The impact of stress on body function: A review

Lockdown Social Isolation and Lockdown Stress During the COVID-19 Pandemic in China: The Impact of Mindfulness

This study is aimed to examine the impact of mindfulness in the relationship between social isolation, job and financial insecurity, and stress during the lockdown period of the COVID-19 pandemic. Drawing on Conservation of Resources theory, Psychological Contract theory, Mindfulness theory, and Awareness notion, we propose that lockdown job insecurity partially mediates the link from lockdown social isolation to lockdown financial insecurity, and that the relationship between lockdown social isolation and lockdown stress is mediated as follows: first, simple partial mediation through both lockdown job and financial insecurity and second, sequential mediation through lockdown job and financial insecurity, respectively. Moreover, we assume that mindfulness moderates the relationship between lockdown financial insecurity and lockdown stress. The results from our SEM analyses, using a sample of 1,356 respondents in China, support all the research hypotheses. Based on this empirical work, this study concludes that mindfulness, which is considered by many people to play a role in reducing stress during the COVID-19 lockdown period, is de facto endangering their mental health (that is, they experience more stress) instead. Theoretical and practical implications, as well as limitations and proposals for future research are discussed.

Stress in Medical Students: PRIMES, an Italian, Multicenter Cross-Sectional Study

Medical students (MSs) are healthcare workers and must also cope with education-related stressors. This study aims to assess factors associated with perceived stress in Italian MSs. A cross-sectional study was conducted in 12 Italian medical schools (MSCs) in November 2018. A questionnaire assessed socio-demographic characteristics, habits, opinions about MSC, and concerns about the future. Stress was assessed with the PSS-10. Descriptive and univariable tests were performed. A linear model was fitted to find associations of the PSS-10 score with characteristics. There were 2513 collected questionnaires. Median PSS-10 score was 18 (IQR 11). Median age was 22 (IQR 4) and 61% of the sample was female. Female gender, being part of a sexual minority, poor financial situation, competitive atmosphere, having hobbies, resting, and sleeping hindered by MSC were characteristics associated with higher PSS-10 scores. Current relationship, good family relationship, and no concerns about the future were protective factors. Being part of sexual minorities had greater effects in students not living away from home, while in the other group it was not having satisfying friendships. Medical students suffer higher levels of stress than the general population, and many MSC stressors are associated. Living away from home modifies risk and protective factors, offering the possibility to tailor group-specific interventions.

Stress Evaluation by Hemoglobin Concentration Change Using Mobile NIRS

Previous studies have reported a relationship between stress and brain activity, and stress has been quantitatively evaluated using near-infrared spectroscopy (NIRS). In the present study, we examined whether a relationship exists between salivary amylase levels and brain activity during the trail-making test (TMT) using mobile NIRS. This study aimed to assess stress levels by using mobile NIRS. Salivary amylase was measured with a salivary amylase monitor, and hemoglobin concentration was measured using Neu’s HOT-2000. Measurements were taken four times for each subject, and the values at each measurement were evaluated. Changes in the values at the first–second, second–third, and third–fourth measurements were also analyzed. Results showed that the value of the fluctuations has a higher correlation than the comparison of point values. These results suggest that the accuracy of stress assessment by NIRS can be improved by using variability and time-series data compared with stress assessment using NIRS at a single time point.

Islamic praying changes stress-related hormones and genes

Islamic praying (Namaz) can be considered a mental, spiritual, and physical practice. The study aimed to investigate the early effect of Namaz on stress-related hormones and the expression of stress-induced genes such as IL6 and BDNF. Eighty-three healthy women and men who continually practice Namaz participated in the study. The saliva samples were taken before and after Namaz to measure cortisol and alpha-amylase hormone levels. Also, to evaluate the expression of BDNF and IL6 genes, 11 specimens were selected randomly. Based on baseline sampling, the participants were classified into three groups: cortisol levels lower than 5, between 5-15, and upper than 15 ng/ml. The results indicated that cortisol significantly increased and decreased in the first and third groups after Namaz, respectively. In addition, the increase of alpha-amylase also occurred in subjects with a low baseline level of its concentration. Regarding genetic expression examination, there was a significant decrease in BDNF gene expression after the Namaz. In addition, the change of cortisol and alpha-amylase hormones after Namaz related to the baseline level changed to approach the optimal range after Namaz. These findings were reported for the first time and need more studies.

Hepatitis B Virus-Associated Hepatocellular Carcinoma and Chronic Stress

The Hepatitis B virus is one of the most significant hepatocarcinogens globally. The carcinogenic mechanisms of this virus are complex, and may include interactions with the host’s immune system. Certain factors, such as stress on the body, can also potentiate these mechanisms. Stress, although adaptive in an acute form, is deleterious to health when chronic and can both suppress and activate the host’s defense system. In hepatocellular carcinoma, this can lead to tumor initiation and progression. Those that are more prone to stress, or exposed to situations that incite stress, may be at higher risk of developing cancer. Racial disparities, for example, are a source of chronic psychosocial stress in America and predispose minorities to poorer outcomes. As it remains perplexing why some individuals with chronic hepatitis B develop feared complications while others do not, it is important to recognize as many risk factors as possible, including those often overlooked such as chronic stress.

Validation of the coping self-efficacy scale: Vietnamese version for adolescents

Background

This study aimed to examine the construct validity of the Coping Self-Efficacy Scale-Vietnamese Version (CSES-V) among Vietnamese adolescents.

Methods

This study selected Grade 10 students from eight schools in Hanoi using a multiple-stage sampling method. Multiple aspects of the construct validity were examined including: factorial structure (evaluated using exploratory factor analysis); internal consistency (tested using Cronbach’s alpha coefficient); measurement invariance between male and female participants and longitudinal measurement invariance (tested by employing multiple group confirmatory factor analysis) and external aspect (tested using Pearson’s correlation coefficients between CSES-V and the Depression Anxiety and Stress Subscales of Depression (DASS21-D), Anxiety (DASS21-A), and Stress (DASS21-S) and a measure of mental well-being, Mental Health Continuum Short Form (MHC-SF)).

