Does the threat of COVID-19 modulate automatic imitation?

The tendency to involuntarily imitate the actions of others (automatic imitation) can be modulated by social affiliative cues. Here, we explored whether the disruption to our social lives caused by the COVID-19 pandemic may subsequently influence automatic imitation. Three groups were initially presented a sentence comprehension task that featured either neutral (control), safe or unsafe primes to COVID-19 infection. They then completed an automatic imitation task, where a numeric cue was presented alongside apparent motion of an index or middle finger, which was either compatible or incompatible with the required response. Reaction times were longer for the incompatible compared to compatible trials, and thus demonstrated automatic imitation. However, there was no influence of the primes indicating that automatic imitation was unaffected by the risk of COVID-19. The potential theoretical explanations and practical implications of pathogen avoidance and social bonding incentives are discussed with reference to pandemic events.

Pre-exposure cognitive performance variability is associated with severity of respiratory infection.

Using data from a longitudinal viral challenge study, we find that the post-exposure viral shedding and symptom severity are associated with a novel measure of pre-exposure cognitive performance variability (CPV), defined before viral exposure occurs. Each individual's CPV score is computed from data collected from a repeated NeuroCognitive Performance Test (NCPT) over a 3 day pre-exposure period. Of the 18 NCPT measures reported by the tests, 6 contribute materially to the CPV score, prospectively differentiating the high from the low shedders. Among these 6 are the 4 clinical measures digSym-time, digSym-correct, trail-time, and reaction-time, commonly used for assessing cognitive executive functioning. CPV is found to be correlated with stress and also with several genes previously reported to be associated with cognitive development and dysfunction. A perturbation study over the number and timing of NCPT sessions indicates that as few as 5 sessions is sufficient to maintain high association between the CPV score and viral shedding, as long as the timing of these sessions is balanced over the three pre-exposure days. Our results suggest that variations in cognitive function are closely related to immunity and susceptibility to severe infection. Further studying these relationships may help us better understand the links between neurocognitive and neuroimmune systems which is timely in this COVID-19 pandemic era.

How Has COVID-19 Impacted Our Language Use?

The COVID-19 pandemic has led to severe consequences for people's mental health. The pandemic has also influenced our language use, shaping our word formation habits. The overuse of new metaphorical meanings has received particular attention from the media. Here, we wanted to investigate whether these metaphors have led to the formation of new semantic associations in memory. A sample of 120 university students was asked to decide whether a target word was or was not related to a prime stimulus. Responses for pandemic pairs in which the target referred to the newly acquired metaphorical meaning of the prime (i.e., "trench"-"hospital") were compared to pre-existing semantically related pairs (i.e., "trench"-"soldier") and neutral pairs (i.e., "trench"-"response"). Results revealed greater accuracy and faster response times for pandemic pairs than for semantic pairs and for semantic pairs compared to neutral ones. These findings suggest that the newly learned pandemic associations have created stronger semantic links in our memory compared to the pre-existing ones. Thus, this work confirms the adaptive nature of human language, and it underlines how the overuse of metaphors evoking dramatic images has been, in part, responsible for many psychological disorders still reported among people nowadays.

Global slowness and increased intra-individual variability are key features of attentional deficits and cognitive fluctuations in post COVID-19 patients.

Fatigue, attentional deficits and cognitive fluctuations are the most characterizing symptoms of neurological involvement in Post COVID-19 syndrome (PCS). As the intraindividual variability (IIV) in cognitive performances has been recognized as a hallmark of brain-related disorders associated with cognitive deficits, it could be an interesting measure to elucidate the mechanisms subtending both the attentive impairment and the cognitive fluctuations in these patients. By referring to IIV analysis of Reaction Times (RTs), the present study aims to define the attentive impairment and its relation to fluctuations and fatigue, in patients suffering from Post COVID-19 neurological symptoms. 74 patients were enrolled. They underwent an extensive clinical and neuropsychological assessments, as well as computerized Sustained Attention and Stroop tasks. For studying IIV, RTs distributions of performances in computerized tasks were fitted with ex-Gaussian distribution, for obtaining the τ values. Finally, the Resting Motor Threshold (RMT) was also collected to estimate cortical excitability. 29 healthy volunteers served as controls. Patients showed poorer scores in Montreal Cognitive Assessment and higher RMT, in comparison with controls. In Sustained Attention Task, Mean, µ, σ and τ values were significantly higher in PCS patients (p value = < 0.0001; 0.001; 0.018 and < 0.0001, respectively). Repeated measures ANOVA comparing the RTs mean in Stroop task within-subject and between-subjects revealed significant condition and group effect (p < 0.0001 both) and significant interaction (p = 0.005), indicating worst performances in patients. The mean of the derived interference value was significantly higher in PCS patients than in controls (p = 0.036). Patients suffering from PCS show deficits in attention, both in the sustained and executive components. Both high RTs means and high IIV subtend these deficits and could explain the often-complained cognitive fluctuations in this population.

