Attentional Differences Between Males and Females for Emojis During the Emotional Stroop Task.

Introduction Cognitive load can be intensified by emotional components such as emotive words or facial expressions. Sex differences influence both emotional and cognitive functions for emotional facial expressions. Emojis, in contrast to human faces, serve as digital cues conveying emotional nuances in communication. The present study aimed to compare attentional differences prompted by emojis. Methods This study aimed to compare attentional differences in males and females elicited by emojis in 100 healthy adults (50 males and 50 females) within the age group of 18 to 40 years (mean ± SD: 27.87 ± 5.37 years) while performing the emotional Stroop task (EST). The EST comprised emojis depicting four emotions (happy, fear, sad, and angry) and emotionally charged words conveying similar emotions. An independent sample t-test was used to compare the reaction times among males and females. Results Results showed males had significantly longer reaction times than females across all task conditions. Both genders exhibited significant differences in reaction times across task conditions, except inhibition. Overall, reaction times increased notably from neutral to incongruent conditions for both genders. This suggests that response times increased significantly from neutral to incongruent conditions. Conclusion Emojis introduced in the EST revealed gender-related differences in attentional processing. This study showed the greater proficiency of females in emotional processing during EST compared to males. These findings contribute to our understanding of how gender is associated with cognitive responses to emotional stimuli in digital communication contexts.

Font Matters: Deciphering the Impact of Font Types on Attention and Working Memory.

Introduction Various types of fonts such as serif, sans serif, and script are used during writing and reading, which can affect the reader's attention and working memory, though there is only a subtle difference at the end of the letter. The study aimed to see the effect of font type on working memory and attention. Methods The study included healthy male adults between 18 and 40 years of age. After taking all the necessary precautions, a letter cancellation test and 2-back task in serif, sans serif, and script font types were done to evaluate subjects' attention and working memory. Results A total of 30 subjects participated in the study. The letter cancellation task (LCT) was statistically significant (P<0.05) between the three groups, where the time taken to complete the task was the shortest for serif fonts, indicating heightened attention to serif fonts. However, the accuracy of the N-back test did not show statistically significant differences (P>0.05) among the three font groups, indicating no significant change in working memory. Conclusion The type of font used can impact the reader's attention, with Times New Roman font demonstrating greater attention, particularly in the context of the letter cancellation task.

Attentional Correlates of Colored Lights: Considerations for Cognitive Testing.

Attention, an important index of cognitive function, can be affected amidst colored lights. This work investigated the effects of colored lights on the performance in attention task. Participants (N = 42) performed in one, two, and three letter cancellation task (LCT) during four lighting conditions. The order of LCT and the colored light sessions were randomized. The performance in LCT was evaluated through % accuracy, % omission, and % error. A repeated measures ANOVA showed a statistically significant difference in % accuracy in one LCT (F(2.46, 100.8) = 24.45, p < 0.001), two LCT (F(2.57, 105.4) = 20.53, p < 0.001), and three LCT (F(2.66, 109.22) = 17.96, p < 0.001) among the four colored lights. In addition, % omission revealed a statistically significant difference in one LCT (F(2.46, 100.8) = 24.43, p < 0.001), two LCT (F(2.57, 105.4) = 20.57, p < 0.001), and three LCT (F(2.66, 109.16) = 18.21, p < 0.001) among the four lights. There was no statistically significant difference in % error in one LCT (F(2.05, 84.1) = 1.23, p = 0.3), two LCT (F(2.66, 109.06) = 0.62, p = 0.971), three LCT (F(2.62, 107.53) = 0.97, p = 0.4) among the four lighting conditions. Colored lights affect attention-related cognitive processing. The attentional correlates of white and red lights are more compared to green, and blue lights. Lighting condition should be an important consideration for cognitive testing, for designing workspaces, educational settings, and other environments where attention plays a crucial role.

Use of Multimodality Intraoperative Neuromonitoring in Tethered Cord Syndrome - Experience from a Tertiary Care Center.

