Some 20 percent of women overwhelmed by cancer treatment options: study

(Reuters) – More than one in five women with early-stage breast cancer said they were given too much responsibility for treatment-related decisions – and those patients were more likely to end up regretting the choices they made, according to a U.S. study.

The findings, which appeared in the Journal of General Internal Medicine, don’t mean that women should not be fully informed about their treatment options, researchers said, but rather that doctors may need to find new strategies to communicate with patients, especially the less educated.

“Some women may feel overwhelmed or burdened by treatment choices, particularly if they are not also given the tools to understand and weigh the benefits and harms of these choices,” wrote research leader Jennifer Livaudais and colleagues.

Her team from the Mount Sinai School of Medicine in New York surveyed 368 women who had just had surgery for early-stage breast cancer at one of eight New York City hospitals, and again six months later.

The majority said they typically had trouble understanding medical information and less than one-third knew the possible benefits of surgery, radiation and chemotherapy, Livaudais and her colleagues found.

Lack of both “health literacy” and knowledge about treatment benefits was common among the 21 percent of women who said they had too much responsibility for decision-making – as well as among the seven percent who felt they didn’t have enough responsibility.

Women who were poor, non-white or didn’t finish high school were also more likely to feel that they had either too much or too little say in their treatment.

Close to two-thirds of women on both ends of the spectrum had some regret about their original treatment decisions six months down the line. That compared to one-third of women who originally said they had a “reasonable amount” of decision-making responsibility.

Steven Katz, who has studied cancer-related decision-making at the University of Michigan in Ann Arbor, said that compared to past years, doctors now have better ways to tailor treatment to individual patients. But that also means treatment options are based on more convoluted information.

“The treatments are linked in complicated ways, and the information that doctors draw on to make recommendations has increasingly become more and more complex” said Katz, who wasn’t involved in the new study.

He said that for patients trying to make the best treatment choices, the smartest thing they can do is have a team of doctors – an experienced surgeon, a medical oncologist, a radiation oncologist and a plastic surgeon – all working on their case and sharing ideas.

“The purpose (of the study) was not to say women shouldn’t be provided with these treatment options, but that the information really needs to be tailored better,” said Livaudais, who is now at the University of California, San Francisco.

She recommended that doctors ask each patient how much responsibility she feels comfortable taking.

“Some patients prefer… for the information to be presented in simpler terms, or for the physician to recommend something to them,” she added. SOURCE: http://bit.ly/11d6IIW

(Reporting from New York by Genevra Pittman at Reuters Health; editing by Elaine Lies)

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Buying That First Home Is Getting Harder

The housing market may be recovering, but not everyone’s along for the ride. First-time buyers are becoming a shrinking share of purchasers, according to the results of a monthly survey of 2,500 real estate agents. New home buyers made just 34.7 percent of all purchases in October, the lowest since the Campbell/Inside Mortgage Finance HousingPulse Tracking Survey started in September 2009. Three years ago, first-time borrowers were 47 percent of all buyers, buoyed at the time in part by a tax credit.

First-time homeowners, who typically buy lower-priced homes and need extra financing, are losing share as the market shifts from distressed properties such as foreclosures. Distressed sales, which usually cost less, were almost half of all of purchases a year ago, but now they’re just over a third of sales. At the same time, prices for all existing homes have been rising—prices were up 4.4 percent in September over the previous year, according to the Federal Housing Finance Agency—making homes less affordable for first-time buyers.

For new buyers, rising prices are coupled with difficulties in getting a mortgage. About half of all first-time buyers get their loans through HUD’s Federal Housing Administration, which allows down payments as low as 3.5 percent. Because loans with lower down payments are riskier, the FHA’s rates are typically higher than those of traditional mortgages. With interest rates at near-record lows, the incremental difference wasn’t causing much consternation in the past. But facing concerns that it has taken on too much risk and may need a bailout, the FHA raised rates in August and plans to do so again next year.

Interest rates are still near historic lows, rents are rising, and home prices (adjusted for inflation) are still at levels not seen in more than a decade. That means first-time buyers may be missing out on quite the opportunity, if they just can find a loan and a home they can afford.

