Miracle-dz/UniFAR-FTUs huggingface dataset:
Fishy curves: a case of bias and confounding?

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Prognostic value of B-type natriuretic peptide in elderly patients with aortic valve stenosis: the COFRASA–GENERAC study

Objective Previous studies suggested an independent prognostic value of B-type natriuretic peptide (BNP) in aortic valve stenosis (AS) but were impeded by small sample sizes and inclusion of relatively selected young patients. We aimed to evaluate the relationship among N-terminal fragment of proBNP (Nt-proBNP), AS severity, symptoms and outcome in a large cohort of elderly patients with AS. Design Observational cohort study, COhorte Française de Retrecissement Aortique du Sujet Agé (clinicalTrial.gov number-NCT00338676) and GENEtique du Retrecissement Aortique (clinicalTrial.gov number-NCT00647088). Setting Single-centre study. Patients Patients older than 70 years with at least mild AS. Interventions None. Measurements A comprehensive clinical, biological and echocardiographic evaluation was performed at study entry. Asymptomatic patients were prospectively followed on a 6-months basis and AS-related events (sudden death, congestive heart failure or new onset of AS-related symptoms) collected. Results We prospectively enrolled 361 patients (79±6 years, 230 severe AS). Nt-proBNP increased with the grade of AS severity and the NYHA class (all p<0.0001) but there was an important overlap between grades/classes. Consequently, diagnostic value of Nt-proBNP for the diagnosis of severe symptomatic AS was only modest (area under the curve of the receiver operator characteristic analysis=0.73). At 2 years, 28 AS-related events occurred among 142 asymptomatic patients prospectively followed. Nt-proBNP was associated with outcome in univariate analysis (p=0.04) but not after adjustment for age, gender and AS severity (p=0.40). Conclusions The present study clearly highlights the limitations of Nt-proBNP for the evaluation and management of AS patients. Our results suggest that Nt-proBNP should be considered cautiously, at least as a single criterion, in the decision-making process of AS patients especially in the elderly population.
USE OF FIRST-PERSON PRONOUNS

To the Editor:— It strikes me that there are remarks which are open to question in the extract at the bottom of page 1861 in the Aug. 20 issue ofThe Journal. Speaking with whatever authority a number of rejection slips and few acceptances might indicate, I can say that many an otherwise dull story has been enlivened by its first-person pronouns. It is true that medical writing is not creative in the same sense as such writing as Poe's short stories, for instance. Its frequent dull and uninspired composition attests to this with drab eloquence. Still, it should be, and some of the medical classics indicate that it can be. Turn to these and notice that their most delightfully refreshing feature is usually a style which makes liberal use of "my," "I," and "me. " Indeed, the "once-upon-a-time" approach is as insufferably dull and archaic as it is childish and
Alcohol use disorders and mortality: a systematic review and meta-analysis.

AIMS To conduct a systematic review and meta-analysis on all-cause mortality in people with alcohol use disorders. METHODS Using the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines, studies were identified through MEDLINE, EMBASE, and Web of Science up to August, 2012. Prospective and historical cohort studies including a comparison of alcohol use disorder with a control group investigating all-cause mortality risk were included. RESULTS This meta-analysis included 81 observational studies with 221 683 observed deaths among 853 722 people with alcohol use disorder. In men, the relative risk (RR) among clinical samples was 3.38 (95% confidence interval [CI]: 2.98-3.84); in women it was 4.57 (95% CI: 3.86-5.42). Alcohol use disorders identified in general population surveys showed a twofold higher risk compared with no alcohol use disorder in men; no data were available for women. RRs were markedly higher for those ≤40 years old (ninefold in men, 13-fold in women) while still being at least twofold among those aged 60 years or older. CONCLUSIONS Mortality in people with alcohol use disorders is markedly higher than thought previously. Women have generally higher mortality risks than men. Among all people with alcohol use disorders, people in younger age groups and people in treatment show substantially higher mortality risk than others in that group.
Do societal wealth, family affluence and gender account for trends in adolescent cannabis use? A 30 country cross-national study.