Detethering of the spinal cord is done in nearly all cases of tethered cord syndrome (TCS), which can damage nerve roots, and hence, there is a need to identify filum terminale during surgery. Multimodality intraoperative neuromonitoring (IONM) may be useful in this regard to prevent postoperative morbidity. Twenty-six patients (13 males and 13 females, age range: one year to 56 years) with TCS were recruited for the study. Triggered electromyography (t-EMG), transcranial motor evoked potential (TcMEP) and free-running electromyography (f-EMG) were used in the study on a case-to-case basis. Warning criteria were followed according to the standard guidelines. Nerve roots and filum terminale were successfully identified and detethered in all cases. There was no new postoperative deficit seen. Transcranial motor evoked potentials did not change during surgery and no new limb weakness was seen in any of the investigated cases. Triggered EMG successfully helps in identifying nerve roots and filum terminale, while TcMEP is a good prognostic indicator of motor viability. Multimodality IONM use during tethered cord surgery should be encouraged to prevent postoperative deficits.

Assessment of the use and Safety of Protection Box for Intubation and Extubation Among Anaesthesiologists During COVID-19 Pandemic- A Cross-sectional Survey.

Introduction: Covid 19 epidemic has affected the people making them undergo emergency procedures requiring intubation. A protective box was innovated at our tertiary care centre to safeguard the HCW during intubation and/or extubation and the study was planned to assess its use and safety among the anaesthesiologists. Methods: A cross sectional, questionnaire base survey was done among anaesthesiologists in various strata of residency. The intubation box was used on the patient for intubation and extubation. The experience of participants was recorded via a Google Form and one response per participant was restricted. Participants were divided into two groups, Group 1(1stand 2nd year junior residents) and Group 2 (Senior resident and 3rd year junior resident). A valid response, was received from 25 anaesthesiologists who were either performing or assisting the intubation. The residents were evaluated based on the ease of use and safety features of the box. Results: There was a significant difference in the time taken to intubate between the two groups (p = 0.048) and it was found that Group 2 with more experience took less time to intubate than Group 1. Also, more respondents in Group 2 found it easier to manoeuvre the hands to handle instruments than Group 1(p = 0.024). Conclusion: We recommend that usage of intubation box during intubation or extubation is a non-harmful and necessary compromise that we must make to protect the /safeguard the well-being of Health Care Worker without affecting patient care in our fight with COVID-19. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-023-03692-7.

Autonomic Correlates of Letter Cancelation Task: What the Attention Load May Evoke?

OBJECTIVE: Attention can be assessed through Letter cancelation tasks (LCT) that employ visuospatial selection and appropriate motor responses. We examined the performance in the LCT with increasing attention load, and determined the related autonomic changes. METHODS: Autonomic parameters were estimated in healthy males at baseline and during three different cognitive load conditions using the LCT. RESULTS: Results revealed a statistically significant difference (n = 30) in the percent accuracy (χ2(2) = 15.2, p < .001) and percent omission (χ2(2) = 13.3, p = 0.001) with the increasing challenge in the LCT. The vagally-mediated measures of heart rate variability were significantly decreased with the commencement of the task revealing a parasympathetic withdrawal. The respiratory sinus arrythmia was decreased, and the photoplethysmography amplitude was significantly reduced (χ2(3) = 14.2, p = 0.003) as the attention demand increased. CONCLUSION: The performance declined with the increasing attention load. LCT evokes autonomic perturbations though overall autonomic variability does not change remarkably.

Critical Self-Appraisal Towards the Better Use of a Webinar Series as an Online Tool for Postgraduate Teaching.

INTRODUCTION: The current coronavirus disease 2019 (COVID-19) pandemic adversely affected the conventional teaching mode, resulting in an exponential rise in online modalities such as webinars. Simultaneously, the lockdown provided substantial time to pursue potential academic content on the web. It is known that newly admitted postgraduate students of Physiology require a structured program that can guide them to conduct research for the completion of the course. METHODS: Gauging the opportunity, a webinar series was conducted on basic research methodology and thesis writing in Physiology. The series comprised hourly lectures delivered between 4:00 and 5:00 pm for seven consecutive days. Suggestions for future topics for webinars were sought through open-ended questions. Additionally, feedback for increment in students' knowledge at the end of the webinar was also inquired on a Likert scale. Open-ended answers were pooled into fields, and Likert scale scores were evaluated. RESULTS: There were 364 (35.8%) postgraduate students who registered for the webinar. The remaining were faculty (51.6%), research scholars (8.8%), and senior residents (3.8%). Among the postgraduate students who submitted the feedback, a majority (98.4%) of them agreed that their knowledge was enhanced at the end of the series. Most of the postgraduate students (31%) chose Biostatistics for future webinars. CONCLUSION: Webinars are a useful tool for postgraduate teaching. They should be constructed with engaging infrastructure and relevant examples. The availability of recorded content on the online forum is beneficial for asynchronous learners. Having an idea about students' choice for essential topics helps in the advanced planning of a demanding webinar.

