Doing two things at once is difficult. When two tasks have to be performed within a short interval, the second is sharply delayed, an effect called the Psychological Refractory Period (PRP). Similarly, when two successive visual targets are briefly flashed, people may fail to detect the second target (Attentional Blink or AB). Although AB and PRP are typically studied in very different paradigms, a recent detailed neuromimetic model suggests that both might arise from the same serial stage during which stimuli gain access to consciousness and, as a result, can be arbitrarily routed to any other appropriate processor. Here, in agreement with this model, we demonstrate that AB and PRP can be obtained on alternate trials of the same cross-modal paradigm and result from limitations in the same brain mechanisms. We asked participants to respond as fast as possible to an auditory target T1 and then to a visual target T2 embedded in a series of distractors, while brain activity was recorded with magneto-encephalography (MEG). For identical stimuli, we observed a mixture of blinked trials, where T2 was entirely missed, and PRP trials, where T2 processing was delayed. MEG recordings showed that PRP and blinked trials underwent identical sensory processing in visual occipito-temporal cortices, even including the non-conscious separation of targets from distractors. However, late activations in frontal cortex (>350 ms), strongly influenced by the speed of task-1 execution, were delayed in PRP trials and absent in blinked trials. Our findings suggest that PRP and AB arise from similar cortical stages, can occur with the same exact stimuli, and are merely distinguished by trial-by-trial fluctuations in task processing.

Human performance exhibits strong multi-tasking limitations in simple response time tasks. In the psychological refractory period (PRP) paradigm, where two tasks have to be performed in brief succession, central processing of the second task is delayed when the two tasks are performed at short time intervals. Here, we aimed to probe the cortical network underlying this postponement of central processing by simultaneously recording electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) data while 12 subjects performed two simple number-comparison tasks. Behavioral data showed a significant slowing of response times to the second target stimulus at short stimulus-onset asynchronies, together with significant correlations between response times to the first and second target stimulus, i.e., the hallmarks of the PRP effect. The analysis of EEG data showed a significant delay of the post-perceptual P3 component evoked by the second target, which was of similar magnitude as the effect on response times. fMRI data revealed an involvement of parietal and prefrontal regions in dual-task processing. The combined analysis of fMRI and EEG data-based on the trial-by-trial variability of the P3-revealed that BOLD signals in two bilateral regions in the inferior parietal lobe and precentral gyrus significantly covaried with P3 related activity. Our results show that combining neuroimaging methods of high spatial and temporal resolutions can help to identify cortical regions underlying the central bottleneck of information processing, and strengthen the conclusion that fronto-parietal cortical regions participate in a distributed "global neuronal workspace" system that underlies the generation of the P3 component and may be one of the key cerebral underpinnings of the PRP bottleneck.

Words judged for relevance in a survival situation are remembered better than words judged for relevance in a nonsurvival context. This survival processing effect has been explained by selective tuning of human memory during evolution to process and retain information specifically relevant for survival. According to the richness-of-encoding hypothesis the survival processing effect arises from a domain-general mechanism-namely, a particularly rich and distinct form of encoding. This form of information processing is effortful and requires limited cognitive capacities. In our experiment, we used the well-established psychological refractory period framework in conjunction with the effect propagation logic to assess the role of central cognitive resources for the survival processing effect. Our data demonstrate that the survival memory advantage indeed relies on the capacity-limited central stage of cognitive processing. Thus, rating words in the context of a survival scenario involves central processing resources to a greater amount than rating words in a nonsurvival control condition. We discuss implications for theories of the survival processing effect.

It is often assumed that word reading proceeds automatically. Here, we tested this assumption by recording event-related potentials during a psychological refractory period (PRP) paradigm, requiring lexical decisions about written words. Specifically, we selected words differing in their orthographic neighborhood size-the number of words that can be obtained from a target by exchanging a single letter-and investigated how influences of this variable depend on the availability of central attention. As expected, when attentional resources for lexical decisions were unconstrained, words with many orthographic neighbors elicited larger N400 amplitudes than those with few neighbors. However, under conditions of high temporal overlap with a high priority primary task, the N400 effect was not statistically different from zero. This finding indicates strong attentional influences on processes sensitive to orthographic neighbors during word reading, providing novel evidence against the full automaticity of processes involved in word reading. Furthermore, in conjunction with the observation of an underadditive interaction between stimulus onset asynchrony (SOA) and orthographic neighborhood size in lexical decision performance, commonly taken to indicate automaticity, our results raise issues concerning the standard logic of cognitive slack in the PRP paradigm.