Businessweek.com — Top News

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Rapper PSY wants Tom Cruise to go ‘Gangnam Style’

BANGKOK (AP) — The South Korean rapper behind YouTube’s most-viewed video ever has set what might be a “Mission: Impossible” for himself.

Asked which celebrity he would like to see go “Gangnam Style,” the singer PSY told The Associated Press: “Tom Cruise!”

Surrounded by screaming fans, he then chuckled at the idea of the American movie star doing his now famous horse-riding dance.

PSY’s comments Wednesday in Bangkok were his first public remarks since his viral smash video — with 838 million views — surpassed Justin Bieber‘s “Baby,” which until Saturday held the record with 803 million views.

“It’s amazing,” PSY told a news conference, saying he never set out to become an international star. “I made this video just for Korea, actually. And when I released this song — wow.”

The video has spawned hundreds of parodies and tribute videos and earned him a spotlight alongside a variety of superstars.

Earlier this month, Madonna invited PSY onstage and they danced to his song at one of her New York City concerts. MC Hammer introduced the Korean star at the American Music Awards as, “My Homeboy PSY!”

Even President Barack Obama is talking about him. Asked on Election Day if he could do the dance, Obama replied: “I think I can do that move,” but then concluded he might “do it privately for Michelle,” the first lady.

PSY was in Thailand to give a free concert Wednesday night organized as a tribute to the country’s revered King Bhumibol Adulyadej, who turns 85 next month. He paid respects to the king at a Bangkok shopping mall, signing his name in an autograph book placed beside a giant poster of the king. He then gave an outdoor press conference, as screaming fans nearby performed the pop star’s dance.

Determined not to be a one-hit wonder, PSY said he plans to release a worldwide album in March with dance moves that he thinks his international fans will like.

“I think I have plenty of dance moves left,” he said, in his trademark sunglasses and dark suit. “But I’m really concerned about the (next) music video.”

“How can I beat ‘Gangnam Style’?” he asked, smiling. “How can I beat 850 million views?”

___

Associated Press writer Thanyarat Doksone contributed to this report.

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Nintendo Unveils Wii Mini for the Canucks

Nintendo‘s pushing the new $ 299 Wii U console hard (and has already sold 400K units in the process), but in at least one region, the gaming company has a new back-up plan: The $ 99 Nintendo Wii Mini.

[More from Mashable: Wii U Sells 400,000 Units in First Week]

The new smaller, black box with red trim is a simpler game console. It offers no Internet access and cannot play older GameCube console games. What it does do is play virtually all Wii games (Nintendo says there are around 1,300 of them). The other major caveat is that the console is only available in Canada. According to a Nintendo press release on the new system, “Wii Mini is available exclusively in Canada during the holiday season. No information is available about its potential availability in other territories in the future.”

Nintendo also left out some details on the console itself. We do not know the exact size or weight of the box, though judging from the above image, it’s not much wider than a Wii Remote.

[More from Mashable: Meet the Super Fan Who Waited in Line for a Month for a Wii U [VIDEO]]

As Nintendo describes it, the Wii Mini is “all about games,” and without the Internet, it has to be. No Web browsing, cavorting with other Mii’s or multi-player gaming. It’s also worth noting that while the Wii Mini ships with a single Wii Remote Plus and Nunchuk (both red), a brand new Black Wii with Wii Sports and Wii Sports Resort (including Remote and Nunchuk) is currently $ 119 at Best Buy.

What do you think of the Wii Mini? Would you game without the Internet? Is this the perfect gift for young, Canadian children? Let us know in the comments.

GamePad

The Wii U GamePad has a 6.2-inch touchscreen.

Click here to view this gallery.

This story originally published on Mashable here.

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Cloudy with a chance of flu? Study offers influenza forecast

WASHINGTON (Reuters) – New research suggests it may be possible to forecast flu outbreaks in much the same way meteorologists predict weather, a potential boon for public health officials and consumers, one of the study’s authors said on Tuesday.

Using real-time U.S. data gathered by Google Inc, along with a computer model showing how flu spreads, the researchers offered a system that could generate local forecasts of the severity and length of a particular flu outbreak.

This kind of forecasting could improve preparation and management of annual flu outbreaks in the United States, said Irene Eckstrand of the National Institutes of Health.

