Resting EEG asymmetry markers of multiple facets of the behavioral approach system: a LORETA analysis

Previously published models of frontal activity linked high relative left frontal activity to the behavioral approach system (BAS) and impulsivity. Additionally, these models did not account for BAS facets encompassing the anticipation of reward, i.e., goal-driven persistence (BAS–GDP) and reward interest (BAS–RI), from those that deal with the actual hedonic experience of reward, i.e., reward reactivity (BAS–RR) and impulsivity (BAS–I). Using resting electroencephalographic (EEG) recordings, the source localization (LORETA) method allowed us to calculate the hemispheric asymmetry of the current density within the alpha band (7.5–13 Hz) in ten regions of interest. Compared to low BAS subtrait scorers, high BAS subtrait scorers (except for BAS–I) were correlated with greater relative left-sided activity in the superior frontal gyrus (BA10). Further, an isolated effective coherence (iCOH) analysis of the beta activity (21 Hz) disclosed that high impulsive scorers as compared to low impulsive ones had higher connectivity between the superior frontal gyrus and middle temporal gyrus, which was not compensated for by enhanced inhibitory alpha (11 Hz) connectivity between these regions. For the beta frequency, we also found in highly impulsive individuals that (i) both left and right middle temporal lobes directly influenced the activity of the left and right superior frontal lobes, and (ii) a clear decoupling between left and right superior frontal lobes. These findings could indicate reduced control by the supervisory system in more impulsive individuals

The Behavioral Approach System and Augmenting/Reducing in auditory event-related potentials during emotional visual stimulation

In the recent Reinforcement Sensitivity Theory Personality Questionnaire (RST-PQ, Corr and Cooper, 2016) the behavioral approach system (BAS) has been conceptualized as multidimensional in which facets of reward interest and reactivity, and goal-drive persistence, are separate from impulsivity. Aim of the present work was to highlight the predictive power of BAS and its facets in differentiating electrocortical responses by using an auditory augmenting/reducing event-related potential (ERP) paradigm during emotional visual stimulation. ERPs were recorded for 5 levels of intensity in 39 women. The RST-PQ was used to measure the total BAS (T-BAS) and its four facets of Goal-Drive Persistence (GDP), Reward Interest (RI), Reward Reactivity (RR), and Impulsivity (IMP). T-BAS and RI, and to a less extent GDP and RR, were significantly associated with higher N1/P2 amplitudes at central sites (C3, Cz, C4) across neutral, positive and negative slides. Similar, but less pronounced relations were found for GDP and RR, but this relation was lacking for Imp facet. In addition, N1/P2 slope at central sites was positively correlated with T-BAS, GDP, RI, RR, but not Imp. Indeed, T-BAS facets failed to maintain a significant correlation with N1/P2 slope, after controlling for T-BAS residual scores, indicating that T-BAS drives these significant correlations. LORETA analysis at 219ms (P2 wave) from tone onset revealed a significant activation of the right inferior parietal lobule (IPL, BA40) and left anterior cingulate gyrus (BA32) in high T-BAS compared to low T-BAS participants. Results are discussed within a revised RST framework differentiating reward components from impulsivity

Surrounding skin management in venous leg ulcers: A systematic review

Objectives: Chronic venous insufficiency may lead to the development of venous leg ulcers, the most common form of chronic wounds in the lower extremity. Key to venous leg ulcer care is the maintenance of healthy skin surrounding the ulcer, as failure to maintain skin integrity may influence the healing outcome. We thus reviewed the scientific literature looking for assessment and management instruments regarding this common but often neglected issue. Method: The search included all studies published between 2000 and May 2019. Keywords used were: “peri-wound skin care”, “surrounding skin venous ulcers”, “surrounding skin management leg ulcers”, and “peri-lesional skin management”. Results: Management of moisture-balance with the selection of appropriate dressings is the most important target in surrounding-wound skin care. Moreover, contact dermatitis related to products and the dressings themselves is a neglected problem in patients with chronic leg ulcers which clinicians increasingly have to manage. The literature search revealed that there is an increasing interest in the use of noninvasive assessment tools in the field of wound care, and focusing on the surrounding-wound skin plays a role in assessing the potential of wound healing. Transepidermal water loss measurement (TEWL) and ultrasonography are two of the measurement techniques available. Conclusion: The integrity of the surrounding skin is necessary for wound healing, and appropriate management is needed to address this aspect which is part of an overall approach to treating wounds

City watchdog finds no evidence for recent political ‘debanking’ – but private banks have been picky for centuries

Disclosure statement: The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.After a row over the closure of his bank account earlier this year, former politician Nigel Farage has hit out at the UK financial regulator for saying it has found no recent evidence of customers being “de-banked” over their personal views