Web-Based Independent Versus Laboratory-Based Stop-Signal Task Performance: Within-Subjects Counterbalanced Comparison Study.

BACKGROUND: Considered a facet of behavioral impulsivity, response inhibition facilitates adaptive and goal-directed behavior. It is often assessed using the Stop-Signal Task (SST), which is presented on stand-alone computers under controlled laboratory conditions. Sample size may consequently be a function of cost or time and sample diversity constrained to those willing or able to attend the laboratory. Statistical power and generalizability of results might, in turn, be impacted. Such limitations may potentially be overcome via the implementation of web-based testing. OBJECTIVE: The aim of this study was to investigate if there were differences between variables derived from a web-based SST when it was undertaken independently-that is, outside the laboratory, on any computer, and in the absence of researchers-versus when it was performed under laboratory conditions. METHODS: We programmed a web-based SST in HTML and JavaScript and employed a counterbalanced design. A total of 166 individuals (mean age 19.72, SD 1.85, range 18-36 years; 146/166, 88% female) were recruited. Of them, 79 undertook the independent task prior to visiting the laboratory and 78 completed the independent task following their laboratory visit. The average time between SST testing was 3.72 (SD 2.86) days. Dependent samples and Bayesian paired samples t tests were used to examine differences between laboratory-based and independent SST variables. Correlational analyses were conducted on stop-signal reaction times (SSRT). RESULTS: After exclusions, 123 participants (mean age 19.73, SD 1.97 years) completed the SST both in the laboratory and independently. While participants were less accurate on go trials and exhibited reduced inhibitory control when undertaking the independent-compared to the laboratory-based-SST, there was a positive association between the SSRT of each condition (r=.48; P<.001; 95% CI 0.33-0.61). CONCLUSIONS: Findings suggest a web-based SST, which participants undertake on any computer, at any location, and in the absence of the researcher, is a suitable measure of response inhibition.

Increased ambulance on-scene times but unaffected response times during the first wave of the COVID-19 pandemic in Southern Denmark.

BACKGROUND: During the first wave of the COVID-19 pandemic, a lockdown was imposed on the Danish society. Reports from other countries that were hit by the COVID-19 pandemic before Denmark instilled fear of flooding of the emergency departments. To mitigate this flooding, increased competencies were conveyed to the paramedics in the ambulances aiming to allow for a release of a higher number of patients prehospitally. The increased competencies in the prehospital personnel were expected to increase the on-scene time and thus the total workload of the ambulances potentially resulting in delays in the acute care. We sought to elucidate the effects of the pandemic on the workload of the prehospital system during the first wave. METHODS: This was a retrospective study using operational data from the regional emergency medical dispatch centre in the Region of Southern Denmark. We collected the number of ambulance runs, the response times, the on-scene times, and the mission outcome of all ambulance runs with lights and sirens in the Region of Southern Denmark during the first wave of the pandemic. We compared the numbers with a similar period in the year before. RESULTS: Compared with the year before the pandemic we observed a 10.3% reduction in call volume and a corresponding reduction in the total number of missions with lights and sirens. We found an increase in on-scene times in both missions with patients conveyed to hospital (20.6 min vs. 18.7 min) and missions with non-conveyed patients (37.4 min versus 30.7 min). The response times were unaffected. CONCLUSION: The increased on-scene times of the ambulances may largely be attributed to time utilised to exert the increased competencies concerning treat-and-release of patients.. Despite an increased on-scene time of the ambulances, we believe that the combination of a reduction in the number of total missions and the existing capacity in the ambulance service in the Region of Southern Denmark nullified the prolongation of ambulance response times that was seen in other countries during the pandemic. This capacity allowed for time spent performing in-depth examinations of patients with the potential to be released at the scene.