Influenza kills 250,000 to 500,000 people each year around the globe; the U.S. annual flu death toll is 35,000.

If the forecasts are reasonably accurate, they could help public health officials target vaccines and anti-viral drugs to areas of greatest need, said study co-author Jeffrey Shaman of Columbia University’s Mailman School of Public Health.

“If you have a six-week forecast with good confidence that you’re going to have an outbreak in New York City and nothing’s going on in L.A., you’d send the vaccines there (to New York) because there’s enough time to distribute them … before there’s an actual outbreak,” Shaman said.

He suggested that flu forecasts might be distributed through TV weather programming. Individuals then could decide whether to get the flu vaccine, keep their distance from people who sneeze or cough and closely monitor symptoms.

This pilot study, published on Monday in the journal Proceedings of the National Academy of Sciences, looked only at the New York City area, using data from 2003 through 2008.

TRACKING FLU MOVEMENTS

Even so, if all goes well, the system could offer rudimentary forecasts as soon as next year’s flu season, Shaman said. It might be possible to issue a few flu forecasts this season, though those would be in “test-case form,” he said.

“We have to try it for other regions, other cities,” said Shaman. “We have to look and see how it worked during the pandemic years … we have to see the differences in performance depending on the aggressiveness of the strain of flu.”

The computer program the scientists used is a standard epidemiological model showing how influenza moves through a population, from those who are susceptible to flu, to those who have it, to those who have recovered, said study co-author Alicia Karspeck of the National Center for Atmospheric Research in Boulder, Colorado.

The problem with this model is that it’s nearly impossible to pinpoint who is susceptible and difficult to track recoveries, though it is possible to figure out the trajectory of an outbreak, Karspeck said.

To conduct their research, the authors said, they needed real-time data, and they found it in an online tool called Google Flu Trends, which uses search terms people put into the Web-based search engine to figure out where influenza is occurring. The tool, launched in 2008, then notifies the U.S. Centers for Disease Control and Prevention in real time.

In a process known as retrospective forecasting, the scientists tested their findings against what happened in the New York area from 2003 through 2008. Because they knew what had happened in these years, they could check their work.

Using the computer program and the flu trends data, they generated retrospective weekly flu forecasts, which predicted the peak of the outbreak more than seven weeks before it occurred.

(Reporting by Deborah Zabarenko, Environment Correspondent; Edited by Marilyn W. Thompson and Lisa Shumaker)

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Obama promotes tax agenda, Congress in stand-off

WASHINGTON (Reuters) – President Barack Obama on Tuesday launched a public relations push for his bid to raise taxes on wealthy Americans, but U.S. lawmakers remained deadlocked over dramatic, year-end tax increases and spending cuts known as the “fiscal cliff.”

At the White House, small business leaders emerged from a one-hour meeting with Obama to voice support for his goal of extending low tax rates for the middle class beyond the end of the year, while letting rates rise for wealthier taxpayers.

The business owners urged Obama “to fight to keep the middle class tax cuts,” said Lew Prince, co-founder of Vintage Vinyl, an independent music store in St. Louis, Mo.

“What grows jobs in America is consumers spending money, and the average person needs that two or three thousand dollars a year in his pocket to help drive the economy,” Prince told reporters at a news conference outside the White House.

Republicans want to extend low tax rates – enacted a decade ago under the administration of former Republican President George W. Bush – for all taxpayers, including households earning more than $ 250,000 a year.

Raising tax rates on the wealthy would discourage investment and hiring at a time of high unemployment, Republicans say.

Congressional Democrats allied with the president showed no signs of backing down from his stance on raising taxes for the wealthy. But both sides have softened on some long-held positions: Republicans have been showing a willingness to consider new revenue increases while Democrats have relaxed their hard line against new savings to the Medicare and Medicaid healthcare programs.

With just a month left before the Bush tax cuts expire and automatic spending cuts begin to take hold, markets were anxious about predictions that falling off the “fiscal cliff” could trigger another recession.

“There remains no clarity on the ultimate status on the Bush tax cuts, which have to be resolved before you can move forward with the remainder of the fiscal cliff,” said Chris Krueger, an analyst at Guggenheim Securities’ Washington Research Group.