Results

A total of 1082 adolescents (aged 14–16 years) was included in this study. Data supported a three-factor structure (comprising 24 items) that explained 97.6% of the total variance of the CSES-V. Cronbach’s alpha coefficients of all three factors were acceptable. All levels of measurement invariance between male and female participants and longitudinal measurement invariance were well-supported. The three factors of the CSES-V were positively correlated with MHC-SF and were negatively correlated with the DASS21 subscales at a low or moderate level, supporting the external aspect of the construct validity.

Conclusions

CSES-V is recommended to assess coping self-efficacy among Vietnamese adolescents who are attending school.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40359-022-00770-3.

Molecular Biomarkers of Adult Human and Dog Stress during Canine-Assisted Interventions: A Systematic Scoping Review

Simple Summary

Interactions between people and dogs may lower participants’ stress levels. However, this is a fairly new area of research and there has not been a review of what we know across studies. We examined the existing research and found that human–dog interactions consistently improve some indications of human stress levels and don’t seem to negatively affect dogs. However, we need to do more research to gain a better understanding of the impacts on people and dogs with a wider lens that looks at more markers of stress.

Abstract

Positive relationships, including those between humans and other animals, particularly dogs, may be a way to reduce stress in humans. However, research into this area is relatively new, and a comprehensive review of the impacts of these interactions on humans and dogs has not been conducted. A scoping review of the scientific literature was conducted to explore what is known about the impacts of canine-assisted interventions on molecular biomarkers (e.g., cortisol and oxytocin) and associated measures (e.g., heart rate and blood pressure) of human and canine stress. As reported across 27 identified studies, canine-assisted interventions have consistently been demonstrated to elicit positive changes in human stress markers, and typically do not cause negative impacts on the studied canine stress markers. However, results were inconsistent across measures of stress. For example, in humans, it was common for a study to show improvements to cortisol levels but no change to self-reported stress, or vice versa. Many of the reviewed studies also had significant methodological issues, such as not aligning the timing of sample collections to when the analyzed stress biomarkers could be expected to peak. More rigorous research should be conducted on the impacts of canine-assisted interventions on a wider range of stress biomarkers.

Yoga and meditation, an essential tool to alleviate stress and enhance immunity to emerging infections: A perspective on the effect of COVID-19 pandemic on students

The COVID-19 pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) has negatively impacted the global healthcare and economic systems worldwide. The COVID-19 pandemic has also created an emotional and psychological pandemic among people of all ages irrespective of economic status and physical wellbeing. As a consequence of prolonged lockdowns, one of the most severely affected age groups globally is the young adults' group, especially students. Uncertainties in the academic calendar, restricted outdoor activities, and unusual daily routines during lockdowns led to higher incidences of stress, anxiety, and depression among students worldwide. In this review, we summarise the available evidence on the effect of lockdowns on students and discuss possible positive impacts of yoga and meditation on various psychological, emotional, and immunological parameters, which can significantly influence the general wellbeing and academic performance of students. Perspectives shared in the review will also bring awareness on how yoga and meditation could boost students' performance and assist them in maintaining physical and mental wellbeing during stressful conditions such as future epidemics and pandemics with novel infections. This information could help create better educational curriculums and healthy routines for students.

Body Mass and Emotional Eating: Emotional Eater Questionnaire (EEQ) in the Polish Adolescents' COVID-19 Experience (PLACE-19) Study

Stress caused by the Coronavirus Disease 2019 (COVID-19) pandemic may lead to emotional eating which may have a negative impact on the weight status. This study aimed to analyze the association between emotional eating and body mass, as well as changes in body mass during the COVID-19 pandemic, within the Polish Adolescents’ COVID-19 Experience (PLACE-19) Study. A total of 1126 Polish adolescents, aged 15–20, were included. A random quota sampling was performed within a national sample, and emotional eating was assessed using Emotional Eater Questionnaire (EEQ). Based on the declared height and weight before and during the pandemic, the respondents were categorized according to their body mass (malnourished, normal weight, overweight, obese) and changes in body mass during the COVID-19 pandemic (lost weight, no body mass change, gained weight). Higher EEQ scores were achieved by female respondents compared with males (p < 0.0001), respondents who stated that they gained weight during the pandemic compared with those who stated either weight loss or no body mass change (p < 0.0001), and overweight and obese respondents compared with those who had normal weight and who were malnourished (p < 0.0001). A higher share of emotional eaters and very emotional eaters was found among female respondents, respondents stating weight gain during the pandemic, and overweight and obese respondents, compared with the other ones (p < 0.0001). Based on the findings, it may be concluded that among Polish adolescents gender, body mass, and body mass change during the COVID-19 pandemic are the major determinants of emotional eating behaviors and that female individuals, obese individuals, and those gaining weight are especially vulnerable to emotional eating behaviors. The results of the study suggest that the issue of emotional eating should be addressed in general public health policy and appropriate education should be provided to vulnerable groups such as female and obese adolescents.

Performance Evaluation of EEG Based Mental Stress Assessment Approaches for Wearable Devices

Mental stress has been identified as the root cause of various physical and psychological disorders. Therefore, it is crucial to conduct timely diagnosis and assessment considering the severe effects of mental stress. In contrast to other health-related wearable devices, wearable or portable devices for stress assessment have not been developed yet. A major requirement for the development of such a device is a time-efficient algorithm. This study investigates the performance of computer-aided approaches for mental stress assessment. Machine learning (ML) approaches are compared in terms of the time required for feature extraction and classification. After conducting tests on data for real-time experiments, it was observed that conventional ML approaches are time-consuming due to the computations required for feature extraction, whereas a deep learning (DL) approach results in a time-efficient classification due to automated unsupervised feature extraction. This study emphasizes that DL approaches can be used in wearable devices for real-time mental stress assessment.