Postpartum women’s psychological experiences during the COVID-19 pandemic: a modified recurrent cross-sectional thematic analysis

Background: COVID-19 has placed additional stressors on mothers during an already vulnerable lifecourse transition. Initial social distancing restrictions (Timepoint 1; T1) and initial changes to those social distancing restrictions (Timepoint 2; T2) have disrupted postpartum access to practical and emotional support. This qualitative study explores the postpartum psychological experiences of UK women during different phases of the COVID-19 pandemic and associated ‘lockdowns’. Methods: Semi-structured interviews were conducted with 12 women, approximately 30 days after initial social distancing guidelines were imposed in the UK (22 April 2020). A separate 12 women were interviewed approximately 30 days after the initial easing of social distancing restrictions (10 June 2020). Data were transcribed verbatim, uploaded into NVivo for management and analysis, which followed a recurrent cross-sectional approach to thematic analysis. Results: Two main themes were identified for T1: ‘Motherhood is Much Like Lockdown’ and ‘A Self-Contained Family Unit’. Each main T1 theme contained two sub-themes. Two main themes were also identified for T2: ‘Incongruously Held Views of COVID-19’ and ‘Mothering Amidst the Pandemic’. Each main T2 theme contained three sub-themes. Comparisons between data gathered at each timepoint identified increased emotional distress over time. Current findings call for the improvement of postpartum care by improving accessibility to social support, and prioritising the re-opening of schools, and face-to-face healthcare appointments and visitation. Conclusion: Social distancing restrictions associated with COVID-19 have had a cumulative, negative effect on postpartum mental health. Recommendations such as: Allowing mothers to ‘bubble’ with a primary support provider even at their healthcare appointments; allowing one support partner to attend all necessary healthcare appointments; and providing tailored informational resources, may help to support postpartum emotional wellbeing during this, and similar health crises in the future

Il trattamento del diabete mellito di tipo 2 nei pazienti affetti da malattia renale cronica: cosa aspettarsi dai nuovi ipoglicemizzanti orali

Worldwide, an estimated 200 million people have chronic kidney disease (CKD), whose most common causes include hypertension, arteriosclerosis, and diabetes. About 40% of patients with diabetes develop CKD. Intensive blood glucose control through pharmacological intervention can delay CKD progression. Standard therapies for the treatment of type 2 diabetes include metformin, sulfonylureas, meglitinides, thiazolidinediones and insulin. While these drugs have an important role in the management of type 2 diabetes, only the thiazolidinedione pioglitazone can be used across the spectrum of CKD (stages 2\u20135) and without dose adjustment. Newer therapies, particularly dipeptidyl peptidase-IV inhibitors, glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter-2 inhibitors are increasingly being used in the treatment of type 2 diabetes. However, a major consideration is whether these newer therapies can also be used safely and effectively across the spectrum of renal impairment

The antenatal psychological experiences of women during two phases of the COVID-19 pandemic: A recurrent, cross-sectional, thematic analysis

Initial COVID-19-related social distancing restrictions, imposed in the UK in March 2020, and the subsequent lifting of restrictions in May 2020 caused antenatal disruption and stress which exceeded expected vulnerabilities associated with this lifecourse transition. The current study aimed to explore the antenatal psychological experiences of women during different phases of pandemic-related lockdown restrictions in the UK. Semi-structured interviews were held with 24 women about their antenatal experiences: twelve were interviewed after the initial lockdown restrictions (Timepoint 1; T1), and a separate twelve women were interviewed after the subsequent lifting of those restrictions (Timepoint 2; T2). Interviews were transcribed and a recurrent, cross-sectional thematic analysis was conducted. Two themes were identified for each timepoint, and each theme contained sub-themes. T1 themes were: ‘A Mindful Pregnancy’ and ‘It’s a Grieving Process’, and T2 themes were: ‘Coping with Lockdown Restrictions’ and ‘Robbed of Our Pregnancy’. COVID-19 related social distancing restrictions had an adverse effect on women’s mental health during the antenatal period. Feeling trapped, anxious, and abandoned were common at both timepoints. Actively encouraging conversations about mental wellbeing during routine care and adopting a prevention opposed to cure attitude toward implementing additional support provisions may serve to improve antenatal psychological wellbeing during health crises

Gli inibitori della Neprilisina nei pazienti affetti da Malattia Renale Cronica e Sindrome Cardio-Renale