MARKETS DOWN MODESTLY

Stock prices declined modestly despite government reports that planned U.S. business spending rose again in October and that single-family home prices rose again in September.

Despite a mild sell-off in stocks, the Dow Jones industrial average closed at about 12,878, up 14 percent from a year ago.

Brian Gardner, an analyst at financial firm Keefe Bruyette & Woods, said a limited deal would likely be struck to avert the fiscal cliff, with larger fiscal issues pushed into 2013.

“Fiscal cliff headlines could have the biggest impact on the market,” he said. “Over the coming weeks, we expect many headlines that will raise and then dash investors’ hopes … The next three weeks could be a bumpy ride.”

Fresh from his November 6 re-election, Obama was set to hold another meeting with business executives from larger companies on Wednesday and then to travel to a toy factory in Pennsylvania on Friday to press his case on taxes.

Senate Republican leader Mitch McConnell ripped into Obama for planning to take his agenda to the public. “Rather than sitting down with lawmakers of both parties and working out an agreement, he’s back out on the campaign trail,” McConnell roared on the Senate floor.

“We already know the president is a very good campaigner. What we don’t know is whether he has the leadership qualities necessary to lead his party to a bipartisan agreement.”

Obama last met with congressional leaders on November 16. A follow-up session was not expected this week, but could come next week, congressional aides said.

In the interim, little progress was made over the holidays in meetings between the staffs of the White House and Republican Speaker of the House of Representatives John Boehner, aides said.

LEADERS CANVAS RANKS

Ron Bonjean, a former aide to Republican leaders in the House and Senate, said leaders were still checking with their rank-and-file to gauge what concessions they might be able to stomach. In a week or so, Bonjean said, “the level of intensity will go up” with more meetings.

Senate Democratic leader Harry Reid said he was disappointed there has been “little progress” on a deal to avoid the “fiscal cliff” and warned that “we only have a couple weeks to get something done.

Despite frustration, Reid said he was optimistic lawmakers would avoid plunging off the “cliff,” a convergence of an estimated $ 600 billion in tax increases and spending cuts. “I’m extremely hopeful, and I do not believe that the Republicans are going to allow us to go over the cliff,” he said.

While Republicans have not shifted from their opposition to tax rate increases, a few have publicly disavowed a no-new-taxes pledge to which most of them have adhered for years, putting tax revenues, if not higher rates, on the negotiating table.

Also on Tuesday, Dick Durbin, a senior Senate Democrat and close Obama ally, urged fellow liberals to consider reforming the costly Medicare and Medicaid healthcare programs, signaling possible Democratic compromise in an area where they have steadfastly resisted change.

“Progressives should be willing to talk about ways to ensure the long-term viability of Medicare and Medicaid” for the elderly and poor, Durbin said in excerpts from a speech.

But he added that Medicare and Medicaid should not be part of the current negotiations on averting the fiscal cliff. On that front, Durbin stood firmly with Obama, urging extension of middle class tax cuts for 98 percent of Americans.

(Additional reporting by Thomas Ferraro, Kim Dixon, Patricia Zengerle, Lucia Mutikani and Mark Felsenthal, with Adam Kerlin in New York. Writing by Kevin Drawbaugh. Editing by Karey Wutkowski, Jackie Frank and Vicki Allen)

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Rugby-England add flyhalf Burns to squad for All Blacks’ test

LONDON, Nov 27 (Reuters) – England called up uncapped Gloucester flyhalf Freddie Burns on Tuesday to their squad for Saturday’s test against New Zealand in place of the injured Toby Flood.

Flood sustained ligament damage to a big toe during the 16-15 loss to South Africa at Twickenham last Saturday.

Owen Farrell, whose last start was in the first test in South Africa this year, is set to replace Flood in the starting XV against the world champions.

Lock Courtney Lawes, who missed England’s first three tests of the November series because of a knee injury, has also been included in the 23-man squad. Two other locks, Mouritz Botha and Tom Palmer, have been omitted.

After beating Fiji in their opening match, England have lost to Australia and the Springboks and now face a daunting match against the All Blacks who are unbeaten in 20 tests since the start of their victorious World Cup campaign last year.

