors agreed to be accountable for all aspects of the work.