Development and standardization of Indian Alcohol Photo Stimuli (IAPS) for cue-reactivity paradigms in patients with alcohol use disorder.

Background: The availability of appropriate alcohol-related stimuli is a crucial concern for the evaluation and treatment of patients with alcohol dependence syndrome. The study aimed to standardize alcohol-related images with cultural relevance to the Indian setting. Methods: We produced an extensive database of 203 pictures, the Indian Alcohol Photo Stimuli (IAPS), portraying different categories and types of alcoholic beverages, after removing the confounding effects of low-level stimulus parameters (e.g. brightness and blurriness). Thirty patients with alcohol dependence syndrome, currently abstinent, rated each image on visual analog scale (VAS) ranging from 0 (no craving) to 10 (extreme), to determine how typical the stimuli served as craving-relevant stimuli. Results: The mean VAS scores across beverages (ordered from highest to lowest) were whiskey >rum >beer >wine >vodka. Repeated-measures analysis of variance (ANOVA) showed a significant difference in mean VAS scores across beverages (F = 2.93, df = 2.9/86.3, P = 0.039, Greenhouse-Geisser corrected); the effect size for the difference was small (ηp2 = 0.092). A post hoc Bonferroni shows significantly higher VAS scores with whiskey compared with vodka (P = 0.029), whereas the scores were similar across other beverages. A two-way repeated-measures ANOVA for interaction between type of alcoholic beverages and activity was not significant (F = 2.67, df = 2.6/76.6, P = 0.061, Greenhouse-Geisser corrected). Conclusions: We created a standardized alcohol-related image database for studying cue-reactivity paradigms in individuals with alcohol use disorder (AUD). Further research is needed to validate the impact of image features on cue reactivity.

Cognitive function and heart rate variability in open and closed skill sports.

OBJECTIVES: The differences in sporting environments between open and closed skill sports impose unique demands on athletes' cognitive and motor capabilities. Our study aims to investigate and compare cognitive function and Heart Rate Variability (HRV) among individuals involved in different sports, namely basketball, swimming, and a sedentary non-sports group. MATERIALS AND METHODS: The study consisted of three groups, namely basketball players, swimmers, and sedentary individuals, with each group comprising twenty-six participants. HRV was assessed with the help of PowerLab. Cognition was assessed using the Ebbinghaus Memory Procedure Test (EMT), Go/No-Go Task (GNG), Color Stroop task, Trail Making Test (TMT), and Letter Cancellation test (LCT). RESULTS: The results of the Multivariate Analysis of Covariance (MANCOVA) analyses indicated that there was significance between the groups. However, no significant differences were observed between swimmers and basketball players in cognitive functions and HRV measures. Overall, the sport group outperformed the sedentary group. Specifically, basketball players and swimmers completed LCT and TMT faster than the sedentary group (p = 0.044 and p < 0.001 for basketball players, p = 0.002 and p = 0.001 for swimmers). Additionally, basketball players took fewer trials in EMT (p = 0.013) and less time (p = 0.026) compared to the sedentary group. CONCLUSION: The results of the study indicate that sports training, regardless of sport type, positively impacts overall cognitive function. However, no significant differences were observed in cognitive task performance and HRV measures between open and closed skill sport players. These findings suggest that sports can enhance cognitive functions, regardless of the sport played.

Enhancing our ability to diagnose cardiac valve disease by applying a graphical educational game.