“For those in Saturday’s squad the message is clear – last week we went toe to toe with the second best team in the world and felt we should have won,” England head coach Stuart Lancaster said in a statement.

“Now we have a chance to take on the number one side in front of a passionate Twickenham crowd, who have been fantastic throughout the Internationals, and it is a challenge we will meet head on.” (Reporting by John Mehaffey; Editing by Ken Ferris)

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$1,499 Gaming Laptop is Ready for Steam on Linux

Alternative, Linux-based operating systems like Ubuntu haven’t historically carried much weight with PC gamers. Very few PC games have been made for Linux, over the years, ever since the company that was porting AAA gaming titles to Linux (Loki Games) went bankrupt in 2001. And while it’s possible to use a “compatibility layer” such as Wine to run Windows PC games in Linux, the results are mixed at best and require a lot of technical tweaking, sometimes even in between updates.

Colorado-based indie PC hardware company System76, however, clearly expects that not only are there PC gamers on Linux out there, but that some of them are willing to pay $ 1,499 for a tricked-out gaming laptop — the 17.3-inch Bonobo Extreme. Like all of System76′s machines, it runs the Ubuntu flavor of Linux; and its actual price tag is $ 1,599, but it’s gotten a $ 100 discount for the holidays.

Is it ahead of its time, like the Loki Games ports? Or has the time come for a new age of Linux gaming? For whatever reason, Valve — the creators of the Steam social gaming service — seems to think the latter.

​The hardware

The 17.3-inch screen is full 1080p, with a 1920×1080 resolution. Pretty much every spec starts out at “high end” and maxes out at “over the top”; it comes standard with an Intel Core i7 processor, 8 GB of RAM and a 500 GB, 7200 RPM hard drive, with a second drive bay and the option to swap the DVD burner out for a third storage disk. All three have the option of going up to a 512 GB Crucial solid state disk, or a 480 GB Intel SSD.

Gaming graphics are powered by an nVidia GeForce GTX 670MX, with 3 GB of memory. An extra $ 340 will get you a GTX 680M with 4 GB of memory. All told, with every possible hardware upgrade the Bonobo Extreme maxes out at an “extreme” $ 4,333 … and the Alienware-style, multicolored light-up keyboard is included for free.

​But what about the games?

Valve’s Linux Steam client is currently in beta, with another 5,000 testers added over the Thanksgiving holiday. About two dozen games are already available for purchase, including Valve’s free-to-play multiplayer online shooter Team Fortress 2 and a selection of games from previous Humble Indie Bundles.

The HIB previously became famous not just for having nearly all of its games support Linux, but for posting public sales figures online, and showing that a good-sized chunk of each bundle’s sales were for Linux gamers. Efforts such as this helped to convince Valve that supporting Linux would be worthwhile … and also seem to have reached someone at System76.

Jared Spurbeck is an open-source software enthusiast, who uses an Android phone and an Ubuntu laptop PC. He has been writing about technology and electronics since 2008.
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Berry’s ex says he was threatened before fight

LOS ANGELES (AP) — Halle Berry‘s ex-boyfriend claims the actress’s fiance threatened to kill him during a Thanksgiving confrontation that left him with a broken rib, bruised face and under arrest.

Gabriel Aubry‘s claims are included in court filings that led a judge Monday to grant a restraining order against actor Olivier Martinez, who is engaged to the Oscar-winning actress.

Aubry, 37, was arrested on suspicion of misdemeanor battery after his confrontation with Martinez on Thursday, but he states in the civil court filings that he was not the aggressor and that he was threatened and attacked without provocation. Martinez told police that Aubry had attacked first, the filings state.

A representative for Martinez could not be immediately reached for comment.

Aubry’s filing claims Martinez threatened him the day before the fight at an event at his daughter’s school that he and the actors attended. Aubry, a model, has a 4-year-old daughter with Berry and the former couple have been engaged in a lengthy custody battle.

The proceedings have been confidential, but Aubry states a major aspect of the case was Berry’s wish to move to Paris and take her daughter with her. The request was denied Nov. 9, Berry’s court filings state, and Aubry shares joint custody of the young girl.

