***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Near-miss events are situations in which an action yields a negative result but is very close to being successful . They are known to influence behavior , especially in gambling scenarios . Previous neuroimaging studies have described an ' anomalous ' activity of brain reward areas following these events . The goal of the present research was to study electrophysiological correlates of near-misses in the expectation and outcome phases .  Electroencephalography was recorded while  participants were playing a simplified version of a slot machine .  Four possible outcomes ( gain , near-miss , loss and no-information ) were presented in a pseudor and om order to ensure fixed proportions . Results from the time-frequency analysis for the theta ( 4 - 8 Hz ) , alpha ( 9 - 13 Hz ) , low beta ( 15 - 22 Hz ) and beta-gamma ( 25 - 35 Hz ) frequency-b and s presented larger power increases for wins and near-misses compared with losses . In the anticipation phase , power changes were lower than in the resolution phase . The current results are in agreement with previous studies showing that near-miss events recruit brain areas of the reward network . Likewise , the oscillatory activity in near-misses is very similar to the one elicited in the gain condition . In addition , present findings suggest that oscillatory activity in the expectation phase does not play a crucial role in near-miss events This study was conducted to examine the effects of the " near miss , " when a player almost wins , and the " big win , " a large early monetary gain , on persistence at slot machine gambling . One hundred eighty male and female undergraduates played a 4-wheel computerized slot machine . A 2 x 3 r and omized factorial design and an acquisition-extinction procedure were used . The dependent variable , persistence , was defined by the number of trials in the extinction phase . As hypothesized , the near miss had a statistically significant effect on the number of trials in extinction . An inverted U-shaped effect of the near miss showed that the 30 % near miss condition led to the greatest persistence , as compared to 45 % and 15 % near miss conditions . There was no statistically significant effect of the big win . Both cognitive and behavioral theories are discussed as explanations for effects of the near miss Problematic gambling is thought to be influenced by neurobiological mechanisms . However , the neuroendocrine response to gambling is largely unknown . Therefore , the effect of casino gambling on the sympathoadrenal system , the HPA-axis , and pituitary hormones were analyzed . Fourteen male problem gamblers and 15 non-problem gamblers were examined in a balanced cross-over design . In the experimental session , participants played blackjack in a casino wagering their own money . During the control session , subjects played cards for accumulation of points .  Heart rate and endocrine measures were recorded at baseline , at 30 , 60 and 90 min during gambling/card playing , and after the game . Heart rate and norepinephrine levels increased with the onset of blackjack in both groups , with problem gamblers showing significantly higher levels across the entire gambling session . In addition , dopamine levels were significantly higher in problem gamblers during casino gambling compared to non-problem gamblers . Cortisol levels were transiently increased with the onset of blackjack in both groups . Casino gambling as a " real life " situation induces activation of the HPA-axis and the sympathoadrenergic system , with significantly more pronounced changes in problem gamblers . These findings may contribute to a better underst and ing of neuroendocrine disturbances in problem gambling A particularly rapid onset of pathological gambling ( PG-onset ) through the use of gambling machines has been widely alluded to , but this is the first study to empirically examine the phenomenon . This study compared the latency of PG-onset in those who gambled primarily on machines , compared to those who gambled primarily on more “ traditional ” forms of gambling at PG-onset . Subjects were 44 adult pathological gamblers ( PGs ) seeking outpatient treatment in Rhode Isl and ( 17 females ; mean age = 46.9 ) . Subjects completed question naires and a diagnostic interview including a complete history of gambling activities and the course of PG . The “ latency ” of PG-onset was defined as the time ( in years ) elapsed between the age of regular involvement in the primary form of gambling and the age at which DSM-IV criteria were first met . “ Machine ” PGs ( n = 25 ) had a significantly shorter latency of onset than did “ traditional ” PGs ( 1.08 years vs. 3.58 years ) . Females and machine PGs had a significantly older age of onset , but gender was not associated with latency of PG-onset . Lifetime comorbidity of either substance use disorders ( SUDS ) or depressive disorders ( DDS ) was also not associated with the latency of PG-onset . The results of the current study suggest that intrapersonal variables such as gender and comorbid disorders do not generally affect the speed with which people develop PG . Rather , the social , environmental , and stimulus features of mechanized gambling are implicated . Prospect i ve