Craving in gambling disorder: A systematic review

Background and objectives: Craving is one of the main criteria for the diagnosis of substance use disorder according to the DSM-5; however, it is not included in the main criteria for gambling disorder (GD). In the present systematic review, we aimed to evaluate the available body of knowledge regarding gambling craving to help step forward to a consensus regarding this topic. Data sources: PsycINFO/PsycARTICLES and PubMed/Medline were used. Study eligibility criteria, participants, and interventions: (1) individuals of both genders who had a clinical diagnosis of GD in which the presence of gambling craving were studied by means of tasks or self-report tools; (2) we included three types of studies: (a) validation articles of craving psychometric tools in which GD was assessed; (b) articles in which craving–GD association was explored; and (c) treatment articles for GD in which craving was assessed. Results: n 5 63 studies were finally included in the systematic review. Some studies described an association between craving- and gambling-related factors, and craving was also described as a predictor of GD severity, gambling episodes, chasing persistence and income-generating offenses. Gambling craving also seems to be associated with emotional states and negative urgency. Finally, some studies implemented specific interventions for GD and assessed its impact on reducing gambling craving. Conclusions: There is a growing body of knowledge on the relevant role of craving in gambling behavior and GD. Further studies are needed to reach a consensus on the diagnostic criterion for GD

Transcranial Direct Corrent stimulation (tDCS) of the anterior prefrontal cortex (aPFC) modulates reinforcement learning and decision-making under uncertainty: A doubleblind crossover study

Reinforcement learning refers to the ability to acquire information from the outcomes of prior choices (i.e. positive and negative) in order to make predictions on the effect of future decision and adapt the behaviour basing on past experiences. The anterior prefrontal cortex (aPFC) is considered to play a key role in the representation of event value, reinforcement learning and decision-making. However, a causal evidence of the involvement of this area in these processes has not been provided yet. The aim of the study was to test the role of the orbitofrontal cortex in feedback processing, reinforcement learning and decision-making under uncertainly. Eighteen healthy individuals underwent three sessions of tDCS over the prefrontal pole (anodal, cathodal, sham) during a probabilistic learning (PL) task. In the PL task, participants were invited to learn the covert probabilistic stimulusoutcome association from positive and negative feedbacks in order to choose the best option. Afterwards, a probabilistic selection (PS) task was delivered to assess decisions based on the stimulus-reward associations acquired in the PL task. During cathodal tDCS, accuracy in the PL task was reduced and participants were less prone to maintain their choice after positive feedback or to change it after a negative one (i.e., winstay and lose-shift behavior). In addition, anodal tDCS affected the subsequent PS task by reducing the ability to choose the best alternative during hard probabilistic decisions. In conclusion, the present study suggests a causal role of aPFC in feedback trial-by-trial behavioral adaptation and decision-making under uncertainty

Expectancy to Eat Modulates Cognitive Control and Attention Toward Irrelevant Food and Non-food Images in Healthy Starving Individuals. A Behavioral Study

It is thought that just as hunger itself, the expectancy to eat impacts attention and cognitive control toward food stimuli, but this theory has not been extensively explored at a behavioral level. In order to study the effect of expectancy to eat on attentional and cognitive control mechanisms, 63 healthy fasting participants were presented with an affective priming spatial compatibility Simon task that included both food and object (non-food) distracters. The participants (N = 63) were randomly assigned to two groups: an “immediate expectancy” group made up of participants who expected to eat immediately after the task (N = 31; females = 21; age = 26.8 ± 9.6) and a “delayed expectancy” cohort made up of individuals who expected to eat a few hours later (N = 32; females = 21; age = 25.0 ± 8.0). Slower reaction times (RTs) toward the food and non-food distracters and a more pronounced effect on the RTs in the incompatible condition [i.e., the Simon effect (SE)] were noted in both groups. The effect of the food and non-food distracters on the RTs was more pronounced in the immediate with respect to the delayed expectancy group. The magnitude of the SE for the food and the non-food distracters was also greater in the immediate with respect to the delayed expectancy group. These results seem to indicate that when the expectancy to eat is short, the RTs are delayed, and the SE is more pronounced when food and non-food distracters are presented. Instead, when the expectancy to eat is more distant, the distracters have less of an effect on the RTs and the correspondence effect is smaller. Our results suggest that the expectancy to eat can modulate both attention orienting and cognitive control mechanisms in healthy fasting individuals when distracting details are competing with information processing during goal directed behavior

PAX2/Renal Coloboma Syndrome Expresses Extreme Intrafamilial Phenotypic Variability

Renal coloboma syndrome (RCS) is a disease characterized by kidney and ocular anomalies (kidney hypodysplasia and coloboma). RCS is caused, in half of the cases, by mutations in the paired box 2 (PAX2) gene, a critical organogenesis transcriptional factor. We report the case of a newborn with kidney hypodysplasia in a negative parental context where mother and father were phenotypically unaffected at the initial evaluation. The maternal family presented an important history of kidney disease with undefined diagnosis. Molecular characterization identified a PAX2 variant, classified as likely pathogenic. This variant segregates with the disease, and it was also found in the newborn, explaining his severe symptoms. It is noteworthy that the mother shows the same PAX2 variant, with an apparently negative kidney phenotype, displaying the possibility of an extreme variable expressivity of the disease. This feature suggests extreme caution in segregation analysis and family counseling of PAX2 pedigrees