Effects of the COVID-19 pandemic on stroke response times: a systematic review and meta-analysis.

OBJECTIVES: COVID-19 presents a risk for delays to stroke treatment. We examined how COVID-19 affected stroke response times. METHODS: A literature search was conducted to identify articles covering stroke during COVID-19 that included time metrics data pre- and post-pandemic. For each outcome, pooled relative change from baseline and 95% CI were calculated using random-effects models. Heterogeneity was explored through subgroup analyses comparing comprehensive stroke centers (CSCs) to non-CSCs. RESULTS: 38 included studies reported on 6109 patients during COVID-19 and 14 637 patients during the pre-COVID period. Pooled increases of 20.9% (95% CI 5.8% to 36.1%) in last-known-well (LKW) to arrival times, 1.2% (-2.9% to 5.3%) in door-to-imaging (DTI), 0.8% (-2.9% to 4.5%) in door-to-needle (DTN), 2.8% (-5.0% to 10.6%) in door-to-groin (DTG), and 19.7% (11.1% to 28.2%) in door-to-reperfusion (DTR) times were observed during COVID-19. At CSCs, LKW increased by 24.0% (-0.3% to 48.2%), DTI increased by 1.6% (-3.0% to 6.1%), DTN increased by 3.6% (1.2% to 6.0%), DTG increased by 4.6% (-5.9% to 15.1%), and DTR increased by 21.2% (12.3% to 30.1%). At non-CSCs, LKW increased by 12.4% (-1.0% to 25.7%), DTI increased by 0.2% (-2.0% to 2.4%), DTN decreased by -4.6% (-11.9% to 2.7%), DTG decreased by -0.6% (-8.3% to 7.1%), and DTR increased by 0.5% (-31.0% to 32.0%). The increases during COVID-19 in LKW (p=0.01) and DTR (p=0.00) were statistically significant, as was the difference in DTN delays between CSCs and non-CSCs (p=0.04). CONCLUSIONS: Factors during COVID-19 resulted in significantly delayed LKW and DTR, and mild delays in DTI, DTN, and DTG. CSCs experience more pronounced delays than non-CSCs.

Attention profile of physically recovered COVID-19 inpatients on the day of discharge.

Few studies have reported specific attention deficits in post-COVID-19 patients. Attention consists of different subdomains. Disruptions to specific attention subdomains might impair a wide range of everyday tasks, including road safety. As there are millions of COVID-19 patients with different socio-economic backgrounds, screening of attentional performance less dependent on education is needed. Here, we verified if physically recovered COVID-19 inpatients showed specific attention decrements at discharge. The Continuous Visual Attention Test (CVAT) is a Go/No-go task which is independent of participants' schooling. It detects visuomotor reaction time (RT = intrinsic alertness), variability of reaction time (VRT = sustained attention), omission (focused-attention), and commission errors (response-inhibition). Thirty physically functional COVID-19 inpatients at discharge and 30 non-infected controls underwent the CVAT. A MANCOVA was performed to examine differences between controls and patients, followed by post-hoc ANCOVAs. Then, we identified the percentile score for each patient within the distribution of the CVAT performance of 211 subjects mentally capable of driving (reference group). COVID-19 patients at discharge showed greater RT and VRT, and more omission errors than controls. Twenty-two patients (73%) had performance below the 5th percentile of the reference group in one or more subdomains. As slow visuomotor RT, deficits in focusing and difficulties in keeping visual attention are associated with traffic accidents, we concluded that most COVID-19 patients at discharge had deficits that may increase the risk of road injuries. As these deficits will probably affect other daily activities, a routine assessment with the CVAT could provide useful information on whom to send to post-COVID centers.

Unconscious associations between stressor type and ability to cope: An experimental approach using ancient and modern sources of stress.

