Change detection in visual short-term memory: the relative impact of pairwise switches and identity substitutions

Numerous kinds of visual events challenge our ability to keep track of objects that populate our visual environment from moment to moment. These include blinks, occlusion, shifting visual attention and changes to object’s visual and spatial properties over time. These visual events may lead to objects falling out of our visual awareness but can also lead to unnoticed changes, such as undetected object replacements and positional exchanges. Current visual memory models do not predict which visual changes are likely to be the most difficult to detect. We examined the accuracy with which switches (where two objects exchange locations) and substitutions (where one or two objects are replaced) are detected. Inferior performance for one-object substitutions vs. two-objects switches, along with superior performance for two-object substitutions vs. two-object switches was found. Our results are interpreted in terms of object file theory, trade-offs between diffused and localized attention, and net visual change

Vitamin D Deficiency as an Important Biomarker for the Increased Risk of Coronavirus (COVID-19) in People From Black and Asian Ethnic Minority Groups

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Patients with mild cognitive impairment show lower visual short-term memory performance for feature binding tasks

Background: Early cognitive changes in people at risk of developing dementia may be detected using behavioral tests that examine the performance of typically affected brain areas, such as the hippocampi. An important cognitive function supported by the hippocampi is memory binding, in which object features are associated to create a unified percept. Aim: To compare visual short-term memory (VSTM) binding performance for object names, locations, and identities between a participant group known to be at higher risk of developing dementia (mild cognitive impairment [MCI]) and healthily aging controls. Methods: Ten MCI and 10 control participants completed five VSTM tests that differed in their requirement of remembering bound or unbound object names, locations, and identities, along with a standard neuropsychological test (Addenbrooke’s Cognitive Examination [ACE]-III). Results: The performance of the MCI participants was selectively and significantly lower than that of the healthily aging controls for memory tasks that required object-location or name-location binding. Conclusion: Tasks that measure unimodal (object-location) and crossmodal (name-location) binding performance appear to be particularly effective for the detection of early cognitive changes in those at higher risk of developing dementia due to Alzheimer’s disease

Need to improve awareness and treatment compliance in high-risk patients for diabetic complications in Nepal

Objective/introduction It is known that knowledge, awareness, and practice influence diabetic control. We compared factors pertaining to healthy lifestyle (exercising, avoiding smoking), self-help (attending appointments, following treatment regimens), and diabetic awareness in high-risk patients for diabetic complications, specifically, those on insulin versus non-insulin treatment, and also those with a longer diabetic duration (≥5 years) versus a shorter duration. Methods 200 consecutive patients with type 2 diabetes (52.0±11.6 years) attending diabetic clinic at a referral hospital in Nepal were recruited. A structured questionnaire explored non-clinical parameters including age, gender, diabetic duration, awareness about diabetes control, self-help, and lifestyle. Clinical data were also measured: HbA1c, fasting blood sugar (FBS), blood pressure, and treatment type (insulin, diet/tablet). Results A significantly higher proportion of patients on insulin (vs non-insulin) or with diabetic duration ≥5 years (vs <5 years) self-reported not doing regular exercise, forgetting to take medicine, and not knowing whether their diabetes was controlled (p≤0.005). HbA1c/FBS levels were significantly higher for patients on insulin or with a longer diabetic duration (p≤0.001). 92% of those on insulin (vs 31% on non-insulin) and 91% with diabetic duration ≥5 years (vs 28% of <5 years) self-reported to seeking medical help due to episodes of uncontrolled blood sugar in the last year (p<0.001). Conclusion Poor self-help/lifestyle and reduced knowledge/awareness about diabetic control was found in patients on insulin or with longer diabetic duration. This is a worrying finding as these patients are already at high risk for developing diabetic complications. The findings highlight need for targeting this more vulnerable group and provide more support/diabetic educational tools

Impact of living with a bilateral central vision loss due to geographic atrophy—qualitative study

Objective- Geographic atrophy (GA), a type of dry age-related macular degeneration, affects vision as central vision loss (CVL). The challenges faced due to bilateral CVL in activities of daily living and strategies taken to overcome those challenges are not very well understood in the Indian population. This qualitative study aims to understand the impact on everyday life activities and related adaptive and coping strategies in people with long-standing bilateral CVL due to GA in India. Design, participants, setting and methods- A qualitative study using a semistructured face-to-face interview was conducted on 10 people with bilateral CVL after obtaining written informed consent. The interviews were audio-recorded, and were transcribed verbatim. Thematic analysis was carried out to understand the challenges faced and adaptive methods due to the impact of CVL. Results-Ten participants (50% male) with a median age (IQR) of 72 (70, 74) years were interviewed. All the participants had best-corrected visual acuity of ≤6/60 in the better eye and reported an absolute central scotoma with the home Amsler chart. Qualitative thematic analysis identified four main themes: challenges in everyday living (difficulty in face identification, reading), challenges with lifestyle and socialisation (driving, cooking, reading for a longer duration, watching TV, socially inactive), psychological implications (depression, poor self-esteem, fear due to poor vision) and strategies to overcome the challenges (voice identification, technology support). Conclusion- GA has a severe negative impact on the quality of life in people with CVL. Inability to recognise faces was the main reason for dependency on others and being socially disconnected. The findings will help clinicians in providing improved rehabilitative care

How does aging influence object-location and name-location binding during a visual short-term memory task?

