Hair Regrowth with Cannabidiol (CBD)-rich Hemp Extract - A Case Series.

Androgenetic alopecia (AGA) is the most common cause of hair loss. Several FDA approved medications are available but offer limited results. Studies have shown that the endocannabinoid system (ECS) is a key player in hair follicle cell growth. The ECS cannabinoid type one (CB1) receptors are well expressed in the hair follicle cells. Cannabidiol CBD is a negative allosteric modulator of the CB1 receptor and has been shown to result in hair shaft elongation. In addition, the hair follicle cycle phases are controlled by the ECS vanilloid receptor-1 (TRPV1). CBD has also been shown to increase Wnt signaling pathways that are involved in the differentiation of dermal progenitor cells into new hair follicles and maintaining the anagen phase of the hair cycle. The effects of CBD on hair growth are dose dependent and higher doses may result in premature entry into the catagen phase via a receptor known as vanilloid receptor-4 (TRPV4). Topical application of CBD reaches hair follicles where it is a CB1 negative modulator, and TRPV1, and TRPV4 agonist. A study was done of 35 subjects with AGA using a once daily topical hemp oil formulation, averaging about 3-4 mg per day of CBD and minimal amounts of other cannabinoids for six months. A hair count of the greatest area of alopecia was carried out before treatment and again after six months. The results revealed that men did slightly better than women, and the vertex area did better than the temporal areas. On average there was statistically significant 93.5% increase in hair after 6 months. All subjects had some regrowth. There were no reported adverse effects. Since the CBD works through novel mechanisms different from finasteride and minoxidil it can be used in conjunction with these current drugs and would be expected to have synergistic effects.

New Anticancer Drugs Associated With Large Increases In Costs And Life Expectancy.

Spending on anticancer drugs has risen rapidly over the past two decades. A key policy question is whether new anticancer drugs offer value, given their high cost. Using data from the Surveillance, Epidemiology, and End Results (SEER)-Medicare database, we assessed the value of new cancer treatments in routine clinical practice for patients with metastatic breast, lung, or kidney cancer or chronic myeloid leukemia in the periods 1996-2000 and 2007-11. We found that there were large increases in medical costs, but also large gains in life expectancy. For example, among patients with breast cancer who received physician-administered drugs, lifetime costs-including costs for outpatient and inpatient care-increased by $72,000 and life expectancy increased by thirteen months. Changes in life expectancy and costs were much smaller among patients who did not receive these drugs.

Clinical and economic outcomes by first-line treatment among women with HR+/HER2- metastatic breast cancer in a large US health plan database.

BACKGROUND: Guidelines recommend that women with hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2-) metastatic breast cancer (mBC) initiate hormonal therapy before chemotherapy. This study compared outcomes of women with mBC who received chemotherapy first vs hormonal therapy. METHODS: A retrospective cohort study of women with mBC was conducted using a large US commercial health plan database between January 1, 2008-April 30, 2013. Subjects had evidence of a HR+/HER2- tumor sub-type in a cancer registry and use of chemotherapy or hormonal therapy in claims. Subjects were continuously enrolled for ≥6 months after metastasis and assigned to cohorts for receiving chemotherapy only or hormonal therapy only during first-line (CT-1L vs HT-1L). Adjusted incidence rates of clinically significant events were compared using a negative binomial model, and adjusted healthcare costs were compared using a generalized linear model. RESULTS: Three hundred and twenty-four women with HR+/HER2- mBC met the selection criteria; 179 (55%) received CT-1L and 145 (45%) received HT-1L. Mortality rates did not differ between cohorts (unadjusted incidence rate ratio (IRR) = 1.67, 95% CI = 0.82-3.46; adjusted IRR = 0.64, 95% CI = 0.32-1.27). Adjusted average total all-cause healthcare costs were $11 090 for women with CT-1L and $6743 for women with HT-1L (cost ratio =1.64, 95% CI =1.36-1.99). CONCLUSIONS: Observed use of first-line chemotherapy (>50%) was higher than expected given the HR + molecular profile of the tumors. Chemotherapy use during first-line did not appear to be associated with a survival benefit, but was associated with significantly higher costs compared with the use of hormonal therapy during first-line; however, this comparison is limited by demographic and baseline characteristic differences between the two cohorts. This study contributes to understanding real-world treatment patterns and the associated clinical and economic outcomes of using chemotherapy vs hormonal therapy as a first-line treatment option for the HR+/HER2- mBC population.

Ennobling an old molecule: thiazyl trifluoride (N≡SF3), a versatile synthon for Xe-N bond formation.