Olfactory training for olfactory dysfunction in COVID-19: A promising mitigation amidst looming neurocognitive sequelae of the pandemic.

Olfactory dysfunction (OD) is a recognized symptom of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is independently associated with neurodegenerative disorders. Moreover, the central nervous system manifestations in patients infected with the coronavirus-2019 (COVID-19) have demonstrated cognitive decline and neuropsychiatric manifestations. Hence, OD in COVID-19 necessitates perusal of its mechanism and available treatment options to avert possible development of neurocognitive sequelae of the pandemic. The article presents a literature review organized from the published information about olfactory training (OT) for OD during COVID-19. The methodology comprised retrieval of available literature from database searches and subsequent scrutinization of relevant information. Inferentially, injury to the sustentacular cells, possessing angiotensin-converting enzyme 2 (ACE-2) receptors, is an important mechanism causing OD in COVID-19. Olfactory dysfunction may be prolonged in severe cases of anosmia predisposing to neurodegenerative and cognitive impairment in COVID-19 infection. Olfactory training demonstrates an effective treatment for OD based on human and animal-derived evidence through recent studies. It curtails the progression of OD, besides inducing neural rearrangement and changes in functional connectivity in patients receiving OT. Additionally, contemporary reports support that the administration of OT for COVID-induced anosmia is effective and encompasses no significant adverse effects. The present review highlights the prominence of olfactory training as a recommended intervention for OD in COVID-19. This review can guide the clinicians in curbing neurological repercussions of COVID besides enhancing cognitive rehabilitation through olfactory training.

Correlation of tumour and treatment characteristics to dose received by cochlea in volumetric arc therapy.

PURPOSE: This is a radiation field simulation study using CT images designed to see the cochlear dosimetry and its correlation with tumour and treatment characteristics during radiotherapy for head and neck cancers (HNC) for identifying the factors associated with a higher dose delivered to the cochlea. METHODS: From 2018 to 2020, 80 patients with HNC underwent volumetric arc therapy (VMAT) to a dose of 66-70 Gy at 2 Gy per fraction with bilateral cochlea contoured for VMAT optimization as an organ at risk. Minimum, mean and maximum planned radiation dose to the cochlea based on tumour and treatment characteristics and dose-volume histogram variables of VMAT plans were analysed. RESULTS: Mean (standard deviation, SD) cochlear volume was 0.14 (0.06) cm3 with maximum and mean planned doses of 10.3 (SD = 11.6) Gy and 8.5 (SD = 9.8) Gy, respectively. We found a statistically significant correlation between mean dose received by bilateral cochlea (P-0.000, rright-0.84, rleft-0.78, rmidline-0.92). Tumours of the paranasal sinuses, and the parotids and more advanced T stages were associated with a higher mean dose to cochlea but was not significant statistically. The dose received by the 95% target nodal volume (D95%) showed a significant correlation with the cochlear mean dose (P-0.000, rright-0.85, rleft-0.77, rmidline-0.93) CONCLUSION: With VMAT we have achieved a better sparing of cochlea. The mean dose to the cochlea of one side significantly differed from the other side in patients with lateralized cancers. D95% of nodal volume also showed a significant correlation with the cochlear mean dose.

Future Solutions for Voice Rehabilitation in Laryngectomees: A Review of Technologies Based on Electrophysiological Signals.

Loss of voice is a serious concern for a laryngectomee which should be addressed prior to planning the procedure. Voice rehabilitation options must be educated before the surgery. Even though many devices have been in use, each device has got its limitations. We are searching for probable future technologies for voice rehabilitation in laryngectomees and to familiarise with the ENT fraternity. We performed a bibliographic search using title/abstract searches and Medical Subject Headings (MeSHs) where appropriate, of the Medline, CINAHL, EMBASE, Web of Science and Google scholars for publications from January 1985 to January 2020. The obtained results with scope for the development of a device for speech rehabilitation were included in the review. A total of 1036 articles were identified and screened. After careful scrutining 40 articles have been included in this study. Silent speech interface is one of the topics which is extensively being studied. It is based on various electrophysiological biosignals like non-audible murmur, electromyography, ultrasound characteristics of vocal folds and optical imaging of lips and tongue, electro articulography and electroencephalography. Electromyographic signals have been studied in laryngectomised patients. Silent speech interface may be the answer for the future of voice rehabilitation in laryngectomees. However, all these technologies are in their primitive stages and are potential in conforming into a speech device.