OBJECTIVES: Work has emerged that suggests it is salient and feasible to include a chronological approach to the taxonomy of stress. The ability to make an explicit distinction between ancient stressors (AS) and modern stressors (MS) has been reported in young and older adults; AS have been associated with greater ability to cope and MS with poorer health outcomes. Whether these explicit distinctions exist at an implicit, unconscious level, has yet to be determined. DESIGN: A quantitative design employed a computer-based Implicit Association Test (IAT) to examine implicit associations between AS/MS and coping appraisal. METHODS: One hundred adults (75 females) aged 18-58 years (M = 28.27 years, SD = 10.02) completed the AS/MS IAT, to compare reaction time (RT) and accuracy between consistent pairs (AS/ability to cope; MS/inability to cope) and inconsistent pair responses (AS/inability to cope; MS/ability to cope); followed by an explicit self-report questionnaire. RESULTS: Repeated measures ANCOVAs, controlling for sex and age, revealed significant main effects of faster RT and higher accuracy in responses for consistent than inconsistent pairs. Adult participants made implicit associations indicating an unconscious AS and MS distinction. Using the D algorithm, a univariate ANCOVA and independent t-tests found that males, compared to females, showed a stronger implicit preference for consistent than inconsistent pairs. CONCLUSIONS: Findings suggest an implicit association between ancient and modern stressors and perceived coping ability. Utilizing a chronological taxonomy for understanding evolutionary origins that drive individual's responses to stress has implications for developing effective coping strategies to improve health outcomes.

Reaction Times among Batik Workers: The Influence of Gender and Occupational Lead Exposure.

(1) Background: Neglected occupational health and safety aspects in batik industries cause their workers to have an increased risk of lead exposure. The effect of occupational lead exposure on neurocognitive performance is inconclusive. Therefore, we conducted an observational study to examine the difference in simple reaction time between lead-exposed batik workers and non-exposed referents. (2) Methods: This cross-sectional study was conducted in seven batik enterprises in Lendah District, Indonesia, excluding workers with medical conditions impairing reaction time. Simple reaction time tests were conducted using an online tool. Two-way model ANCOVAs examined interactions between gender and job types on the mean differences in reaction time. (3) Results: After controlling for age and body mass index, we observed longer reaction times among lead-exposed batik workers than non-exposed referents with an adjusted mean difference of 0.19 (95% CI: 0.016-0.368) seconds. A more prominent detrimental effect of lead exposure on reaction time among female workers than among male workers was observed. (4) Conclusions: Our results suggest that occupational lead exposure could contribute to longer reaction time, notably among female workers. Thus, occupational health and safety precautions are vital to protect batik workers and preserve their important contributions to cultural heritage.

Portable and Label-Free Quantitative Loop-Mediated Isothermal Amplification (LF-qLamp) for Reliable COVID-19 Diagnostics in Three Minutes of Reaction Time: Arduino-Based Detection System Assisted by a pH Microelectrode.

Loop-mediated isothermal amplification (LAMP) has been recently studied as an alternative method for cost-effective diagnostics in the context of the current COVID-19 pandemic. Recent reports document that LAMP-based diagnostic methods have a comparable sensitivity and specificity to that of RT-qPCR. We report the use of a portable Arduino-based LAMP-based amplification system assisted by pH microelectrodes for the accurate and reliable diagnosis of SARS-CoV-2 during the first 3 min of the amplification reaction. We show that this simple system enables a straightforward discrimination between samples containing or not containing artificial SARS-CoV-2 genetic material in the range of 10 to 10,000 copies per 50 µL of reaction mix. We also spiked saliva samples with SARS-CoV-2 synthetic material and corroborated that the LAMP reaction can be successfully monitored in real time using microelectrodes in saliva samples as well. These results may have profound implications for the design of real-time and portable quantitative systems for the reliable detection of viral pathogens including SARS-CoV-2.

Can situations awaken emotions? The compilation and evaluation of the Emotional Situation Sentence System (ESSS).