Objectives: This study aimed to compare a newly designed graphical educational game (GEG) with a case-based learning (CBL) exercise and to enhance our ability to apply physiological knowledge of the cardiac cycle to diagnose cardiac valvular diseases among preclinical medical students. Methods: In this interventional study, first-year undergraduate medical students were randomly assigned to a GEG group (n = 42) and a CBL group (n = 37). The GEG group involved shading cardiac cycle graphs and pressure-volume loops while the CBL group worked on two cases of cardiac valve diseases. A multiple-choice question (MCQ) test was then used to assess conceptual understanding of the cardiac cycle. After brief exposure to murmur auscultation on a simulator manikin, the groups were assessed in a simulator manikin test for their ability to diagnose cardiac valve disease. Median MCQ scores and mean scores in the simulator test were then compared using the Mann-Whitney U test. The student's perspectives of the GEG and simulation session were acquired on a 5-point Likert scale questionnaire. Results: The GEG group had significantly higher median MCQ scores (p < 0.001) and mean simulator test scores (p < 0.001) when compared to the CBL group. Moreover, 91% of students agreed that the GEG helped them to clarify concepts, and 88% agreed that the concepts and knowledge gained through the GEG helped them to diagnose valve disease in the manikins. Conclusion: The GEG was positively received by students and was more useful than the CBL in enhancing the application of cardiac physiology concepts and improving diagnostic ability in a simulated clinical setting.

A combined stimuli presentation for assessing facial emotion related N170, N250 and visual mismatch negativity in neuropsychiatric disorders.

Event-related potential (ERP) is a useful approach to assess the neurophysiological correlates of facial emotion processing. Previous studies examined the facial emotion recognition (FER) related ERPs (N170, N250, visual MisMatch Negativity) individually using ERP specific paradigms. This approach can be time-consuming and may not resemble real-life scenarios where an individual must process multiple stimuli simultaneously. The aim of the study was to assess the utility of a combined paradigm when compared to individual paradigms to measure N170, N250 and visual MisMatch Negativity (vMMN) in healthy controls (HC), utilizing emotion stimuli standardized in the Indian population. Further, the combined paradigm was examined in patients with schizophrenia (SCZ) to detect the differences in ERPs compared to HC. Within paradigms, ERPs showed higher amplitudes for emotion compared to neutral stimuli suggesting that the paradigms were able to detect valence associated with emotional stimuli. The combined paradigm was able to elicit decipherable peaks of N170, N250 and vMMN similar to individual paradigms. ERP data quality as assessed by analytic Standardized Measurement Error (aSME) showed a satisfactory aggregate score of above 2 for all the three paradigms. Combined paradigm approaches to record ERPs in neuropsychiatric conditions has the advantage of reducing the time required for task administration, avoiding practice effects, better subject cooperation and participation.

One-month long foundation course for newly joined Indian medical undergraduates: Faculty and students' perspective.

BACKGROUND: A one-month long foundation course has been introduced at the entry-level for first-year MBBS (Bachelor of Medicine and Bachelor of Surgery) students in the medical institutions across India from 2019. Therefore, the present study is aimed at describing the experience of implementing a one-month long foundation course conducted for the Competency-based Undergraduate Medical Curriculum (CBUC) of Indian Medical Graduate as per the guidelines from the National Medical Commission (NMC) (erstwhile Medical Council of India, MCI). We have evaluated the student and faculty perceptions towards the effectiveness of the program. METHODS: The foundation course had six modules Orientation, Skills, Field visit to Community Health Centre, Professional Development including Ethics, Sports and Extracurricular activities, Computer Skills, and Language enhancement program. Regular feedback wascollected from students (N = 250) and teachers (N = 26) involved in the Foundation course using a semi-structured questionnaire. The program's overall feedback was also obtained at the end of the course, using a validated questionnaire. The quantitative findings were expressed in frequency and percentage. The qualitative observations (reflections of students and faculty) were subjected to thematic. RESULTS: The students and faculty appreciated the one-month long foundation course. The course's defined objectives were met as indicated by most students (98.4%) and faculty (75%). The course seemed to be useful for students to embark on a formal MBBS curriculum. It also exposed them to new knowledge and practices, as indicated by the feedback. Thematic analysis of the students' and faculty's reflections was carried out and two themes were identified, i.e., 'strengths' and 'challenges.' The Foundation Course Committee will work out appropriate remedial measures to overcome the challenges in the future sessions for subsequent batches. CONCLUSIONS: The one-month-long foundation course was found to be beneficial for newly joined students to get introduced and adjusted to higher education systems' demands. Also, the challenges faced during the program needs to be addressed with suitable remedial measures while implementing for subsequent batches. This effort will ensure a smooth conduct of the foundation course for the future batches of medical undergraduates and make the program more effective.