Although recent studies focused on traditional Chinese medicine (TCM) for the treatment of refractory schizophrenia have reported that it may be beneficial, there is still lack of convincing evidence and critical meta-analytic work regarding its effectiveness as an adjunctive therapy. Therefore, we performed a meta-analysis to investigate the effectiveness of TCM in combination with antipsychotics for refractory schizophrenia. Fourteen articles involving 1725 patients published as of December 2016 were included which compared antipsychotic therapies to either TCM alone, or TCM as an adjunctive therapy. TCM was observed to have beneficial effects on aspects of the Positive and Negative Syndrome Scale (PANSS) including total score changes and negative score changes, as well as clinical effects estimated with PANSS or the Brief Psychiatric Rating Scale (BPRS). The changes in extrapyramidal side effects (RSESE) scores from baseline to the end of the treatment period were similar in two groups of related trials. TCM was also reported to mitigate some anti-psychotic related side-effects and overall, TCM adjuvant therapy was generally safe and well tolerated. While, the results indicated the potential utility of TCM as an alternative adjunctive therapeutic for refractory schizophrenia treatment, there remains a need for further high-quality studies.

The lifestyle and habit changes that have emerged as a result of quarantine measures may have had a negative impact on defecation habits. However, there is a lack of data on combined estimates of its occurrence and prevalence.

While multitasking has received a great deal of attention from researchers, we still know little about how well people adapt their behavior to multitasking demands. In three experiments, participants were presented with a multicolumn subtraction task, which required working memory in half of the trials. This primary task had to be combined with a secondary task requiring either working memory or visual attention, resulting in different types of interference. Before each trial, participants were asked to choose which secondary task they wanted to perform concurrently with the primary task. We predicted that if people seek to maximize performance or minimize effort required to perform the dual task, they choose task combinations that minimize interference. While performance data showed that the predicted optimal task combinations indeed resulted in minimal interference between tasks, the preferential choice data showed that a third of participants did not show any adaptation, and for the remainder it took a considerable number of trials before the optimal task combinations were chosen consistently. On the basis of these results we argue that, while in principle people are able to adapt their behavior according to multitasking demands, selection of the most efficient combination of strategies is not an automatic process.

Why is it hard to divide attention between dissimilar activities, such as reading and listening to a conversation? We used functional magnetic resonance imaging (fMRI) to study interference between simple auditory and visual decisions, independently of motor competition. Overlapping activity for auditory and visual tasks performed in isolation was found in lateral prefrontal regions, middle temporal cortex and parietal cortex. When the visual stimulus occurred during the processing of the tone, its activation in prefrontal and middle temporal cortex was suppressed. Additionally, reduced activity was seen in modality-specific visual cortex. These results paralleled impaired awareness of the visual event. Even without competing motor responses, a simple auditory decision interferes with visual processing on different neural levels, including prefrontal cortex, middle temporal cortex and visual regions.

Simultaneous interpreting (SI) is a highly complex activity and requires the performance and coordination of multiple, simultaneous tasks: analysis and understanding of the discourse in a first language, reformulating linguistic material, storing of intermediate processing steps, and language production in a second language among others. It is, however, an open issue whether persons with experience in SI possess superior skills in coordination of multiple tasks and whether they are able to transfer these skills to lab-based dual-task situations. Within the present study, we set out to explore whether interpreting experience is associated with related higher-order executive functioning in the context of dual-task situations of the Psychological Refractory Period (PRP) type. In this PRP situation, we found faster reactions times in participants with experience in simultaneous interpretation in contrast to control participants without such experience. Thus, simultaneous interpreters possess superior skills in coordination of multiple tasks in lab-based dual-task situations.

When two (or more) tasks, each requiring a rapid response, are performed at the same time then serial processing may occur at certain processing stages, such as the response selection. There is accumulating evidence that such serial processing involves additional control processes, such as inhibition, switching, and scheduling (termed the active scheduling account). The present study tested whether the existence of serial processing in multitasking leads to a requirement for processes that coordinate processing in this way (active scheduling account) and, furthermore, whether such control processes are linked to the executive functions (EF) of working memory (WM). To test this question, we merged the psychological refractory period (PRP) paradigm with a WM task, creating a complex WM span task. Participants were presented with a sequence of letters to remember, followed by a processing block in which they had to perform either a single task or a dual task, and finally were asked to recall the letters. Results showed that WM performance, i.e. the amount of letters recalled in the correct order, decreased when performing a dual task as compared to performing a single task during the retention interval. Two further experiments supported this finding using manipulations of the dual task difficulty. We conclude that the existence of serial processing in multitasking demands additional control processes (active scheduling) and that these processes are strongly linked to the executive functions of working memory.