We aimed to establish and evaluate a standardized emotional situation sentence system (ESSS) relevant to the lives of college students to supplement prior literature and adapt to the needs of emotional research. Two studies were designed for this research; study 1 examined the effect of words in the ESSS and study 2 involved the use of pictures. For Study 1, 778 items were selected by 607 college students and 15 experts. We then tested the scale with 80 undergraduate participants. The ESSS sentences were rated on their degree of valence, arousal, and dominance using a 9-point scale. Cronbach's α (greater than 0.986) of the overall score as well as each sub-score in the three components confirmed the scale's reliability. As seen on a scatter plot, the results suggest that negative emotions (fear, disgust, anger, sadness, anxiety) are convergent and different from the distribution of positive (happiness) and neutral emotions. Study 2 included 30 participants to compare the difference in valence and arousal between the ESSS and emotional pictures. The results indicate that the ESSS is a standardized, situational, and ecological emotional contextual text system, well-suited to invoke emotion in college students. The ESSS has significantly better arousal and potency than pictures; moreover, it can be applied to experimental studies of anxiety-related emotions. However, emotion pictures have shorter response times, and wider application ranges, and they can include more cross-cultural characteristics compared to words.

Assessment of Attentional Functioning in Health Professionals of a Brazilian Tertiary Referral Hospital for COVID-19.

This study is aimed at assessing differences in basic attentional functioning between substantial and minimal work-related exposure to COVID-19 patients in professionals working in a tertiary referral hospital in Rio de Janeiro, Brazil. Therefore, hospital employees performed a Continuous Visual Attention Test. This test consisted of a 90-second Go/No-Go task with 72 (80%) targets and 18 (20%) nontargets. For each participant, reaction time and intraindividual variability of reaction times of all correct target responses, as well as the number of omission and commission errors, were evaluated. Participants were divided into 2 groups based on their exposure to COVID-19 patients (substantial versus minimal exposure). The substantial exposure group consisted of participants with 24 hours/week or more direct contact with COVID-19 patients. This cut-off was based on the clear division between professionals working and not working with COVID-19 patients and considered that 12-hour and 24-hour daily shifts are common for hospital employees in Brazil. A MANCOVA was performed to examine between-group differences, using age, sleep quality, sex, education level, previous COVID-19 infection, and profession as covariates. Of 124 participants, 80 had substantial exposure and 44 had minimal exposure to COVID-19. The overall MANCOVA reached statistical significance (P = 0.048). Post hoc ANCOVA analysis showed that the substantial exposure group had a statistically significantly higher intraindividual variability of reaction time of all correct target responses (P = 0.017, Cohen's δ = -0.55). This result remained after removing those with a previous COVID-19 infection (P = 0.010, Cohen's δ = -0.64) and after matching groups for sample size (P = 0.004, Cohen's δ = -0.81). No other variables reached statistical significance. Concluding, hospital professionals with a substantial level of exposure to patients with COVID-19 show a significant attention decrement and, thus, may be at a higher risk of accidental SARS-CoV-2 infection.

Do data from mechanical Turk subjects replicate accuracy, response time, and diffusion modeling results?

Online data collection is being used more and more, especially in the face of the COVID crisis. To examine the quality of such data, we chose to replicate lexical decision and item recognition paradigms from Ratcliff et al. (Cognitive Psychology, 60, 127-157, 2010) and numerosity discrimination paradigms from Ratcliff and McKoon (Psychological Review, 125, 183-217, 2018) with subjects recruited from Amazon Mechanical Turk (AMT). Along with these tasks, we collected data from either an IQ test or a math computation test. Subjects in the lexical decision and item recognition tasks were relatively well-behaved, with only a few giving a significant number of responses with response times (RTs) under 300 ms at chance accuracy, i.e., fast guesses, and a few with unstable RTs across a session. But in the numerosity discrimination tasks, almost half of the subjects gave a significant number of fast guesses and/or unstable RTs across the session. Diffusion model parameters were largely consistent with the earlier studies as were correlations across tasks and correlations with IQ and age. One surprising result was that eliminating fast outliers from subjects with highly variable RTs (those eliminated from the main analyses) produced diffusion model analyses that showed patterns of correlations similar to the subjects with stable performance. Methods for displaying data to examine stability, eliminating subjects, and implementing RT data collection on AMT including checks on timing are also discussed.

Cognitive and psychophysiological impact of surgical mask use during university lessons.