Association Between Socio-Affective Symptoms and Glutathione and CD4 and CD8 Lymphocytes in College Students

Background: The prevalence of anxiety and depression in young students is associated with biosocial factors and scholastic stress. However, few studies have evaluated emotional-affective symptoms that are related to the immune system and antioxidant parameters in young individuals without diagnoses of affective disorders. Aim: This study aims to assess the relationship between emotional-affective symptoms and glutathione concentrations and CD4 and CD8 lymphocyte counts in college students. Methods: College students (n = 177) completed standardized psychometric instruments, including the Perceived Stress Scale, Hamilton Anxiety Scale, Beck Depression Inventory, Familiar Social and Friends Support Scale, and Rosenberg Scale. Blood samples were biochemically analyzed. Analyses of variance were conducted between four groups according to symptom severity. Results: A considerable prevalence of stress, anxiety, and depression symptoms was observed and negatively correlated with self-esteem and socio-familiar support. Perceived stress was sexually dimorphic. Although biochemical parameters were within reference ranges, glutathione, CD4, and CD8 tended to be lower in participants with anxiety and depression symptoms, which may be of predictive value. Conclusion: The relationship between antioxidant/immune parameters and socio-affective scores is latent in undiagnosed college students who might develop affective disorders. The findings suggest that during the initial development of affective disorders, stress management strategies should be implemented to help college students cope with the academic load and monitor negative changes in their physiological state.

Molecular mechanisms linking stress and insulin resistance

To date, there is ample evidence to support the strong relationship between stress and insulin resistance. While diabetes mellitus acts as a potent stress inducer, stress may be an upstream event for insulin resistance as well. It is widely recognized that diabetes mellitus is more prevalent among people who have a stressful lifestyle; however, the underlying mechanisms are not well understood. In the current study, we surveyed the scientific literature for possible interactions between stress and insulin resistance and found that stress can impair glucose homeostasis, working through at least six molecular pathways.

A Longitudinal Examination of Quality of Life of Older Adults with Complicated Grief Receiving Accelerated Resolution Therapy

Objective: To examine the effect of Accelerated Resolution Therapy (ART) on the quality of life (QOL) of older adults with complicated grief (CG) over time. Design: Subanalysis of a randomized controlled trial. Setting/Subject: Older adult, former caregivers were recruited from a large hospice in the southeastern United States to be treated with ART for CG. Measurement: The CDC Health-Related Quality of Life (HRQOL) Healthy Days Module was administered pre-, post-, and eight weeks after therapy. Results: The subsample consisted of 27 older adults. A multilevel model indicated a statistically significant, negative difference of 8.21 (improvement) in QOL scores for each period of data collection (β = -8.21, t = 4.02, p < 0.001). Both the intervention (11%, p = 0.013) and time (7.8%, growth curve p = 0.014) contributed significantly. Conclusion: There was a significant large effect of ART on CG. This study supports concurrent improved patient-related outcome-QOL.

Predicting Chronic Stress among Healthy Females Using Daily-Life Physiological and Lifestyle Features from Wearable Sensors

Background

Chronic stress is a highly prevalent condition that may stem from different sources and can substantially impact physiology and behavior, potentially leading to impaired mental and physical health. Multiple physiological and behavioral lifestyle features can now be recorded unobtrusively in daily-life using wearable sensors. The aim of the current study was to identify a distinct set of physiological and behavioral lifestyle features that are associated with elevated levels of chronic stress across different stress sources.

Methods

For that, 140 healthy female participants completed the Trier inventory for chronic stress (TICS) before wearing the Fitbit Charge3 sensor for seven consecutive days while maintaining their daily routine. Physiological and lifestyle features that were extracted from sensor data, alongside demographic features, were used to predict high versus low chronic stress with support vector machine classifiers, applying out-of-sample model testing.

Results

The model achieved 79% classification accuracy for chronic stress from a social tension source. A mixture of physiological (resting heart-rate, heart-rate circadian characteristics), lifestyle (steps count, sleep onset and sleep regularity) and non-sensor demographic features (smoking status) contributed to this classification.

Conclusion

As wearable technologies continue to rapidly evolve, integration of daily-life indicators could improve our understanding of chronic stress and its impact of physiology and behavior.

Coping Strategies Influence Cardiometabolic Risk Factors in Chronic Psychological Stress: A Post Hoc Analysis of A Randomized Pilot Study

Chronic psychological stress can result in physiological and mental health risks via the activation of the hypothalamic–pituitary–adrenal (HPA) axis, sympathoadrenal activity and emotion-focused coping strategies. The impact of different stress loads on cardiometabolic risk is poorly understood. This post hoc analysis of a randomized pilot study was conducted on 61 participants (18–65 years of age) with perceived chronic stress. The Perceived Stress Questionnaire (PSQ₃₀), Psychological Neurological Questionnaire (PNF), anthropometric, clinical and blood parameters were assessed. Subjects were assigned to ‘high stress’ (HS; PSQ₃₀ score: 0.573 ± 0.057) and ‘very high stress’ (VHS; PSQ₃₀ score: 0.771 ± 0.069) groups based on the PSQ₃₀. Morning salivary cortisol and CRP were elevated in both groups. Visceral adiposity, elevated blood pressure and metabolic syndrome were significantly more frequent in the HS group vs. the VHS group. The fatty liver index (FLI) was higher (p = 0.045), while the PNF score was lower (p < 0.001) in the HS group. The HS group was comprised of more smokers (p = 0.016). Energy intake and physical activity levels were similar in both groups. Thus, high chronic stress was related to visceral adiposity, FLI, elevated blood pressure and metabolic syndrome in the HS group, while very high chronic stress was associated with psychological–neurological symptoms and a lower cardiometabolic risk in the VHS group, probably due to different coping strategies.