longitudinal studies on the onset and course of PG are needed , as well as more basic research on the features of machine gambling that may contribute to rapid onset Near-miss outcomes during gambling are non-win outcomes that fall close to a pay-out . While objective ly equivalent to an outright miss , near-misses motivate ongoing play and may therefore be implicated in the development of disordered gambling . Given naturalistic data showing increases in heart rate ( HR ) and electrodermal activity ( EDA ) during periods of real gambling play , we sought to explore the phasic impact of win , near-miss and full-miss outcomes on physiological arousal in a controlled laboratory environment . EDA and HR were monitored as healthy , student participants ( n = 33 ) played a simulated slot-machine task  involving unpredictable monetary wins . A second gambling distortion , perceived personal control , was manipulated within the same task by allowing the participant to select the play icon on some trials , and having the computer automatically select the play icon on other trials . Near-misses were rated as less pleasant than full-misses . However , on trials that involved personal choice , near-misses produced higher ratings of ‘ continue to play ’ than full-misses . Winning outcomes were associated with phasic EDA responses that did not vary with personal choice . Compared to full-misses , near-miss outcomes also elicited an EDA increase , which was greater on personal choice trials . Near-misses were also associated with greater HR acceleration than other outcomes . Near-miss outcomes are capable of eliciting phasic changes in physiological arousal consistent with a state of subjective excitement , despite their objective non-win status Significance Gambling games are associated with a distorted psychological processing of r and om sequences ( the gambler ’s fallacy ) and unrewarded outcomes that fall close to a jackpot ( near misses ) . Problem gamblers appear more susceptible to these effects . Here , we show that these two gambling distortions are disrupted in patients with brain injury affecting the insula compared with patients with damage to the ventromedial prefrontal cortex or amygdala . In a roulette task ( red/black predictions ) , comparison groups chose either color less after longer runs of that color outcome . On a slot machine task , comparison groups rated higher motivation following near misses relative to full misses . Our results generate a clinical hypothesis that , in disordered gambling , these cognitions may be underpinned by excessive recruitment of insula circuitry . Gambling is a naturalistic example of risky decision-making . During gambling , players typically display an array of cognitive biases that create a distorted expectancy of winning . This study investigated brain regions underpinning gambling-related cognitive distortions , contrasting patients with focal brain lesions to the ventromedial prefrontal cortex ( vmPFC ) , insula , or amygdala ( “ target patients ” ) against healthy comparison participants and lesion comparison patients ( i.e. , with lesions that spare the target regions ) . A slot machine task was used to deliver near-miss outcomes ( i.e. , nonwins that fall spatially close to a jackpot ) , and a roulette game was used to examine the gambler ’s fallacy ( color decisions following outcome runs ) . Comparison groups displayed a heightened motivation to play following near misses ( compared with full misses ) , and manifested a classic gambler ’s fallacy effect . Both effects were also observed in patients with vmPFC and amygdala damage , but were absent in patients with insula damage . Our findings indicate that the distorted cognitive processing of near-miss outcomes and event sequences may be ordinarily supported by the recruitment of the insula . Interventions to reduce insula reactivity could show promise in the treatment of disordered gambling Responses to fear- and sadness-inducing films  were assessed using a broad range of cardiovascular ( heart rate , T-wave amplitude , low- and high-frequency heart rate variability , stroke volume , preejection period , left-ventricular ejection time , Heather index , blood pressure , pulse amplitude and transit time , and finger temperature ) , electrodermal ( level , response rate , and response amplitude ) , and respiratory ( rate , tidal volume and its variability , inspiratory flow rate , duty cycle , and end-tidal pCO(2 ) ) measures . Subjective emotional experience and facial behavior ( Corrugator Supercilii and Zygomaticus Major EMG ) served as control measures . Results indicated robust differential physiological response patterns for fear , sadness , and neutral ( mean classification accuracy 85 % ) . Findings are discussed in terms of the fight-flight and conservation-withdrawal responses and possible limitations of a valence-arousal categorization of emotion in affective space 
    Output:
    
The systematic review revealed that near misses motivate continued play , but have varying effects on the emotional state or betting behaviour of the player .
Near miss events were also shown to be associated with elevated skin conductance levels and diffuse activity across the brain , most consistently in areas processing reinforcement and reward .