The aim of the present study was to analyze the impact of surgical mask use in cognitive and psychophysiological response of university students during a lesson. We analyzed 50 volunteers university students (age 20.2 ± 2.9) in two 150 min lessons. i. personal class using a surgical mask and ii. online class with student at home without the mask. Blood oxygen saturation, heart rate and heart rate variability, mental fatigue and reaction time were measured before and immediately after both lectures. We found how both lesson produced an increase in mental fatigue, reaction time and autonomous sympathetic modulation, being heart rate significantly higher (77.7 ± 18.2 vs. 89.3 ± 11.2 bpm, not mask, mask respectively) and blood oxygen saturation significantly lower (98.4 ± 0.5 vs. 96.0 ± 1.8%, mask, not mask respectively) using the surgical mask. The use of surgical mask during a 150 min university lesson produced an increased heart rate and a decrease in blood oxygen saturation, not significantly affecting the mental fatigue perception, reaction time and time, frequency and nonlinear hear rate variability domains of students.

The effect of small versus large clog size on emergency response time: A randomized controlled trial.

OBJECTIVES: To assess the effect on healthcare professional emergency response time and safety of small compared to large clog size. DESIGN: Randomized controlled trial. SETTING: The intensive care unit of a single university medical centre in The Netherlands. PARTICIPANTS: Intensive care medicine professionals. INTERVENTIONS: Participants were randomized to wear European size 38 clogs (US male size 6½, US female size 7½) or European size 47 clogs (US male size 13½, US female size 14½) clogs and were required to run a 125 m course from the coffee break room to the elevator providing access to the emergency department. MAIN OUTCOME MEASURES: The primary outcome was the time to complete the running course. Height, shoe size, self-described fitness, age and staff category were investigated as possible effect modifiers. Secondary endpoints were reported clog comfort and suspected unexpected clog-related adverse events (SUCRAEs). RESULTS: 50 participants were randomized (25 to European size 38 clogs and 25 to size 47 clogs). Mean age was 37 years (SD 12) and 29 participants (58%) were female. The primary outcome was 4.4 s (95% CI -7.1; -1.6) faster in the size 5 clogs group compared to the size 12 clogs group. This effect was not modified by any of the predefined participant characteristics. No differences were found in reported clog comfort or SUCRAEs. CONCLUSIONS: European size 38 clogs lead to faster emergency response times than size 47 clogs. TRIAL REGISTRATION: NCT04406220.

Psychosocial factors and hospitalisations for COVID-19: Prospective cohort study based on a community sample.

BACKGROUND: While certain infectious diseases have been linked to socioeconomic disadvantage, mental health problems, and lower cognitive function, relationships with COVID-19 are either uncertain or untested. Our objective was to examine the association of a range of psychosocial factors with hospitalisation for COVID-19. METHODS: UK Biobank, a prospective cohort study, comprises around half a million people who were aged 40-69 years at study induction between 2006 and 2010 when information on psychosocial factors and covariates were captured. Hospitalisations for COVID-19 were ascertained between 16th March and 26th April 2020. RESULTS: There were 908 hospitalisations for COVID-19 in an analytical sample of 431,051 England-based study members. In age- and sex-adjusted analyses, an elevated risk of COVID-19 was related to disadvantaged levels of education (odds ratio; 95% confidence interval: 2.05; 1.70, 2.47), income (2.00; 1.63, 2,47), area deprivation (2.20; 1.86, 2.59), occupation (1.39; 1.14, 1.69), psychological distress (1.58; 1.32, 1.89), mental health (1.50; 1.25, 1.79), neuroticism (1.19; 1.00, 1.42), and performance on two tests of cognitive function - verbal and numerical reasoning (2.66; 2.06, 3.34) and reaction speed (1.27; 1.08, 1.51). These associations were graded (p-value for trend ≤ 0.038) such that effects were apparent across the full psychosocial continua. After mutual adjustment for these characteristics plus ethnicity, comorbidity, and lifestyle factors, only the relationship between lower cognitive function as measured using the reasoning test and risk of the infection remained (1.98; 1.38, 2.85). CONCLUSIONS: A range of psychosocial factors revealed associations with hospitalisation for COVID-19 of which the relation with cognitive function, a marker of health literacy, was most robust.