Relative contributions of radiation and cisplatin-based chemotherapy to sensorineural hearing loss in head-and-neck cancer patients.

BACKGROUND: One of the debilitating complications of head and neck cancer radiotherapy is hearing loss. OBJECTIVE: To quantify the magnitude of sensory neural hearing loss (SNHL) in the head and neck cancer patients undergoing chemoradiation therapy. DESIGN AND METHODS: This is a prospective study. Eighty patients with head and neck cancers and undergoing volumetric arc therapy were taken up for the study. Regular audiological evaluation was done. The changes in audiological parameters from baseline are correlated with cochlear dose. RESULTS: Cochlea received maximum doses of up to 28.52 Gy without causing SNHL in the absence of chemotherapy. But in concurrent chemoradiotherapy, hearing loss was found at least dose of 9 Gy at frequency range of 4 KHz-8 KHz. The risk of SNHL is independent of cumulative doses of Cisplatin. In 106 ears receiving concurrent chemoradiation, 82.1% and 74.5% ears had sensorineural hearing loss at 4 KHz and 8 KHz respectively, following the completion of treatment. Otoacoustic emissions in the chemoradiation group showed a significant change at the completion of treatment. CONCLUSION AND SIGNIFICANCE: Volumetric arc therapy have facilitated sparing of cochlea (< 40 Gy). This has resulted in better clinical outcome in terms of SNHL. The inclusion of concurrent cisplatin chemotherapy is a significant risk factor for the development of SNHL at higher frequencies.

Medical Education During the COVID-19 Pandemic: A Single Institution Experience.

Social distancing to curb the COVID-19 pandemic has caused suspension of classroom teaching in all educational institutions. We implemented a novel online classroom platform at our institute to continue medical education. The program attracted encouraging feedback from the students. It may serve as a model for uninterrupted teaching and training during times of crisis.

A low-cost solution for converting existing stethoscope into tele-stethoscope in resource-constrained setting for COVID-19 pandemic.

In the present scenario of COVID-19, there has been a sudden surge in demand for tele- consultancy. Such measures require resources to support the system. Replacement of conventional equipment used in a clinic with digital equipment is not feasible due to their cost and scalability issues. The authors developed a simple low-cost (almost zero cost) method to convert a conventional stethoscope into a tele-stethoscope. Such a simple modification can be useful in periphery wherein doctors are still not available and the growing number of patients would require a diagnosis of the chest conditions.

Performance Differences in Hindi and English Speaking Bilinguals on Stroop Task.

Previous studies have found that bilinguals differ in their response times on the bilingual version of Stroop Task. Automaticity and control and Language proficiency have emerged as important factors that lead to differences in the response time. This study aimed to understand Stroop Effect in Hindi-English bilinguals on the computerized version of Hindi and English language Stroop task. The study was conducted on 42 Hindi-English bilinguals. All were more proficient in the Hindi language as compared to the English Language. Results of the study revealed greater Stroop Effect in the English language as compared to the Hindi language.

Cardiac Autonomic Neuropathy in Patients with Type 2 Diabetes Mellitus at High Risk for Foot Ulcers.

AIM: To study the prevalence of cardiac autonomic neuropathy (CAN) in patients with Type 2 diabetes mellitus at high risk for foot ulcers. MATERIALS AND METHODS: We screened patients attending diabetic clinic for identifying patients at high risk for foot ulcers. Those with foot risk category 1, 2 and 3 as per criteria of Foot Care Interest Group were subjected to battery of cardiovascular autonomic reflex tests. Those with one abnormal test were termed as probable CAN and those with two abnormal tests as definite CAN. Those with postural fall in blood pressure with one other abnormal test were termed to have advanced CAN. RESULTS: A total of 74 patients were recruited in the study. The prevalence of abnormal cardiovascular autonomic reflex test was sustained hand grip 81%, E/I ratio 66.2%, 30:15 ratio 28.3% and orthostatic hypotension 13.5%. The prevalence of possible CAN was 31.0% (23/74) and definite CAN was 66.2% (49/74). Ten patients had advanced CAN. There was no observable difference in presence of probable or definite CAN in three risk category for foot ulcers. CONCLUSION: We found a high prevalence of CAN in subgroup of diabetic patients at increased risk for foot ulcer.