The fields of sulfur-nitrogen-fluorine chemistry and noble-gas chemistry have been significantly extended by the syntheses and characterizations of four new Xe-N-bonded cations derived from N≡SF(3). The adduct-cation, F(3)S≡NXeF(+), has provided the entry point to a significant chemistry through HF solvolysis of the coordinated N≡SF(3) ligand and HF-catalyzed and solid-state rearrangements of F(3)S≡NXeF(+). The HF solvolyses of [F(3)S≡NXeF][AsF(6)] in anhydrous HF (aHF) and aHF/BrF(5) solutions yield the F(4)S═NXe(+) cation, which likely arises from an HF-catalyzed mechanism. The F(4)S═NXe(+) cation, in turn, undergoes HF displacement to form F(4)S═NH(2)(+) and XeF(2), as well as HF addition to the S═N bond to form F(5)SN(H)Xe(+). Both cations undergo further solvolyses in aHF to form the F(5)SNH(3)(+) cation. The F(4)S═NXe(+) and F(4)S═NH(2)(+) cations were characterized by NMR spectroscopy and single-crystal X-ray diffraction and exhibit high barriers to rotation about their S═N double bonds. They are the first cations known to contain the F(4)S═N- group and significantly extend the chemistry of this ligand. The solid-state rearrangement of [F(3)S≡NXeF][AsF(6)] at 22 °C has yielded [F(4)S═NXe][AsF(6)], which was characterized by Raman spectroscopy, providing the first examples of xenon bonded to an imido nitrogen and of the F(4)S═N- group bonded to a noble-gas element. The rearrangement of [F(3)S≡NXeF][AsF(6)] in a N≡SF(3) solution at 0 °C also yielded [F(4)S═NXe−N≡SF(3)][AsF(6)], which represents a rare example of a N−Xe−N linkage and the first to be characterized by X-ray crystallography. Solvolysis of N≡SF(3) in aHF was previously shown to give the primary amine F(5)SNH(2), whereas solvolysis in the superacid medium, AsF(5)/aHF, results in amine protonation to give [F(5)SNH(3)][AsF(6)]. Complete structural characterizations were not available for either species. Isolation of F(5)SNH(2)·nHF from the reaction of N≡SF(3) with HF has provided a structural characterization of F(5)SNH(2) by Raman spectroscopy. Crystal growth by sublimation of F(5)SNH(2)·nHF at -30 to -40 °C has resulted in the X-ray crystal structure of F(5)SNH(2)·2[F(5)SNH(3)][HF(2)]·4HF and structural characterizations of F(5)SNH(2) and F(5)SNH(3)(+). The redox decomposition of [F(4)S═NXe−N≡SF(3)][AsF(6)] in N≡SF(3) at 0 °C generated Xe, cis-N(2)F(2), and [F(3)S(N≡SF(3))(2)][AsF(6)].

On the reactivity of F(3)S[triple bond]NXeF(+): syntheses and structural characterizations of [F(4)S=N-Xe---N[triple bond]SF(3)][AsF(6)], a rare example of a N-Xe-N linkage, and [F(3)S(N[triple bond]SF(3))(2)][AsF(6)].

The F(4)S=N-Xe---N[triple bond]SF(3)(+) cation has been synthesized as the AsF(6)(-) salt by rearrangement of [F(3)S[triple bond]NXeF][AsF(6)] in N[triple bond]SF(3) solvent at 0 degrees C. Deep yellow [F(4)S=N-Xe---N[triple bond]SF(3)][AsF(6)], which crystallized from a N[triple bond]SF(3) solution at -10 degrees C, was characterized by Raman spectroscopy (-160 degrees C) and by single-crystal X-ray diffraction (-173 degrees C). The Xe-N bond length (2.079(3) A) of the F(4)S=N-Xe---N[triple bond]SF(3)(+) cation is among the shortest Xe-N bonds presently known. The F(4)S=NXe(+) cation interacts with N[triple bond]SF(3) by means of a Xe---N donor-acceptor bond (2.583(3) A) that is significantly longer than the primary Xe-N bond (2.079(3)A) but significantly shorter than the sum of the Xe and N van der Waals radii (3.71 A). The F(4)S=N-Xe---N[triple bond]SF(3)(+) cation undergoes a redox decomposition in N[triple bond]SF(3) at 0 degrees C, forming [F(3)S(N[triple bond]SF(3))(2)][AsF(6)], cis-N(2)F(2), and Xe, which were characterized by low-temperature Raman spectroscopy in the solid state and by (19)F NMR spectroscopy in N[triple bond]SF(3) solvent (0 degrees C). Colorless [F(3)S(N[triple bond]SF(3))(2)][AsF(6)] crystallized from N[triple bond]SF(3) at -10 degrees C and was characterized by low-temperature, single-crystal X-ray diffraction. The S(IV) atom of F(3)S(N[triple bond]SF(3))(2)(+) has long contacts with the N atoms of two N[triple bond]SF(3) molecules and a F ligand of a neighboring AsF(6)(-) anion. The arrangement of long contacts avoids, to the maximum extent, the F atoms of SF(3)(+) and the nonbonding electron pair situated on the pseudo-3-fold axis opposite the F ligands of SF(3)(+), providing distorted octahedral coordination about the S(IV) atom. Quantum-chemical calculations using MP2, B3LYP, and PBE1PBE methods were employed to arrive at the gas-phase geometries, charges, bond orders, valencies, and vibrational frequencies for F(4)S=N-Xe---N[triple bond]SF(3)(+) and F(3)S(N[triple bond]SF(3))(2)(+) to aid in the assignments of experimental vibrational frequencies. The F(4)S=N-Xe---N[triple bond]SF(3)(+) cation expands the known chemistry of the F(4)S=N- group and is the first example of a N-Xe-N linkage to be structurally characterized by single-crystal X-ray diffraction.