The possibility that interference between motor responses contributes to dual-task costs has long been neglected, yet is supported by several recent studies. There are two competing hypotheses regarding this response-related interference. The motor-bottleneck hypothesis asserts that the motor stage of Task 1 triggers a refractory period that delays the motor stage of Task 2. The response-monitoring hypothesis asserts that monitoring of the Task-1 motor response delays the response-selection stage of Task 2. Both hypotheses predict lengthening of Task-2 response time (RT2) when Task 1 requires motor processing relative to when it does not. However, they assume different loci for the response-related bottleneck, and therefore make different predictions regarding (a) the interaction between Task-1 motor requirement and the Task-2 difficulty effect as measured by RT2 and (b) the premotoric durations and motoric durations of Task 2 as measured by lateralized readiness potentials (LRPs). To test these predictions, we conducted two experiments manipulating the Task-1 motor requirement (Go vs. NoGo) and Task-2 response-selection difficulty, as well as the stimulus-onset asynchrony (SOA). Task-1 motor processing significantly lengthened RT2, suggesting response-related interference. Importantly, the Task-1 motor response reduced the Task-2 difficulty effect at the short SOA, indicating postponement of the Task-2 motor stage, consistent with the motor-bottleneck hypothesis. Further consistent with the motor-bottleneck hypothesis, the Task-2 LRP indicated a consistent premotoric duration of Task 2 regardless of Task-1 motor requirement. These results are difficult to reconcile with the response-monitoring hypotheses, which places the response-related bottleneck before the response-selection stage of Task 2. The results also have important implications regarding use of locus-of-slack logic in PRP studies.

Categorical choices are preceded by the accumulation of sensory evidence in favor of one action or another. Current models describe evidence accumulation as a continuous process occurring at a constant rate, but this view is inconsistent with accounts of a psychological refractory period during sequential information processing. During multisample perceptual categorization, we found that the neural encoding of momentary evidence in human electrical brain signals and its subsequent impact on choice fluctuated rhythmically according to the phase of ongoing parietal delta oscillations (1-3 Hz). By contrast, lateralized beta-band power (10-30 Hz) overlying human motor cortex encoded the integrated evidence as a response preparation signal. These findings draw a clear distinction between central and motor stages of perceptual decision making, with successive samples of sensory evidence competing to pass through a serial processing bottleneck before being mapped onto action.

When it comes to simultaneous processing of two tasks, information processing capacity is usually below par and not desirable. Therefore, this preliminary study aimed to investigate the effect of transcranial direct-current stimulation (tDCS) of dorsolateral prefrontal cortex (DLPFC) on performing dual tasks. Twenty-six students (average age 25.2 ± 2.43 years) were selected and then randomly divided into experimental and sham groups. All of the participants conducted the Stroop effect test in a dual task situation before and after the tDCS. This test included two intervals between the stimuli of 100 and 900 ms. The results of mixed-ANOVA showed that the average second reaction time of the experimental stimulated group was reduced (in both dual tasks with congruent and incongruent stimuli) significantly after the tDCS. Therefore, it can be stated that the tDCS of the DLPFC increases the information processing speed and the capacity of attention and, as a result, decreases the effect of the psychological refractory period.

The monitoring of cognitive functions is central to the assessment and consecutive management of multiple sclerosis (MS). Though, especially cognitive processes that are central to everyday behavior like dual-tasking are often neglected. We examined dual-task performance using a psychological-refractory period (PRP) task in N = 21 patients and healthy controls and conducted standard neuropsychological tests. In dual-tasking, MS patients committed more erroneous responses when dual-tasking was difficult. In easier conditions, performance of MS patients did not differ to controls. Interestingly, the response times were generally not affected by the difficulty of the dual task, showing that the deficits observed do not reflect simple motor deficits or deficits in information processing speed but point out deficits in executive control functions and response selection in particular. Effect sizes were considerably large with d∼0.80 in mild affected patients and the achieved power was above 99%. There are cognitive control and dual tasking deficits in MS that are not attributable to simple motor speed deficits. Scaling of the difficulty of dual-tasking makes the test applied suitable for a wide variety of MS-patients and may complement neuropsychological assessments in clinical care and research setting.

