8 research outputs found

    Medicinal cannabis as a potential treatment for chronic pain and anxiety

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    Since its legalisation in Australia in 2016, the most common indications for which medicinal cannabis is prescribed are chronic pain and anxiety. This thesis aimed to explore the real-world use of cannabis for these indications, and the potential of translating this evidence into a clinical trial setting. The effectiveness and tolerability of medicinal cannabis for chronic pain, with a subset analysis on arthritis was explored using data from the CA Clinics Observational Study (CACOS). The chronic pain patients and arthritis subset reported significantly reduced pain intensity, with dry mouth, somnolence, and fatigue the most common AEs reported. The incidence of AEs in this cohort, and the association that these may have with concomitant medicines, cannabis constituents, and dose was also reported. Each patient was taking a median of six concomitant medications. Patients taking a gabapentinoid were more likely to report dizziness, and those taking a tricyclic antidepressant were more likely to report somnolence and anxiety. Next in this thesis clinical trial protocols were developed, the first to examine the efficacy of a transdermal CBD cream on patients with osteoarthritis. The second protocol follows a review on aromatase inhibitor associated-arthralgia, and proposes an oral CBD-extract to improve joint pain and health-related quality of life (HRQoL). Finally, use of cannabis for anxiety was reviewed and the effectiveness and tolerability of cannabis for anxiety, including post-traumatic stress disorder (PTSD) was explored using CACOS data. Significantly reduced anxiety was observed in patients with unspecified anxiety and PTSD, and the most common AEs reported were dry mouth, somnolence, and fatigue. The observed improvements in various HRQoL outcomes in both the chronic pain and anxiety cohorts, and the possible safety concerns raised in this thesis supports ongoing exploration of medicinal cannabis in clinical trial settings

    Inter-rater agreement and reliability of the assessment of lithium response in the two-stage case-vignette rating procedure: kappa and intra-class correlation analysis.

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    <p>TS: total score.</p><p>ICC: intra-class correlation.</p><p>CI: confidence interval.</p>*<p>Mixed and random effects models.</p>§<p>70 raters.</p>¶<p>48 raters.</p

    Empirical and theoretical distributions of the total score in the Consortium on Lithium Genetics sample.

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    <p>Frequentist, <b>A</b>, and Bayesian minimum message length, <b>B</b>, mixture modeling identify three subpopulations of non responders (grey), partial responders (red), and full responders (blue) in total scores of 1,308 bipolar disorder patients characterized for response to lithium maintenance treatment.</p

    Number of raters from the Consortium on Lithium Genetics (ConLiGen) centres participating in the two-stage case-vignette rating procedure for inter-rater reliability and agreement.

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    <p>ConLiGen: Consortium on Lithium Genetics.</p>*<p>Hokkaido, Osaka, Tokio, Riken Brain Science Institute.</p

    Distribution of total and A scores in the Consortium on Lithium Genetics sample.

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    <p>Histogram plot of the scale scores in 1,308 bipolar disorder patients characterized for response to lithium maintenance treatment.</p

    Coronal Heating as Determined by the Solar Flare Frequency Distribution Obtained by Aggregating Case Studies

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    Flare frequency distributions represent a key approach to addressing one of the largest problems in solar and stellar physics: determining the mechanism that counter-intuitively heats coronae to temperatures that are orders of magnitude hotter than the corresponding photospheres. It is widely accepted that the magnetic field is responsible for the heating, but there are two competing mechanisms that could explain it: nanoflares or Alfv\'en waves. To date, neither can be directly observed. Nanoflares are, by definition, extremely small, but their aggregate energy release could represent a substantial heating mechanism, presuming they are sufficiently abundant. One way to test this presumption is via the flare frequency distribution, which describes how often flares of various energies occur. If the slope of the power law fitting the flare frequency distribution is above a critical threshold, α=2\alpha=2 as established in prior literature, then there should be a sufficient abundance of nanoflares to explain coronal heating. We performed >>600 case studies of solar flares, made possible by an unprecedented number of data analysts via three semesters of an undergraduate physics laboratory course. This allowed us to include two crucial, but nontrivial, analysis methods: pre-flare baseline subtraction and computation of the flare energy, which requires determining flare start and stop times. We aggregated the results of these analyses into a statistical study to determine that α=1.63±0.03\alpha = 1.63 \pm 0.03. This is below the critical threshold, suggesting that Alfv\'en waves are an important driver of coronal heating.Comment: 1,002 authors, 14 pages, 4 figures, 3 tables, published by The Astrophysical Journal on 2023-05-09, volume 948, page 7

    Sex-Dependent Shared and Nonshared Genetic Architecture Across Mood and Psychotic Disorders

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    Analysis of Outcomes in Ischemic vs Nonischemic Cardiomyopathy in Patients With Atrial Fibrillation A Report From the GARFIELD-AF Registry