Aubry claims Martinez told him, “You cost us $ 3 million,” while he was punched and kicked him in the driveway of Berry’s home. Aubry had gone to the home to allow his daughter to spend Thanksgiving with her mother, the filings state. Aubry claims Martinez threatened to kill him if Aubry didn’t move to Paris.

Berry was not in the driveway during the confrontation and neither was their daughter, the documents state.

Photos of Aubry’s face with cuts and a black eye were included in his court filing.

A judge set a hearing for Dec. 17 to consider whether a three-year restraining order should be granted. Aubry has a Dec. 13 court date for the possible battery case, which has not yet been filed by prosecutors.

___

Anthony McCartney can be reached at http://twitter.com/mccartneyAP .

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Doctors should consider hepatitis C testing: panel

NEW YORK (Reuters Health) – A government-backed panel advises doctors to “consider offering screening” for hepatitis C to adults born between 1945 and 1965, in a draft statement released today.

The recommendations, from the U.S. Preventive Services Task Force (USPSTF), are an update to the group’s 2004 statement, which recommended against screening people at average risk of hepatitis C. At the time, it also said there wasn’t enough evidence for or against screening high-risk adults, such as injection drug users.

“There were a lot of uncertainties in 2004,” said Dr. Albert Siu from the Mount Sinai School of Medicine in New York, who is co-vice chair of the task force.

“The evidence has increased over the years. The tests haven’t really changed, but there is more certainty in terms of the overall net benefit here,” he told Reuters Health.

Earlier this year, the Centers for Disease Control and Prevention called for hepatitis C testing for all baby boomers, who make up three-quarters of people in the United States with the infection.

The USPSTF now also recommends screening all high-risk adults, regardless of when they were born.

Hepatitis C is passed through blood. Along with drug users who share needles, people who had a blood transfusion or received an organ transplant before mandatory viral testing began in 1992 are also at increased risk of hepatitis C.

Between 1 and 2 percent of people in the U.S. have hepatitis C, which can cause cirrhosis and liver failure over many years. Among the baby boomer generation, that rate is between 3 and 4 percent.

In the new draft recommendations, the task force says there is enough evidence showing blood tests used to detect hepatitis C are accurate. However, there is no direct, long-term proof that screening ultimately reduces liver disease and death – in part because the harmful effects of hepatitis C progress slowly and it takes many years to see such results.

Siu said the screening process is safer than it used to be because fewer people are getting invasive liver biopsies to confirm positive blood tests. That helps tip the scale in favor of screening.

In addition, for many people with hepatitis C, treatment with anti-viral drugs – especially three-drug combinations including medications recently approved by the Food and Drug Administration – can decrease the amount of virus in the blood to an undetectable level, the USPSTF found.

Side effects of the newest drugs, known as boceprevir (Victrelis) and telaprevir (Incivek), include anemia and rashes. Those medications are added to a combination regimen of ribavirin and peginterferon alfa (also commonly known as Pegasys and Peg-Intron), which has been the standard of treatment since the early 2000s.

“In general, when we are talking about infectious diseases screening, (question) one is prevalence rate in the population and two is, are there any effective treatments?” said Dr. Lu-Yu Hwang, who has studied hepatitis C infection and transmission at The University of Texas Health Science Center at Houston.

“Today… people are more optimistic for hepatitis C treatment than for hepatitis B or HIV. People believe there’s a good way you can get rid of the virus, and we do have a good number of people recovering from chronic infection,” Hwang, who is not part of the USPSTF, told Reuters Health.

Evidence reviews completed for the task force also suggest that for pregnant women with hepatitis C, delivering a baby via cesarean section or avoiding breastfeeding does not cut down on virus transmission. That suggests transmission may occur while a fetus is still in utero, Dr. Roger Chou and colleagues from Oregon Health & Science University in Portland said.

Hwang suggested screening could be useful for women who are considering becoming pregnant. Then if they are positive for hepatitis C, women can be treated and reduce their viral levels before there’s a risk of passing the virus on to the baby.

The reviews used by the USPSTF are published in the Annals of Internal Medicine. The draft recommendations will be on the task force website (http://bit.ly/9e1DhW) and available for public comment between November 27 and December 24.

SOURCE: http://bit.ly/N0G6LY Annals of Internal Medicine, online November 26, 2012.

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