I pazienti affetti da malattia renale cronica (CKD) presentano una maggiore incidenza di eventi cardiovascolari (acuti e cronici) che, a loro volta, comportano un rischio aumentato di progressione verso la malattia renale cronica terminale (end \u2013 stage renal disease \u2013 ESRD) L\u2019inibizione della neprilisina, oltre ad offrire un nuovo target terapeutico nei pazienti affetti da scompenso cardiaco, potrebbero rappresentare una strategia di potenziale miglioramento negli outcomes, sia cardio-vascolari che renali, dei pazienti affetti da CKD. L\u2019inibizione della neprilisina, favorendo una maggiore biodisponibilit\ue0 dei peptidi natriuretici atriali, determina un incremento della diuresi e della natriuresi, oltre ad esercitare un\u2019azione di inibizione del sistema renina \u2013 angiotensina \u2013 aldosterone (RAAS). L\u2019inibizione del RAAS, a sua volta, genera una serie di controregolazioni in grado di bilanciarne gli effetti sfavorevoli in corso di CKD e di insufficienza cardiaca (HF). L\u2019idea del blocco della neprilisina non \ue8 recentissima, ma i primi farmaci impiegati, essendo molecole di associazione con antagonisti dell\u2019angiotensina II (ARBs), risultavano gravati da un\u2019incidenza inammissibile di angioedema. Tra le molecole di ultima generazione in grado di esercitare un\u2019azione inibente specifica sul recettore della neprilisina e su quello dell\u2019angiotensina II, grazie alla associazione con il valsartan, vi \ue8 l\u2019LCZ696 (sacubitril/valsartan) che ha mostrato evidenti benefici sia nel trattamento dell\u2019ipertensione arteriosa che nell\u2019insufficienza cardiaca.Patients with chronic kidney disease (CKD) have a higher incidence of cardiovascular (acute and chronic) events, which in turn have an increased risk of progression to end-stage renal disease (ESRD) Inhibition of neprilysin, in addition to offering a new therapeutic target in patients with heart failure, could represent a potential improvement strategy in cardiovascular and renal outcome of patients with CKD. Inhibition of neprilysin by inhibiting the breakdown of natriuretic peptides, increases their bioavailability resulting in an increase in diuresis and sodium excretion and, in addition to exerting an inhibition of the renin-angiotensin-aldosterone (RAAS) system. Inhibition of RAAS, in turn, generates a series of counter-regulations that can balance the adverse effects present in CKD and heart failure (HF). The idea of blocking neprilysin is not very recent, but the first drugs used as inhibitors had an inadmissible incidence of angioedema. Among the latest generation molecules that can perform a specific inhibitory action on the neprilysin receptor and, at the same time, on the angiotensin II receptor thanks to the association with valsartan there is the LCZ696 (sacubitril / valsartan). This drug has shown promising benefits both in the treatment arterial hypertension and heart failure. It is hoped that equally positive effects may occur in CKD patients, particularly those with macroproteinuria

Gli inbitori della neprilisina nei pazienti affetti da malattia renale cronica sindrome cardio-renale

I pazienti affetti da malattia renale cronica (CKD) presentano una maggiore incidenza di eventi cardiovascolari (acuti e cronici) che, a loro volta, comportano un rischio aumentato di progressione verso la malattia renale cronica terminale (end \u2013 stage renal disease \u2013 ESRD) L\u2019inibizione della neprilisina, oltre ad offrire un nuovo target terapeutico nei pazienti affetti da scompenso cardiaco, potrebbero rappresentare una strategia di potenziale miglioramento negli outcomes, sia cardio-vascolari che renali, dei pazienti affetti da CKD. L\u2019inibizione della neprilisina, favorendo una maggiore biodisponibilit\ue0 dei peptidi natriuretici atriali, determina un incremento della diuresi e della natriuresi, oltre ad esercitare un\u2019azione di inibizione del sistema renina \u2013 angiotensina \u2013 aldosterone (RAAS). L\u2019inibizione del RAAS, a sua volta, genera una serie di controregolazioni in grado di bilanciarne gli effetti sfavorevoli in corso di CKD e di insufficienza cardiaca (HF). L\u2019idea del blocco della neprilisina non \ue8 recentissima, ma i primi farmaci impiegati, essendo molecole di associazione con antagonisti dell\u2019angiotensina II (ARBs), risultavano gravati da un\u2019incidenza inammissibile di angioedema. Tra le molecole di ultima generazione in grado di esercitare un\u2019azione inibente specifica sul recettore della neprilisina e su quello dell\u2019angiotensina II, grazie alla associazione con il valsartan, vi \ue8 l\u2019LCZ696 (sacubitril/valsartan) che ha mostrato evidenti benefici sia nel trattamento dell\u2019ipertensione arteriosa che nell\u2019insufficienza cardiaca.