AIMS To examine cross-national changes in frequent adolescent cannabis use (40+ times consumed over life-time at age 15) over time and relate these trends to societal wealth, family affluence and gender. DESIGN Data from three cycles (2002, 2006, 2010) of the Health Behaviour in School-aged Children (HBSC) Study were used for cross-sectional and trend analyses of adolescent cannabis use. SETTING Representative surveys in 30 European and North American countries. PARTICIPANTS A total of 160 606 15-year-old students. MEASUREMENTS Respondents' life-time cannabis use, demographics, family affluence (FAS) and frequency of peer contacts were measured individually. Indicators of wealth (gross domestic product per capita, GDP) and perceived availability of cannabis were obtained from national public data bases. FINDINGS The frequency of life-time cannabis use decreased over time among adolescents in Europe and North America, particularly in western European countries and the United States (relative risk (RR) = 0.86: confidence interval (CI) 0.79-0.93). This trend was not observed consistently in rapidly developing countries in eastern, central and southern Europe. Over time (2002-10), cannabis use became: (i) less characteristic of high GDP countries in contrast to lower GDP countries (RR = 0.74: CI 0.57-0.95); (ii) less characteristic of youth from high FAS families in contrast to youth from low FAS families (RR = 0.83: CI 0.72-0.96); and (iii) characterized by an increasing gender gap, i.e. consumption was higher among males (RR 1.26: CI 1.04-1.53). Perceived availability of cannabis and peer contacts remained strong predictors of frequent cannabis use. CONCLUSIONS Among 30 European and North American countries, cannabis use appears to have 'trickled down' over time, with developing countries taking on the former (heavier) use pattern of richer countries, and less affluent youth taking on the former (heavier) use pattern of more affluent youth. Cannabis use continues to be more common among adolescent males than females.
McCarthyism, conflict of interest and addiction's new transparency declaration procedures.

The process of submitting a manuscript to a scientific journal for editorial review has become increasingly bureaucratic. This has partly resulted from the reaction by journal editors to threats to the integrity of science from commercial interests. This editorial describes instances involving Addiction and is aimed at helping to raise awareness of the kinds of issues that arise. It also announces Addiction’s adoption of the International Society of Addiction Journal Editors (ISAJE) transparency form.
Cognitive outcomes after acute coronary syndrome: a population based comparison with transient ischaemic attack and minor stroke

Objective Acute coronary syndrome (ACS) is associated with increased risk of cognitive decline when compared with controls, but case:control studies are subject to selection bias. We therefore compared cognitive outcomes in ACS with transient ischaemic attack (TIA) and minor stroke, diseases with similar risk factor burden generally considered to be at high risk of cognitive decline. Design Prospective population based cohort study Setting Oxford Vascular Study (OXVASC) carried out within a defined population of 91 000 in Oxfordshire, UK. Patients 614 in total: 216 ACS, 182 TIA, 216 minor (non-disabling) stroke. Outcome measures Mini-Mental-State-Examination (MMSE), Telephone Interview for Cognitive Status-modified (TICSm), and Montreal Cognitive Assessment (MoCA) at 1 and 5 years. Results Overall risk factor burden was similar across groups but ACS patients had more smoking (27% vs 14%, p<0.001) and less hypertension (45% vs 53%, p<0.01) and atrial fibrillation (6% vs 14%, p<0.001). Cognitive outcomes were worse at 1 year in ACS versus TIA patients: mean±SD MMSE 26.6±2.7 vs 27.6±2.5, p<0.0001; OR=2.14, 95% CI 1.11 to 4.13 for moderate/severe cognitive impairment (MMSE <24) with a similar trend at 5 years, and ACS outcomes were more similar to minor stroke. Memory and language versus frontal/executive subtests were relatively more impaired in ACS than TIA and minor stroke patients. Conclusions Risk of cognitive impairment after ACS is similar to minor stroke and higher than TIA with implications for clinical practice including consent and adherence with medication. Differences in cognitive domain performance suggest a greater role for degenerative brain pathology in ACS which may be linked to vascular risk profile and cardiac factors.
A 33 × 25 µm2 low-power range finder

Within this paper a time-of-flight single-pixel range finding sensor is presented. The sensor is fabricated in a standard 180 nm 1P6M CMOS process, occupying a total active area of 33 × 25 μm2, at a fill factor of ~ 55%. The pixel power consumption is reduced to 900 nW, facilitating the current domain ambient light (AL) suppression at the same time. Measurement results show a standard deviation of 7 mm at 1.2 m and below 5.2 cm for a range up to 3.2 m. The AL immunity is characterized up to 180 klx, demonstrating a distance deviation within 4 cm.
Facing temptation in the bar: counteracting the effects of self-control failure on young adults' ad libitum alcohol intake.

BACKGROUND AND AIMS The self-control strength model suggests that exertion of self-control leads to poorer subsequent self-control performance. Failure of self-control has been suggested as an important underlying mechanism of excessive drinking. This study tested the effects of self-control failure on ad libitum drinking, and the potential moderating role of glucose and self-awareness on this relationship. DESIGN The current research examined in two experiments whether the effects of self-control failure were different for males and females, and whether glucose (experiment 1) and self-awareness (experiment 2) would counteract the effects of self-control failure. A between-participants design with four conditions was employed in each experiment. SETTING A semi-naturalistic drinking setting in the form of a laboratory bar. PARTICIPANTS Undergraduate students recruited at Radboud University Nijmegen, the Netherlands (experiment 1: n = 106; experiment 2: n = 108). MEASUREMENTS The total amount of alcohol consumed during an experimental break (observational data) and questionnaire data on drinking patterns. FINDINGS Self-control failure led to increased levels of drinking in males (P < 0.05), whereas females drank less after being depleted (P < 0.01). Self-awareness, but not glucose, was found to counteract the effects of self-control failure among males (P < 0.05). CONCLUSIONS Self-control failure leads to increased drinking of alcohol in males and decreased levels of drinking alcohol in females. However, increasing self-awareness appears to be a promising strategy in facing the temptation to drink when cognitive resources to inhibit intake are low.
An international consensus for assessing internet gaming disorder using the new DSM-5 approach.