Effect of Different Concentrations of Esmolol on Perioperative Hemodynamics and Analgesia in Patients Undergoing Colectomy: A Prospective, Randomized Controlled Study

Purpose

The aim of this study was to investigate the efficacy of esmolol on intraoperative hemodynamic and perioperative analgesic management.

Methods

Totally, 125 patients undergoing colectomy were randomly divided into three groups. Group S (saline group) was administered 0.75 mL/kg/h of normal saline for 5 min before anesthesia induction and maintenance of 0.25 mL/kg/h; Group E₁ and Group E₂ were administered 0.5 mg/kg and 1.0 mg/kg esmolol for 5 min before anesthesia induction, and maintained of 0.5 mg/kg/h and 2.0 mg/kg/h, respectively. Several parameters including indexes of hemodynamics variation (primary outcome), intra- and postoperative analgesic usage, and pain score were measured.

Results

Group E₁ and Group E₂ had significantly lower intubation response than Group S (P = 0.007, P = 0.001), and extubation response of Group E₂ was significantly lower than Group S (P = 0.007). The opioid consumption in Group E₁ and Group E₂ was significantly lower than in Group S intraoperatively (P = 0.020 and 0.007). The incidence of postoperative adverse reactions among the three groups was not statistically significant (P = 0.368 and 0.772).

Conclusion

Esmolol 0.5 mg/kg and 1.0 mg/kg infusion before intubation both can effectively inhibit the intubation response, while only maintenance with 2.0 mg/kg/h of esmolol can reduce the incidence of extubation response. At the same time, esmolol can decrease intraoperative opioid requirement without increasing the risk of adverse reactions.

Trial Registration

ChiCTR1900024538 and the date of registration was July 15, 2019 at http://www.chictr.org.cn.

Evaluation of Salivary Alpha-Amylase Levels for Determining Stress Variations in Patients Undergoing Spinal Anesthesia for Infra-Umbilical Surgery

Aims and Objectives:

To evaluate salivary alpha-amylase (sAA) levels for determining stress variations in patients undergoing spinal anesthesia for infra-umbilical surgery.

Materials and Methods:

One hundred and twenty subjects (age 18–65 years) planned for infra-umbilical surgery under spinal anesthesia were included and allocated to Groups A and B ensuring age and sex matching. In both groups, sAA levels (S1 to S4) were assessed sequentially at different times (E1 to E4). S1 and S2 were collected on the evening before surgery (E1) and in the preoperative room on the day of surgery (E2), respectively. Thereafter, in Group A, S3 and S4 were collected before (E3) and 15 min after spinal anesthesia (E4), following which intravenous Midazolam was given. In Group B, intravenous Midazolam was administered first, S3 was collected 5 min later (E3), spinal anesthesia was administered and S4 was collected after15 min (E4).

Results:

In both groups, sAA levels showed a mild increase from E1 to E2 (not significant). Thereafter from E2 to E3 and E3 to E4, a significant sharp rise in sAA levels in Group A and a significantly acute decline in Group B was noted. Mean sAA levels in Group A were higher as compared to group B (P < 0.005) in E3 and E4.

Conclusion:

Sequential documentation of increase in sAA levels in our study, starting with the baseline levels, presents a comprehensive report of the stress that the patients experience during preoperative period and reinforces the need of anxiolytic before spinal anesthesia.

Characterization of Stress Responses in a Drosophila Model of Werner Syndrome

As organisms age, their resistance to stress decreases while their risk of disease increases. This can be shown in patients with Werner syndrome (WS), which is a genetic disease characterized by accelerated aging along with increased risk of cancer and metabolic disease. WS is caused by mutations in WRN, a gene involved in DNA replication and repair. Recent research has shown that WRN mutations contribute to multiple hallmarks of aging including genomic instability, telomere attrition, and mitochondrial dysfunction. However, questions remain regarding the onset and effect of stress on early aging. We used a fly model of WS (WRNexoΔ) to investigate stress response during different life stages and found that stress sensitivity varies according to age and stressor. While larvae and young WRNexoΔ adults are not sensitive to exogenous oxidative stress, high antioxidant activity suggests high levels of endogenous oxidative stress. WRNexoΔ adults are sensitive to stress caused by elevated temperature and starvation suggesting abnormalities in energy storage and a possible link to metabolic dysfunction in WS patients. We also observed higher levels of sleep in aged WRNexoΔ adults suggesting an additional adaptive mechanism to protect against age-related stress. We suggest that stress response in WRNexoΔ is multifaceted and evokes a systemic physiological response to protect against cellular damage. These data further validate WRNexoΔ flies as a WS model with which to study mechanisms of early aging and provide a foundation for development of treatments for WS and similar diseases.

Factors Affecting Specialist Psychiatry Training in South Africa: Are Psychiatry Residents Satisfied with Their Training?

OBJECTIVE

The authors investigated South African psychiatry residents' satisfaction with their training, physical, and mental health to inform the development of a strategy to improve the quality and experiences of training.

METHOD

A cross-sectional online survey was undertaken to assess the factors affecting residents' satisfaction with their current training program. The authors conducted a comparative analysis of residents across the training institutions in South Africa.

RESULTS

Of 179 psychiatry residents in the country, 70 responses were received (39.1% response rate). Most were satisfied with the overall quality of their training, various aspects of training, and access to training resources. However, significant differences across universities were identified with regard to residents' perception of the quality of their training, quality of their experiences, access to training resources, quality of supervision, and clinical workload. More than a quarter were dissatisfied with their mental and/or physical health. The top four factors contributing to stress were all training-related.