Solid-state and solution rearrangements of F3S[triple bond]NXeF+ leading to the F4S=NXe+ cation; syntheses, HF solvolyses, and structural characterizations of [F4S=NXe][AsF6] and[F4S=NH2][AsF6].

The salt, [F(4)S=NXe][AsF(6)], has been synthesized by the solid-state rearrangement of [F(3)S[triple bond]NXeF][AsF(6)] and by HF-catalyzed rearrangement of [F(3)S[triple bond]NXeF][AsF(6)] in anhydrous HF (aHF) and HF/BrF(5) solvents. The F(4)S=NXe(+) cation undergoes HF solvolysis to form F(4)S=NH(2)(+), XeF(2), and the recently reported F(5)SN(H)Xe(+) cation. Both [F(4)S=NXe][AsF(6)] and [F(4)S=NH(2)][AsF(6)] have been characterized by (129)Xe and (19)F NMR spectroscopy in aHF and HF/BrF(5) solvents and by single-crystal X-ray diffraction. The [F(4)S=NXe][AsF(6)] salt was also characterized by Raman spectroscopy. The Xe-N bond of F(4)S=NXe(+) is among the shortest Xe-N bonds presently known (2.084(3) A), and the cation interacts with the AsF(6)(-) anion by means of a Xe---F-As bridge in which the Xe---F distance (2.618(2) A) is significantly less than the sum of the Xe and F van der Waals radii. Both F(4)S=NXe(+) and F(4)S=NH(2)(+) exhibit trigonal bipyramidal geometries about sulfur, with nitrogen in the equatorial plane and the nitrogen substituents coplanar with the axial fluorine ligands of sulfur. The F(4)S=NH(2)(+) cation is isoelectronic with F(4)S=CH(2) and, like F(4)S=CH(2), has a high barrier to rotation about the S=N double bond and to pseudorotation of the trigonal bipyramidal F(4)S=N- moiety. The solution and solid-state rearrangements of F(3)S[triple bond]NXeF(+) to F(4)S=NXe(+) are proposed to result from attack at sulfur by fluoride ion arising from HF in solution and from the AsF(6)(-) anion in the solid state. Quantum-chemical calculations were employed to calculate the gas-phase geometries, charges, bond orders, valencies, and vibrational frequencies of F(4)S=NXe(+) and F(4)S=NH(2)(+). The F(4)S=NXe(+) cation provides the first example of xenon bonded to an imido-nitrogen, and together with the F(4)S=NH(2)(+) cation are presently the only cations known to contain the F(4)S=N-group. Both cations are intermediates in the HF solvolysis pathways of F(3)S[triple bond]NXeF(+) which lead to F(5)SN(H)Xe(+) and F(5)SNH(3)(+), and significantly extend the chemistry of the F(4)S=N-group.

F5SN(H)Xe+; a rare example of xenon bonded to sp3-hybridized nitrogen; synthesis and structural characterization of [F5SN(H)Xe][AsF6].