AIMS For the first time, the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) introduces non-substance addictions as psychiatric diagnoses. The aims of this paper are to (i) present the main controversies surrounding the decision to include internet gaming disorder, but not internet addiction more globally, as a non-substance addiction in the research appendix of the DSM-5, and (ii) discuss the meaning behind the DSM-5 criteria for internet gaming disorder. The paper also proposes a common method for assessing internet gaming disorder. Although the need for common diagnostic criteria is not debated, the existence of multiple instruments reflect the divergence of opinions in the field regarding how best to diagnose this condition. METHODS We convened international experts from European, North and South American, Asian and Australasian countries to discuss and achieve consensus about assessing internet gaming disorder as defined within DSM-5. RESULTS We describe the intended meaning behind each of the nine DSM-5 criteria for internet gaming disorder and present a single item that best reflects each criterion, translated into the 10 main languages of countries in which research on this condition has been conducted. CONCLUSIONS Using results from this cross-cultural collaboration, we outline important research directions for understanding and assessing internet gaming disorder. As this field moves forward, it is critical that researchers and clinicians around the world begin to apply a common methodology; this report is the first to achieve an international consensus related to the assessment of internet gaming disorder.
Effects of depressive symptoms on antecedents of lapses during a smoking cessation attempt: an ecological momentary assessment study.

AIMS To investigate pathways through which momentary negative affect and depressive symptoms affect risk of lapse during smoking cessation attempts. DESIGN Ecological momentary assessment was carried out during 2 weeks after an unassisted smoking cessation attempt. A 3-month follow-up measured smoking frequency. SETTING Data were collected via mobile devices in German-speaking Switzerland. PARTICIPANTS A total of 242 individuals (age 20-40, 67% men) reported 7112 observations. MEASUREMENTS Online surveys assessed baseline depressive symptoms and nicotine dependence. Real-time data on negative affect, physical withdrawal symptoms, urge to smoke, abstinence-related self-efficacy and lapses. FINDINGS A two-level structural equation model suggested that on the situational level, negative affect increased the urge to smoke and decreased self-efficacy (β = 0.20; β = -0.12, respectively), but had no direct effect on lapse risk. A higher urge to smoke (β = 0.09) and lower self-efficacy (β = -0.11) were confirmed as situational antecedents of lapses. Depressive symptoms at baseline were a strong predictor of a person's average negative affect (β = 0.35, all P < 0.001). However, the baseline characteristics influenced smoking frequency 3 months later only indirectly, through influences of average states on the number of lapses during the quit attempt. CONCLUSIONS Controlling for nicotine dependence, higher depressive symptoms at baseline were associated strongly with a worse longer-term outcome. Negative affect experienced during the quit attempt was the only pathway through which the baseline depressive symptoms were associated with a reduced self-efficacy and increased urges to smoke, all leading to the increased probability of lapses.
Molecular Classification and Prognostication of Breast Cancer

Breast cancer is a heterogeneous disease driven by abnormal gene expression within tumors. Recent advances in molecular techniques have enabled researchers to identify the gene expression, “fingerprint,” of individual tumors that would help predict the clinical course and select specific treatment(s). One of the most promising of these techniques is gene expression profiling, which is able to detect the activity of thousands of genes at once. This technique has recently identified several major breast cancer subtypes and resulted in a new classification of breast cancers. The subsets of breast cancer identified with the aid of this new classification schema augment the information gathered from traditional clinicopathologic variables. In addition, a growing number of commercially available molecular assays have recently been marketed to predict breast cancer prognosis and guide patient management. In this review, we will address the contribution of molecular methods to our understanding of breast cancer, and the impact these new developments have on our understanding of breast cancer, its diagnosis, and treatment.
Future orientation and smoking cessation: secondary analysis of data from a smoking cessation trial.