CONCLUSION

While most residents were satisfied with their specialist training, institutional differences in access to training and training resources, quality of training, and availability of quality supervision were evident and need to be addressed to ensure equitable training. There is a need to actively address staff shortages not only for clinical cover during protected academic time but also to meet training needs. A centralized examination process should remain in place to ensure that there is a national standard. Workplace-based assessments could facilitate standardization across institutions, should these assessments be standardized and accompanied by rigorous training of supervisors.

The illness-disease dichotomy and the biological-clinical splitting of medicine

In a recent paper, Sharpe and Greco (2019) argue that some clinical conditions, such as chronic fatigue syndrome (sometimes called myalgic encephalomyelitis), should be treated by altering the patient's experience and response to symptoms without necessarily searching for an underlying cause. As a result, we should allow for the existence of 'illnesses without (underlying) diseases'. Wilshire and Ward (2019) reply that this possibility requires unwarranted causal assumptions about the psychosocial origins of conditions not predicted by a disease model. In so doing, it is argued that Sharpe and Greco introduce epistemological and methodological problems with serious medical consequences, for example, patients feel guilt for seeking treatment for illnesses that only exist 'all in the mind', and medical researchers are discouraged from looking for more effective treatments of such conditions. We propose a view that integrates the insights of both papers. We abandon both the strict distinction between disease and illness and the naïve unidirectional account of causality that accompanies it. This, we claim, is a step towards overcoming the current harmful tendencies to conceptually separate (1) Symptom management and disease-modifying treatments. (2) Rehabilitative-palliative care and 'causal' curing. (3) Most importantly, biomedicine and clinical medicine, where the latter is currently at risk of losing its status as scientific.

Mechanism of Chronic Stress-Induced Glutamatergic Neuronal Damage in the Basolateral Amygdaloid Nucleus

Stress is a ubiquitous part of our life, while appropriate stress levels can help improve the body's adaptability to the environment. However, sustained and excessive levels of stress can lead to the occurrence of multiple devastating diseases. As an emotional center, the amygdala plays a key role in the regulation of stress-induced psycho-behavioral disorders. The structural changes in the amygdala have been shown to affect its functional characteristics. The amygdala-related neurotransmitter imbalance is closely related to psychobehavioral abnormalities. However, the mechanism of structural and functional changes of glutamatergic neurons in the amygdala induced by stress has not been fully elucidated. Here, we identified that chronic stress could lead to the degeneration and death of glutamatergic neurons in the lateral amygdaloid nucleus, resulting in neuroendocrine and psychobehavioral disorders. Therefore, our studies further suggest that the Protein Kinase R-like ER Kinase (PERK) pathway may be therapeutically targeted as one of the key mechanisms of stress-induced glutamatergic neuronal degeneration and death in the amygdala.

Non-enzymatic electrochemical determination of salivary cortisol using ZnO-graphene nanocomposites

Electrochemically deposited ZnO nanoparticles on a pencil graphite electrode (PGE) coated with graphene generate a noteworthy conductive and selective electrochemical sensing electrode for the estimation of cortisol. Electrochemical techniques such as cyclic voltammetry (CV) analysis and electrochemical impedance spectroscopic (EIS) tests were adopted to analyze and understand the nature of the modified sensor. Surface morphological analysis was done using various spectroscopic and microscopic techniques like X-ray photoelectron spectroscopy (XPS), transmission electron microscopy (TEM), and scanning electron microscopy (SEM). Structural characterization was conducted by X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FTIR). The effect of scan rate, concentration, and cycle numbers was optimized and reported. Differential pulse voltammetric (DPV) analysis reveals that the linear range for the detection of cortisol is 5 × 10⁻¹⁰M − 115 × 10⁻¹⁰ M with a very low-level limit of detection value (0.15 nM). The demonstrated methodology has been excellently functional for the determination of salivary cortisol non-enzymatically at low-level concentration with enhanced selectivity despite the presence of interfering substances.

Electrochemically deposited ZnO nanoparticles on a pencil graphite electrode (PGE) coated with graphene generate a noteworthy conductive and selective electrochemical sensing electrode for the estimation of cortisol.

Acute Cold Water-Immersion Restraint Stress Induces Intestinal Injury and Reduces the Diversity of Gut Microbiota in Mice

Growing evidence has demonstrated that stress triggers gastrointestinal (GI) disorders. This study aimed to investigate how the acute cold water-immersion restraint (CWIR) stress affects intestinal injury and gut microbiota (GM) distribution. Male C57BL/6 mice were used to establish a CWIR animal model. Hematoxylin–eosin and periodic acid–Schiff staining were performed to assess intestinal histopathological changes. Reverse transcription quantitative polymerase chain reaction (RT-qPCR) analysis and immunofluorescence staining were used to evaluate the expression of inflammatory cytokines and immune cell infiltration in the intestinal tissues. The gut permeability and intestinal occludin protein expression were determined through fluorescein isothiocyanate-dextran detection and western blot, respectively. GM profiles were analyzed via high-throughput sequencing of the fecal bacterial 16S rRNA genes. Results showed that CWIR induced more severe intestinal mucosal injury compared to the control, leading to a significant increase in tumor necrosis factor-α expression, but no infiltration of neutrophil and T cells. CWIR also resulted in GI disruption and increased the permeability of the intestinal mucosa. GM profiles showed that CWIR reduced GM diversity of mice compared with the control group. Specifically, aerobic and gram-negative bacteria significantly increased after CWIR, which was associated with the severity of gut injury under stress. Therefore, acute CWIR leads to severe intestinal damage with inflammation and disrupts the GM homeostasis, contributing to decreased GM diversity. Our findings provide the theoretical basis for the further treatment of intestinal disorders induced by CWIR.