Objective: Age-related impairments in human visual short-term memory (VSTM) may reflect a reduced ability to retain bound object representations, viz., object form, name, spatial, and temporal location (so called ‘memory sources’). Our objective is to examine how healthy aging affects VSTM in a battery of memory recognition tasks in which sequentially presented objects, locations, and names (as auditory stimuli) were learned, with one component cued at test. Methods: Thirty-six young healthy adults (18-30 years) and 36 normally aging older adults (>60 years with no underlying health and vision issues) completed five VSTM tasks: 1. Object recognition for two or four objects; 2. Spatial location recognition for two or four objects; 3. Bound object-location recognition for two or four objects; 4. Object recognition with location priming for two or four objects; 5. Bound name (auditory)-location (cross-modal) recognition for four objects. Results: Significantly lower performance for older adults was found in spatial location recognition [task 2, p=0.03, 2 (memory loads) × 2 (age groups) ANOVA], bound object-location recognition [task 3, p˂0.001, 2 (memory loads) × 2 (age groups) ANOVA], object recognition with location priming [task 4, p=0.02, 2 (memory loads) × 2 (age groups) ANOVA], and bound name-location recognition [task 5, p=0.001, independent samples t-test] tasks. A significant age group-task interaction was found (p =0.02) Conclusion: Performance for all tests except test 1 was impaired in older adults. Lower performance for older adults was most significant in VSTM tasks requiring object-location (visual only) or name-location (auditory and visual) binding. The findings are compatible with the ‘memory source’ model, demonstrating that age-related binding performance is influenced by spatial coding and location priming deficits

Self-isolation negatively impacts self-management of diabetes during the coronavirus (COVID-19) pandemic

Background/Aim: People with diabetes are at a greater risk of serious complications from Coronavirus disease (COVID-19). Self-management of diabetes is therefore of paramount importance. The purpose of this study is to compare self-management of diabetes pre-COVID-19 and during the COVID-19 pandemic. Methods: 679 participants with diabetes completed an online structured questionnaire survey. Various exposure variables (demographics, duration, treatment and complications of diabetes, self-isolation, etc.) were analysed to examine associations with the following outcome variables: (i) fluctuation of blood glucose levels, (ii) access to diabetes medicine, (iii) access to healthy diet, (iv) physical activity. Adjusted multiple regression analysis ascertained significant associations for each outcome variable against exposure variables. Results: Multiple regression analysis showed that self-isolation was significantly associated with greater fluctuation in blood glucose levels (OR = 1.8, 95% CI = 1.2–2.6, p = 0.005), reduced access to diabetes medicine (OR = 1.9, 95% CI = 1.1–3.1, p = 0.02) and reduced access to healthy diet (OR = 3.0, 95% CI = 2.0–4.6, p < 0.001). Fluctuation in blood glucose level was also significantly associated with having at least one complication of diabetes (OR = 2.2, 95% CI = 1.2–3.9, p = 0.008) and reduced access to diabetes medicine was significantly higher in people who were on insulin (OR = 2.1, 95% CI = 1.3–3.3, p = 0.001). Conclusions: Self-isolation was shown to impact almost all factors that influence self-management of diabetes. A targeted approach to improved access to diabetes medicine, healthy diet for people who needed to self-isolate is vital in order to ensure that they are able to self-manage their diabetes effectively

The impact of stimulus configuration on visual short‐term memory decline in normal aging and mild cognitive impairment

When we memorize simultaneous items, we not only store information about specific items and/or their locations but also how items are related to each other. Such relational information can be parsed into spatial (spatial configuration) and identity (object configuration) components. Both these configurations are found to support performance during a visual short-term memory (VSTM) task in young adults. How the VSTM performance of older adults is influenced by object/spatial configuration is less understood, which this study investigated

Individual patient-centered target-driven intervention to improve clinical outcomes of diabetes, health literacy, and self-care practices in Nepal: A randomized controlled trial

Purpose: To examine the effectiveness of a culturally and linguistically appropriate, patient-centered, target-driven lifestyle intervention with video education training in improving clinical outcomes, health literacy, and diabetic self-care practices in newly diagnosed patients in Nepal. Methods: A total of 110 participants with newly and consequently diagnosed Type 2 were randomly allocated into intervention (mean age = 45 ± 9.7 years) and control (mean age = 47 ± 12.5 years) groups. Intervention group participants were trained on a culturally and linguistically appropriate diabetic video education program and were given a customized dietary and physical activity plan with specific targets to practice at home. Participants’ compliance was monitored weekly via telephone calls. Both groups received the usual treatment from their doctor and were followed up after three months. Outcome measures included changes in: i. diabetic health literacy, diet, and physical activity measured using self-reported questionnaires; and ii. blood glucose (glycated hemoglobin, HbA1c), cholesterol, blood pressure, body mass index, and visual acuity. Clinical outcome measures were blinded from randomization and intervention allocation. Results: After three months, HbA1c decreased to 6.1% from the baseline value of 7.2% in the intervention group compared to 6.6% in the control group from the baseline value of 7.1% (p <0.05). The intervention group had mean total cholesterol and low-density lipoprotein of 174 and 95.5 mg/dL, which were significantly lower than 186 and 107.5 mg/dL in the control group. Daily white rice consumption decreased by 36.5% in the intervention vs. 4% in the control group (p <0.05). After three months, the intervention group participants exercised more than the control group (p <0.05). All intervention group participants self-initiated retinal screening checks since the baseline visit among which 13% showed early diabetic retinopathy signs compared to 0% in the control group. Health literacy improvement in the intervention group was found to be sustained after three months too. Conclusions: A culturally appropriate, target-driven lifestyle intervention with video education training is effective in improving clinical outcomes, health literacy, and self-care practice in newly diagnosed diabetic patients in Nepal, i.e., at a time period when effective diabetes control is vital to prevent further complications. The training intervention could be rolled out nationwide in order to reduce the risk of diabetic-related complications and improve people’s quality of life and productivity