AIMS To examine the association between future orientation (how individuals consider and value outcomes in the future) and smoking cessation at 4 weeks and 6 months post quit-date in individuals enrolled in a smoking cessation study. DESIGN Cohort analysis of randomized controlled trial data. SETTING UK primary care. PARTICIPANTS Adults aged ≥18 years smoking ≥15 cigarettes daily, prepared to quit in the next 2 weeks. MEASUREMENTS Future orientation was measured prior to quitting and at 4 weeks post-quitting using the Consideration of Future Consequences Scale. Smoking cessation at 4 weeks and 6 months was confirmed biochemically. Those lost to follow-up were assumed to not be abstinent. Potential confounders adjusted for were: age, gender, educational attainment, nicotine dependence and longest previous period quit. FINDINGS A total of 697 participants provided data at baseline; 422 provided information on future orientation at 4 weeks. There was no evidence of an association between future orientation at baseline and abstinence at 4 weeks [adjusted odds ratio (aOR) = 1.05, 95% confidence intervals (CI) 0.80-1.38] or 6 months (aOR = 0.85, 95% CI = 0.60-1.20). There was no change in future orientation from baseline to 4 weeks and no evidence that the change differed between those who were and were not quit at 4 weeks (adjusted regression coefficient = -0.04, 95% CI = -0.16 to 0.08). CONCLUSIONS In smokers who are prepared to quit in the next 2 weeks, the extent of future orientation is unlikely to be a strong predictor of quitting over 4 weeks or 6 months and any increase in future orientation following quitting is likely to be small.
Obsessive-compulsive disorder: an overview.

In this article, which is the first in a three-part series, the authors provide an overview of the current state of our knowledge of the phenomenology, etiology, and diagnosis of OCD. The DSM-IV criteria for OCD are presented and explicated. Disorders that are commonly comorbid with OCD (e.g., major depressive disorder, other anxiety dis-orders, Tourette's disorder) are described. The authors also discuss disorders such as body dysmorphic disorder that may be related to OCD and are often termed OCD spectrum disorders. OCD is likely to have multiple causes and the authors discuss behavioral, neuroanatomical, and neurochemical theories of OCD. Two treatments have demonstrated efficacy in OCD, cognitive-behavioral therapy and pharmacotherapy with serotonergic reuptake inhibitors, and the authors discuss how these treatments may work in light of what is known about the etiology of the disorder. The different subtypes of OCD that have been proposed are described along with their implications for treatment. The article concludes with a discussion of diagnosis that provides specific guidance for the clinician on how to assess a patient for possible OCD. The next two articles in this series will cover cognitive-behavioral and medication treatment in detail.
Associations with anticoagulation: a cross-sectional registry-based analysis of stroke survivors with atrial fibrillation

Objective To describe vitamin K antagonist (VKA) anticoagulation prescribing patterns in stroke survivors with atrial fibrillation (AF), with particular emphasis on sociodemographic associations with VKA prescription. Methods We conducted a cross-sectional analysis of city-wide Glasgow primary care data held as part of the Local Enhanced Services (LES) for the year 2010. We collated clinical and sociodemographic data of community-dwelling ischaemic stroke survivors with AF, including risk factors; comorbidity; socioeconomic status and prescribing. We described stroke risk and bleeding risk using recommended stratification tools (CHA2DS2-VASC and HAS-BLED). Univariate and multivariate associations with anticoagulant prescription were described by ORs and corresponding 95% CI. Results We identified 3429 community-dwelling, ischaemic stroke survivors with AF; median age 78 (IQR 72–84); 1699 (49%) male. Median CHA2DS2-VASC score was 5 (IQR 4–6). VKA was prescribed in 1165 (34%). On univariate analysis, higher CHA2DS2-VASC was associated with fewer VKA prescriptions (OR 0.90, 95% CI 0.45 to 0.95). On multivariate analysis, older age (OR 0.97, 95% CI 0.96 to 0.98) and higher deprivation scores (OR 0.59, 95% CI 0.57 to 0.76) were independently associated with non-prescription of VKA. Conclusions Anticoagulation was underused in this high-risk population, and those at highest risk were less likely to be treated. Strategies need to be developed to improve prescription of anticoagulation treatment.
A high speed configurable FPGA architecture for k-mean clustering

This paper presents a high speed configurable FPGA architecture for k-means clustering. The proposed architecture is highly pipelined, parallel and fully configurable. It can achieve an operating frequency of 400 MHz, which is at least three times faster than prior works. The proposed architecture addresses the high speed and throughput requirements of machine vision, multi-media and data mining applications.
Recognising the gross pathology of tuberculosis in South American camelids, deer, goats, pigs and sheep

Tuberculosis (TB) can be difficult to recognise owing to its diverse pathology and similar gross pathology to other conditions. Early detection of TB outbreaks goes a long way to preventing further spread of the disease. This article describes the spectrum of possible gross pathology of TB in a range of non-bovine farmed species for which there is no routine antemortem surveillance. For these species, detection of the disease is dependent on gross pathology at slaughter or postmortem examination findings.