Chronic adolescent stress increases exploratory behavior but does not appear to change the acute stress response in adult male C57BL/6 mice

Chronic stress exposure in adolescence can lead to a lasting change in stress responsiveness later in life and is associated with increased mental health issues in adulthood. Here we investigate whether the Chronic Social Instability (CSI) paradigm influences the behavioral and molecular responses to novel acute stressors in mice, and whether it alters physiological responses influenced by the noradrenergic system. Using large cohorts of mice, we show that CSI mice display a persistent increase in exploratory behaviors in the open field test alongside small but widespread transcriptional changes in the ventral hippocampus. However, both the transcriptomic and behavioral responses to novel acute stressors are indistinguishable between groups. In addition, the pupillometric response to a tail shock, known to be mediated by the noradrenergic system, remains unaltered in CSI mice. Ultra-high performance liquid chromatography analysis of monoaminergic neurotransmitter levels in the ventral hippocampus also shows no differences between control or CSI mice at baseline or in response to acute stress. We conclude that CSI exposure during adolescence leads to persistent changes in exploratory behavior and gene expression in the hippocampus, but it does not alter the response to acute stress in adulthood and is unlikely to alter the function of the noradrenergic system.

Involvement of Ghrelin Dynamics in Stress-Induced Eating Disorder: Effects of Sex and Aging

Stress, a factor that affects appetite in our daily lives, enhances or suppresses appetite and changes palatability. However, so far, the mechanisms underlying the link between stress and eating have not been fully elucidated. Among the peripherally produced appetite-related peptides, ghrelin is the only orexigenic peptide, and abnormalities in the dynamics and reactivity of this peptide are involved in appetite abnormalities in various diseases and psychological states. This review presents an overview of the research results of studies evaluating the effects of various stresses on appetite. The first half of this review describes the relationship between appetite and stress, and the second half describes the relationship between the appetite-promoting peptide ghrelin and stress. The effects of sex differences and aging under stress on appetite are also described.

Protective Effects of Low-Dose Alcohol against Acute Stress-Induced Renal Injury in Rats: Involvement of CYP4A/20-HETE and LTB4/BLT1 Pathways

Low-dose alcohol possesses multiple bioactivities. Accordingly, we investigated the protective effect and related molecular mechanism of low-dose alcohol against acute stress- (AS-) induced renal injury. Herein, exhaustive swimming for 15 min combined with restraint stress for 3 h was performed to establish a rat acute stress model, which was verified by an open field test. Evaluation of renal function (blood creatinine and urea nitrogen), urine test (urine leukocyte esterase and urine occult blood), renal histopathology, oxidative stress, inflammation, and apoptosis was performed. The key indicators of the cytochrome P450 (CYP) 4A1/20-hydroxystilbenetetraenoic acid (20-HETE) pathway, cyclooxygenase (COX)/prostaglandin E₂ (PGE₂) pathway, and leukotriene B₄ (LTB₄)/leukotriene B₄ receptor 1 (BLT1) pathway were measured by real-time PCR and ELISA. We found that low-dose alcohol (0.05 g/kg, i.p.) ameliorated AS-induced renal dysfunction and histological damage. Low-dose alcohol also attenuated AS-induced oxidative stress and inflammation, presenting as reduced malondialdehyde and hydrogen peroxide formation, increased superoxide dismutase and glutathione activity, and decreased myeloperoxidase, interleukin-6, interleukin-1β, and monocyte chemoattractant protein-1 levels (P < 0.05). Moreover, low-dose alcohol alleviated AS-induced apoptosis by downregulating Bax and cleaved caspase 3 protein expression and reduced numbers of terminal deoxynucleotidyl transferase-mediated dUTP nick-end label-positive cells (P < 0.01). Correlation analysis indicated that 20-HETE was strongly correlated with oxidative stress, while LTB₄ was strongly correlated with inflammation. Low-dose alcohol inhibited AS-induced increases in CYP4A1, CYP4A2, CYP4A3, CYP4A8, and BLT1 mRNA levels and LTB₄ and 20-HETE content (P < 0.01). Interestingly, low-dose alcohol had no effect on COX1 or COX2 mRNA expression or the concentration of PGE₂. Furthermore, low-dose alcohol reduced calcium-independent phospholipase A₂ mRNA expression, but did not affect secreted phospholipase A₂ or cytosolic phospholipase A₂ mRNA expression. Together, these results indicate that low-dose alcohol ameliorated AS-induced renal injury by inhibiting CYP4A/20-HETE and LTB₄/BLT1 pathways, but not the COX/PGE₂ pathway.

Impact of Virtual Heartfulness Meditation Program on Stress, Quality of Sleep, and Psychological Wellbeing during the COVID-19 Pandemic: A Mixed-Method Study

Stress and lack of quality sleep affect a large portion of the population around the globe, and the COVID-19 pandemic has genuinely brought attention to these problems. This study aimed to investigate whether using a virtual heart-based meditation program is associated with improved stress levels and quality of sleep among participants from the general population during the COVID-19 pandemic. We recruited 63 participants to receive an 8-week virtually conducted Heartfulness meditation program in a prospective pre–post single-arm intervention study from September 28 to November 22 2020. Perceived Stress Scale (PSS) and Pittsburgh Sleep Quality Index (PSQI) scores were collected at baseline, at 4 weeks, and 8 weeks. Of the 63 participants enrolled in the study, 36 (57%) completed an 8-week Heartfulness meditation program. There was a significant decrease in PSS (mean difference of 6.68 with 95% C.I. 4.89–8.47, p < 0.0001) and in PSQI (mean difference of 2.05 with 95% C.I. 1.03–3.07, p < 0.0001) between week zero and week eight, regardless of Health Care Professional status. The qualitative thematic analysis strongly supported the survey results. A significant reduction in perceived stress score and improvement in sleep quality index was noted at the end of a virtual Heartfulness meditation program. Moreover, Heartfulness meditation practice may help cultivate the quality of empathy, acceptance, and individual peace. We conclude that the effects of virtually accessible Heartfulness meditation practice need to be explored further in larger studies.