Molecular Factors Influencing Retention on Immobilized Artificial Membranes (IAM) Compared to Partitioning in Liposomes and n -Octanol

Purpose. To assess the effect of molecular factors influencing retention on immobilized artificial membrane (IAM) high-performance liquid chromatography columns compared to liposomal partitioning and traditional n-octanol/water partition coefficients. Methods. IAM capacity factors were measured at pH 7.0 on an IAM.PC.DD2 stationary phase. Liposomal partitioning at pH 7.0 and n-octanol/water partition coefficients were measured using the pH metric method. Partitioning in egg-phosphatidylcholine (PhC) liposomes was also measured by equilibrium dialysis for a series of β-blockers. Results. For the ionized β-blockers, potentiometry and equilibrium dialysis yielded consistent partitioning data. For relatively large bases, IAM retention correlated well with PhC liposome partitioning, hydrophobic forces being mainly involved. For more hydrophilic compounds and for heterogeneous solutes, in contrast, the balance between electrostatic and hydrophobic interactions was not the same in the two systems. Hydrogen bonding, an important factor in liposomes partitioning, played only a minor role in IAM retention. Conclusions. Partitioning in immobilized artificial membranes depends on size, hydrophobicity, and charge. When hydrophobic interactions dominate retention, IAM capacity factors are well correlated with liposomal partitioning. On the contary, for hydrophilic solutes, the two systems do not yield the same information and are not interchangeabl

Risks associated with intensive blood pressure control in older patients

Hypertension management forms a cornerstone of cardiovascular prevention. Strong evidence is available supporting the benefits of blood pressure (BP) lowering in older adults and recent studies indicate that intensive BP control may provide additional advantages on cardiovascular and mortality risk, also at older ages. Yet, in older adults the cardiovascular benefit of intensive treatment may come at the expense of increase in adverse events. Indeed, advanced age and frailty may modify the risk/benefit ratio of BP lowering due to a greater predisposition to hypotension and more severe consequences deriving from treatment-related adverse effects. This mostly applies to individuals with poor health status and limited life expectancy, in whom aggressive BP lowering may not lead to cardiovascular benefits, but rather increase the risk of short-term treatment-related complications. Furthermore, the potential harms of intensive BP control might be underestimated in clinical trials due to exclusion criteria which preclude patients with frailty and multimorbidity from being eligible. Syncope and falls are the most frequently mentioned antihypertensive-related safety concern, but aggressive BP lowering may negatively affect also renal function, cognitive performance, quality of life and survival. With the growing emphasis on intensive treatment strategies, raising awareness on potential harms associated with aggressive BP lowering might help improve hypertension management in older adults and encourage implementation of clinical research on safety issues. Given these premises, we present a narrative review illustrating the most relevant risk potentially associated with intensive BP control in older patients

The EPFL Logic Synthesis Libraries

We present a collection of modular open source C++ libraries for the development of logic synthesis applications. These libraries can be used to develop applications for the design of classical and emerging technologies, as well as for the implementation of quantum compilers. All libraries are well documented and well tested. Furthermore, being header-only, the libraries can be readily used as core components in complex logic synthesis systems.Comment: 11 pages, originally accepted at Int'l Workshop on Logic & Synthesis 2018, extended for Workshop on Open-Source EDA Technology 201

Physiotherapists’ knowledge of and adherence to evidence-based practice guidelines and recommendations for ankle sprains management: a cross-sectional study

BackgroundLateral ankle sprain (LAS) is a common and burdensome injury. However, the quality of its management is scant. Nowadays, physiotherapy management of musculoskeletal diseases seems to be generally not based on research evidence. Studies that investigated the knowledge-to-practice gap in LAS management are yet to be carried out. Therefore, this research investigated physiotherapists’ knowledge of and adherence to LAS Clinical Practice Guidelines (CPGs) and recommendations.MethodsA cross-sectional study based on an online survey structured in three sections. The first section collected demographic data. The second section showed two clinical cases (with positive and negative Ottawa Ankle Rules (OAR), respectively). The participants indicated which treatments they would adopt to manage them. Participants were classified as ‘following’, ‘partially following’, ‘partially not following’ and ‘not following’ the CPGs and recommendations. In the third section, participants expressed their agreement with different CPG and recommendation statements through a 1-5 Likert scale.ResultsIn total, 483 physiotherapists (age: 34 ± 10; female 38%, male 61.5%, other 0.5%) answered the survey: 85% completed the first two sections, 76% completed all three sections. In a case of acute LAS with negative OAR, 4% of the participants were considered as ‘following’ recommended treatments, 68% as ‘partially following’, 23% as ‘partially not following’, and 5% as ‘not following’. In a case of acute LAS with positive OAR, 37% were considered ‘following’ recommended treatments, 35% as ‘partially following’, and 28% as ‘not following’. In the third section, the consensus was achieved for 73% of the statements.ConclusionThis study showed that although there is a good knowledge about first-line recommended treatments, a better use of CPGs and recommendations should be fostered among physiotherapists. Our results identify an evidence-to-practice gap in LAS management, which may lead to non-evidence-based practice behaviors