The salt [F5SN(H)Xe][AsF6] has been synthesized by the reaction of [F5SNH3][AsF6] with XeF2 in anhydrous HF (aHF) and BrF5 solvents and by solvolysis of [F3S triple bond NXeF][AsF6] in aHF. Both F5SN(H)Xe(+) and F5SNH3(+) have been characterized by (129)Xe, (19)F, and (1)H NMR spectroscopy in aHF (-20 degrees C) and BrF5 (supercooled to -70 degrees C). The yellow [F5SN(H)Xe][AsF6] salt was crystallized from aHF at -20 degrees C and characterized by Raman spectroscopy at -45 degrees C and by single-crystal X-ray diffraction at -173 degrees C. The Xe-N bond length (2.069(4) A) of the F5SN(H)Xe(+) cation is among the shortest Xe-N bonds presently known. The cation interacts with the AsF6(-) anion by means of a Xe---F-As bridge in which the Xe---F distance (2.634(3) A) is significantly less than the sum of the Xe and F van der Waals radii (3.63 A) and the AsF6(-) anion is significantly distorted from Oh symmetry. The (19)F and (129)Xe NMR spectra established that the [F5SN(H)Xe][AsF6] ion pair is dissociated in aHF and BrF5 solvents. The F5SN(H)Xe(+) cation decomposes by HF solvolysis to F5SNH3(+) and XeF2, followed by solvolysis of F5SNH3(+) to SF6 and NH4(+). A minor decomposition channel leads to small quantities of F5SNF2. The colorless salt, [F5SNH3][AsF6], was synthesized by the HF solvolysis of F3S triple bond NAsF5 and was crystallized from aHF at -35 degrees C. The salt was characterized by Raman spectroscopy at -160 degrees C, and its unit cell parameters were determined by low-temperature X-ray diffraction. Electronic structure calculations using MP2 and DFT methods were used to calculate the gas-phase geometries, charges, bond orders, and valencies as well as the vibrational frequencies of F 5SNH3(+) and F5SN(H)Xe(+) and to aid in the assignment of their experimental vibrational frequencies. In addition to F5TeN(H)Xe(+), the F5SN(H)Xe(+) cation provides the only other example of xenon bonded to an sp (3)-hybridized nitrogen center that has been synthesized and structurally characterized. These cations represent the strongest Xe-N bonds that are presently known.

Synthesis of [F3S(triple bond)NXeF][AsF6] and structural study by multi-NMR and Raman spectroscopy, electronic structure calculations, and X-ray crystallography.

The salt, [F3S(triple bond)NXeF][AsF6], has been synthesized by the reaction of [XeF][AsF6] with liquid N(triple bond)SF3 at -20 degrees C. The Xe-N bonded cation provides a rare example of xenon bound to an inorganic nitrogen base in which nitrogen is formally sp-hybridized. The F3S(triple bond)NXeF+ cation was characterized by Raman spectroscopy at -150 degrees C and by 129Xe, 19F, and 14N NMR spectroscopy in HF solution at -20 degrees C and in BrF5 solution at -60 degrees C. Colorless [F3S(triple bond)NXeF][AsF6] was crystallized from HF solvent at -45 degrees C, and its low-temperature X-ray crystal structure was determined. The Xe-N bond is among the longest Xe-N bonds known (2.236(4) A), whereas the Xe-F bond length (1.938(3) A) is significantly shorter than that of XeF2 but longer than in XeF+ salts. The Xe-F and Xe-N bond lengths are similar to those of HC(triple bond)NXeF+, placing it among the most ionic Xe-N bonds known. The nonlinear Xe-N-S angle (142.6(3)o) contrasts with the linear angle predicted by electronic structure calculations and is attributed to close N...F contacts within the crystallographic unit cell. Electronic structure calculations at the MP2 and DFT levels of theory were used to calculate the gas-phase geometries, charges, bond orders, and valencies of F3S(triple bond)NXeF+ and to assign vibrational frequencies. The calculated small energy difference (7.9 kJ mol-1) between bent and linear Xe-N-S angles also indicates that the bent geometry is likely the result of crystal packing. The structural studies, natural bond orbital analyses, and calculated gas-phase dissociation enthalpies reveal that F3S(triple bond)NXeF+ is among the weakest donor-acceptor adducts of XeF+ with an Xe-N donor-acceptor interaction that is very similar to that of HC(triple bond)NXeF+, but considerably stronger than that of F3S(triple bond)NAsF5. Despite the low dissociation enthalpy of the donor-acceptor bond in F3S(triple bond)NXeF+, 129Xe, 19F, and 14N NMR studies reveal that the F3S(triple bond)NXeF+ cation is nonlabile at low temperatures in HF and BrF5 solvents.

Utilizing technology: the challenges and opportunities facing "substance abuse" professionals in rural communities.

Many rural communities are actively pursuing technology as a resource for solving education, health care, and economic development issues. These communities are establishing a technology and telecommunication infrastructure that makes them appealing to individuals and companies from urban communities. But this has created a challenge and an opportunity for the mental health industry in general, and more specifically, "substance abuse" professionals. The opportunity for the "substance abuse" profession is to design and use new services using the exact same technologies that may precipitate the need for the services.