When two concurrent sensorimotor tasks have to be performed at a short time interval, the second response is generally delayed at a central decision stage. However, in patients who have undergone full or partial transection of forebrain fibers connecting the two hemispheres (split-brain), independent structures subserving all processing stages should reside in each disconnected hemisphere, thus predicting parallel processing of dual tasks. Surprisingly, this prediction is usually not verified behaviorally. We reasoned that brain imaging with high-density recordings of event-related potentials (ERPs) could clarify the extent and limits of parallel processing in callosal patients. We studied a patient (AC) with posterior callosal section in a lateralized number-comparison task. Behaviorally, the split-brain patient showed robust dual-task interference, superficially similar to the psychological refractory period (PRP) effect in the control group of 14 healthy subjects, but significantly different in important aspects such as slowing of response times in the first task. Analysis of ERPs revealed that the parietal P3 component became split into distinct contralateral components in the patient, and was dramatically reduced for targets in his left visual field. In contrast to the control group, P3 latencies showed minimal to nonexistent postponement related to dual-task processing in the patient. In summary, our findings suggest that the left and right hemisphere networks normally involved in a single distributed "global neuronal workspace" that underlies the generation of the P3 component and serial processing, became strongly decoupled after a posterior callosal lesion.

The human brain efficiently solves certain operations such as object recognition and categorization through a massively parallel network of dedicated processors. However, human cognition also relies on the ability to perform an arbitrarily large set of tasks by flexibly recombining different processors into a novel chain. This flexibility comes at the cost of a severe slowing down and a seriality of operations (100-500 ms per step). A limit on parallel processing is demonstrated in experimental setups such as the psychological refractory period (PRP) and the attentional blink (AB) in which the processing of an element either significantly delays (PRP) or impedes conscious access (AB) of a second, rapidly presented element. Here we present a spiking-neuron implementation of a cognitive architecture where a large number of local parallel processors assemble together to produce goal-driven behavior. The precise mapping of incoming sensory stimuli onto motor representations relies on a "router" network capable of flexibly interconnecting processors and rapidly changing its configuration from one task to another. Simulations show that, when presented with dual-task stimuli, the network exhibits parallel processing at peripheral sensory levels, a memory buffer capable of keeping the result of sensory processing on hold, and a slow serial performance at the router stage, resulting in a performance bottleneck. The network captures the detailed dynamics of human behavior during dual-task-performance, including both mean RTs and RT distributions, and establishes concrete predictions on neuronal dynamics during dual-task experiments in humans and non-human primates.

Inflammatory bowel disease has an enormous impact on public health, medical systems, economies, and social conditions. Biologic therapy has ameliorated the treatment and clinical course of patients with inflammatory bowel disease. The efficacy and safety profiles of currently available therapies are still less that optimal in numerous ways, highlighting the requirement for new therapeutic targets. A bunch of new drug studies are underway in inflammatory bowel disease with promising results. This is an outlined guideline of clinical diagnosis and pharmaceutical therapy of inflammatory bowel disease. Outline delineates the overall recommendations on the modern principles of desirable practice to bolster the adoption of best implementations and exploration as well as inflammatory bowel disease patient, gastroenterologist, and other healthcare provider education. Inflammatory bowel disease encompasses Crohn's disease and ulcerative colitis, the two unsolved medical inflammatory bowel disease-subtypes condition with no drug for cure. The signs and symptoms on first presentation relate to the anatomical localization and severity of the disease and less with the resulting diagnosis that can clinically and histologically be non-definitive to interpret and establish criteria, specifically in colonic inflammatory bowel disease when the establishment is inconclusive is classified as indeterminate colitis. Conservative pharmaceuticals and accessible avenues do not depend on the disease phenotype. The first line management is to manage symptoms and stabilize active disease; at the same time maintenance therapy is indicated. Nutrition and diet do not play a primary therapeutic role but is warranted as supportive care. There is need of special guideline that explore solution of groundwork gap in terms of access limitations to inflammatory bowel disease care, particularly in developing countries and the irregular representation of socioeconomic stratification with a strategic plan, for the unanswered questions and perspective for the future, especially during the surfaced global COVID-19 pandemic caused by coronavirus SARS-CoV2 impacting on both the patient's psychological functioning and endoscopy services. Establishment of a global registry system and accumulated experiences have led to consensus for inflammatory bowel disease management under the COVID-19 pandemic. Painstakingly, the pandemic has influenced medical care systems for these patients. I briefly herein viewpoint summarize among other updates the telemedicine roles during the pandemic and how operationally inflammatory bowel disease centers managed patients and ensured quality of care. In conclusion: inflammatory bowel disease has become a global emergent disease. Serious medical errors are public health problem observed in developing nations i.e., to distinguish inflammatory bowel disease and infectious and parasitic diseases. Refractory inflammatory bowel disease is a still significant challenge in the management of patients with Crohn's disease and ulcerative colitis. There are gaps in knowledge and future research directions on the recent newly registered pharmaceuticals. The main clinical outcomes for inflammatory bowel disease were maintained during the COVID-19 pandemic period.