Prevalence and Associated Factors of Common Mental Disorders Among Adult Residents in Silte Zone, Southern Ethiopia

INTRODUCTION

Mental health problems appear to be increasing in importance in Africa. Mental and substance use disorders were the leading cause of yearly lived with disability in Sub-Saharan Africa. Evidence from previous studies shows considerable variation in the prevalence of these disorders. The most acceptable explanation for this wide variation is likely to be the fact that socio cultural factors are major determinants of mental disorders. Therefore a mental disorder has to be understood in a specific setting to develop effective and tailored interventions.

OBJECTIVE

The objective of this study was to determine the prevalence and associated factors of common mental disorders among adult residents in Silte Zone, southern Ethiopia.

METHODS

Community based cross-sectional study was conducted in the study area. A total of 1178 adults were selected by using a three-stage systematic sampling technique. The Self-Reporting Questionnaire (SRQ-20) was used to determine the prevalence of common mental disorders. Data were analyzed by using SPSS version 20. Both bivariate and multiple logistic regression analyses were employed to identify factors associated with common mental disorders.

RESULTS

The prevalence of common mental disorders among adults found to be 39.7%. Increased age (OR = 1.114; 95% CI = 1.095, 1.134), being female (OR = 9.421; 95% CI = 5.947, 14.926), poor social support (OR = 1.987; 95% CI = 1.358, 2.907) and having life threatening experience (OR = 2.162; 95% CI = 1.825, 2.562) were significantly associated with common mental disorders.

CONCLUSION

In the study, the magnitude of common mental disorders remains high in the study area. Increased age, being female, poor social support and having life-threatening experience were significantly associated with common mental disorders.

Acute Response of Stress System in Multiple Sclerosis

Background: It has long been suspected that exposure to stress is a major factor that can increase the risk of Multiple Sclerosis (MS) and exacerbate it, as a stress-related disorder. Therefore, we conducted this study to investigate the response of the hypothalamic-pituitary-adrenal (HPA) axis and sympathetic-adrenal-medullar (SAM) system to acute social stress. Methods: A total of 46 MS patients and 23 age-sex-matched healthy controls were recruited in the study. The Trier Social Stress Test (TSST) was used to induce acute psychosocial stress. We measured salivary cortisol (SC) to evaluate the HPA axis. In addition, electrocardiography (ECG) was recorded to evaluate the SAM system based on the linear and non-linear features of Heart Rate Variation (HRV). Then, SC and HRV were measured before and after the stress exposure. We also used the Depression Anxiety Stress Scale (DASS) and Emotional Visual Analog Scale (EVAS) to conduct the psychometric assessment and evaluate the perceived stress level, respectively. Results: The mean age of the MS group was 35.38 ± 15 years, with a mean disease duration of 7.4 ± 60. Besides, the HC group's mean age was 35.8 ± 9 years. There were no significant differences in demographic features and DASS scores between the two groups. In response to TSST, both MS and healthy individuals showed a significant increase in the SC levels and EVAS scores, as well as changes in the HRV indices. Notably, significant differences were also found between the two groups regarding the basic and post-stress SC levels, EVAS score, and HRV indices. Unlike the HC group, the SC level returned to its baseline after recovery in the MS group, and the sympathetic tone was more sensitive. Conclusions: Our results indicated that both MS and healthy individuals respond to acute stress regarding neuroendocrine assessment; however, patients with multiple sclerosis show some impairments in this response.

Personality Type D, Level of Perceived Stress, Insomnia, and Depression Among High School Teachers in Poland

Teaching is inherently connected with specific burdens that may imply stressful situations. The goal of this study was to explore the prevalence of type D (distressed) personality in teachers. This is known to cause depressive episodes and sleep disorders, which not only have direct physical health effects, but can also impact the wellbeing of individuals and hence adversely affect their job performance. The participants consisted of 412 high school teachers from the Silesian Province, located in the south of Poland. Using the following research tools: Type D Scale (DS14), Perceived Stress Scale, Athens Insomnia Scale, and Beck Depression Inventory, it was found that type D personality was observed in a large percentage of teachers (30.1%). It was reported that teachers with distressed personality suffered from insomnia and depression significantly more often. Findings from the current study indicate the need to implement preventive activities focused on reducing psychosocial risk factors in the work environment in order to reduce the frequency of depressive disorders among teachers.

Association between Self-Perceived Social Support in the Workplace and the Presence of Depressive/Anxiety Symptoms

This study aimed to investigate the association of support from colleagues and supervisors at the workplace on depressive and anxiety symptoms in wage earners from Korea. The data used in this study were from the fifth Korean Working Conditions Survey (KWCS) conducted in 2017 and analyzed using a multivariate logistic regression model. Furthermore, we measured the odds ratios (ORs) and 95% confidence intervals (CIs) of depressive and anxiety symptoms by stratifying covariates. The ORs of depressive and anxiety symptoms for the “non-support” group were higher than for the “support group” in terms of support from both colleagues and supervisors. The results of the stratified analysis of covariates, male, young, highly-educated, full-time, and white-collar groups were associated with the lack of support. Support from colleagues and supervisors was significantly associated with the Korean wage worker’s mental health—depressive and anxiety symptoms, respectively. Further longitudinal and clinical studies on the relationship between mental health and support at the workplace are required.