Hindi and English Letter Cancellation Tasks : Does language have an effect on performance?

Letter Cancellation Tasks (LCTs) are paper-pencil based psychomotor tasks that are commonly used to assess cognitive functions of healthy volunteers and patients. The performance on LCTs can be affected by the proficiency in the language used for the tasks. This is of importance in a country like India where most of the population is not fluent in English. Since most of the cognitive tests are in English, the population that can be recruited for cognitive studies gets limited. It is therefore essential to develop tests in Indian languages like Hindi and compare the results obtained with tests in English. The present study evaluated the effect of Hindi and English language on performance of one, two and three letter cancellation tasks. The study was conducted on 50 healthy volunteers after taking written, informed consent. Subjects were asked to cancel out letters in One, Two and Three LCTs in Hindi and English language. The total time taken to complete each test and number of errors were statistically analyzed by unpaired t-test. The results revealed that a significantly longer time was taken to complete Hindi LCTs than English LCTs. The error rates in the Hindi LCTs were more than that in English with the difference in One Letter Cancellation Task being significant. This is probably because of the complex script for Hindi requiring more time and neural resources for processing.

Executive Functions are not Affected by 24 Hours of Sleep Deprivation: A Color-Word Stroop Task Study.

BACKGROUND: Sleep is an important factor affecting cognitive performance. Sleep deprivation results in fatigue, lack of concentration, confusion and sleepiness along with anxiety, depression and irritability. Sleep deprivation can have serious consequences in professions like armed forces and medicine where quick decisions and actions need to be taken. Color-Word Stroop task is one of the reliable tests to assess attention and it analyzes the processing of information in two dimensions i.e., reading of words and naming of colour. The evidence regarding the effect of sleep deprivation on Stroop interference is conflicting. The present study evaluated the effect of 24 hours of sleep deprivation on reaction time and interference in Stroop task. MATERIALS AND METHODS: The present study was done on 30 healthy male medical student volunteers in the age group of 18-25 years after taking their consent and clearance from Institute Ethics Committee. Recordings of Stroop task were at three times: baseline (between 7-9 am), after 12 hours (7-9 pm) and after 24 hours (7-9 am, next day). The subjects were allowed to perform normal daily activities. RESULTS: The study revealed a significant increase in reaction time after 24 hours of sleep deprivation in comparison to baseline and after 12 hours of sleep deprivation. There was no significant change in interference and facilitation after sleep deprivation in comparison to baseline. The number of errors also did not show any significant change after sleep deprivation. CONCLUSION: The study indicated that there was slowing of responses without change in executive functions after 24 hours of sleep deprivation. It is probable that 24 hours of sleep deprivation does not bring about change in areas of brain affecting executive functions in healthy individuals who have normal sleep cycle. The present study indicated that in professions like armed forces and medicine working 24 hours at a stretch can lead to decrease in motor responses without affecting information processing and judgment ability.

Attention and information processing in end stage renal disease and effect of hemodialysis: a bedside study.

The neurobehavioral syndrome of uremia in chronic kidney disease affects the functioning of the central nervous system. Cognitive impairment is one of the most important manifestations of this dysfunction. The process of hemodialysis is known to bring about conflicting changes in the cognitive status of patients. In the present study an assessment of cognitive status of patients with end stage renal disease was done in comparison to controls before and after a session of hemodialysis using simple bedside paper-pencil tests. Thirty patients of end stage renal disease on maintenance dialysis for at least one month with MMSE score >24 were assessed one hour before and one hour after hemodialysis using Digit Symbol Substitution Test, One Letter and Three Letter Cancellations tasks. Their results were compared to age and sex matched healthy controls. The patients with end stage renal disease had significantly lower performance in cognitive tests in comparison to controls. The performance improved 1 hour after hemodialysis in comparison to pre-dialysis values. However, the values after dialysis were significantly lower than in controls, thereby indicating that though the cognitive functions improved after hemodialysis, they did not reach the control levels. There was also a significant change in the biochemical parameters after dialysis. We conclude that patients with end stage renal disease suffered from cognitive impairment which improved on hemodialysis due to removal of metabolic waste products.