Astrocytic Hydrogen Sulfide Regulates Supraoptic Cellular Activity in the Adaptive Response of Lactating Rats to Chronic Social Stress

Maternal social stress among breastfeeding women can be adapted in chronic process. However, neuroendocrine mechanisms underlying such adaptation remain to be identified. Here, we report the effects of 2 hr/day unfamiliar male rat invasion (UMI) stress on maternal behaviors in lactating rats during postpartum day 8 (UMI8) to postpartum day 12 (UMI12). Rat dams at UMI8 presented signs of maternal anxiety, depression, and attacks toward male intruder. These changes partially reversed at UMI12 except the sign of anxiety. In the supraoptic nucleus (SON), UMI12 but not UMI8 significantly increased the expression of c-Fos and phosphorylated extracellular signal-regulated protein kinase 1/2. At UMI8 but not UMI12, length of glial fibrillary acidic protein (GFAP, astrocytic cytoskeletal element) filaments around oxytocin (OT) neurons was significantly longer than that of their controls; the amount of GFAP fragments at UMI12 was significantly less than that at UMI8. Expression of cystathionine β-synthase (CBS, enzyme for H₂S synthesis) at UMI12 was significantly higher than that at UMI8. CBS expression did not change significantly in the somatic zone of the SON but decreased significantly at the ventral glia lamina at UMI8. In brain slices of the SON, aminooxyacetate (a CBS blocker) significantly increased the expression of GFAP proteins that were molecularly associated with CBS. Aminooxyacetate also reduced the firing rate of OT neurons whereas Na₂S, a donor of H₂S, increased it. The adaptation during chronic social stress is possibly attributable to the increased production of H₂S by astrocytes and the subsequent retraction of astrocytic processes around OT neurons.

A Randomized, Triple-Blind, Placebo-Controlled, Crossover Study to Investigate the Efficacy of a Single Dose of AlphaWave® L-Theanine on Stress in a Healthy Adult Population

Introduction

Stress is a complex life occurrence essential for survival and goal achievement but can be damaging in excess. Because of the high prevalence of stress in North America, a safe supplement that effectively reduces stress is in demand. The objective of this study was to investigate the efficacy and safety of AlphaWave^®l-Theanine on whole-scalp and frontal alpha power, midline theta power, and salivary cortisol in healthy, moderately stressed adults.

Methods

This was a randomized, triple-blind, placebo-controlled, crossover study that consisted of two study periods with a 7-day washout. A single dose of AlphaWave^®l-Theanine (200 mg) or placebo was administered. To induce stress, a mental arithmetic test (MAT) was administered before and after the dose. Electroencephalogram, salivary cortisol, blood pressure, heart rate, self-reported stress, adverse events, clinical chemistry, and hematology were assessed to evaluate efficacy and safety.

Results

Increases in heart rate, blood pressure, and self-reported stress and state anxiety indicated that participants experienced stress during the MAT. AlphaWave^®l-Theanine led to a greater increase in frontal region and whole-scalp alpha power 3 h post-dose compared to placebo (p ≤ 0.050). Within groups, there were increases in alpha power, at 3 h with AlphaWave^®l-Theanine, over the whole recording and during the eyes-open portions (p ≤ 0.048) of the alpha task. The changes in alpha wave activity are supported by greater decreases in salivary cortisol 1 h post-dose (p < 0.001) with AlphaWave^®l-Theanine compared to placebo.

Conclusion

This study was conducted during the SARS-CoV-2 pandemic, which has had a rapid and significant effect on both physical and mental health around the world. A single dose of AlphaWave^®l-Theanine significantly increased frontal region alpha power compared to placebo in response to an acute stress challenge. These changes are indicative of relaxation in the brain and suggest a calming response. AlphaWave^®l-Theanine was found to be safe and well tolerated by participants.

Trial Registration

ClinicalTrials.gov identifier NCT04706494.

Stress is a complex part of life that is essential for survival and achieving goals. Too much stress, however, can be damaging. There is a high prevalence of stress in North America, creating a demand for a safe and effective supplement to reduce it. This study investigated the effectiveness and safety of AlphaWave^®l-Theanine on brainwaves and salivary cortisol in healthy, moderately stressed adults facing an acute stressor. This was a randomized, triple-blind, placebo-controlled, crossover study that consisted of two study periods with a 7-day washout. A single dose of 200 mg of AlphaWave^®l-Theanine or placebo was administered before and after a mental arithmetic test to elicit acute stress. Electroencephalogram, salivary cortisol, blood pressure, heart rate, self-reported stress, and safety were assessed to evaluate efficacy and safety. This study was conducted during the coronavirus pandemic, which has had a rapid and significant effect on both physical and mental health around the world. A single dose of AlphaWave^®l-Theanine had significant positive effects on brainwaves, salivary cortisol, and self-reported state anxiety compared to the placebo in response to an acute stress challenge. These changes are indicative of relaxation in the brain and suggest a calming response in a moderately stressed but otherwise healthy population. AlphaWave^®l-Theanine was found to be safe and well tolerated by participants.

Comparative Analysis of the Antioxidative and Hepatoprotective Activities of Dimethyl Diphenyl Bicarboxylate in Four Animal Models of Hepatic Injury

As a well-known hepatoprotective and antioxidant agent, dimethyl diphenyl bicarboxylate (DDB) has frequently been employed to remedy various liver diseases. However, it is still uncertain whether DDB exerts consistent hepatoprotective and antioxidative activities against varying degrees of hepatic damage. Therefore, DDB (100, 25, 5, or 50 mg/kg depending on the model) was administered to animals in four representative models of liver injury (CCl₄ chemical acute model, DMN subchronic model, TAA chronic model, and restraint stress psychological acute model). Horizontal comparative analysis indicated that DDB significantly lowered the excess serum AST and ALT levels in the CCl₄ and DMN models but not in the TAA and restraint stress models. In accordance with this result, DDB markedly reduced oxidative stress indices (hepatic MDA and ROS) but restored five main antioxidant components (GSH content, GSH-peroxidase, GSH-reductase, SOD, and catalase activity) in the CCl₄ and DMN models. DDB failed to normalize oxidative stressors in the restraint stress-induced injury model and restore these five antioxidant components in the TAA model. Overall, our results produced a comprehensive overview of the effects of DDB on oxidative stressors and the main antioxidative components using four animal models. These findings will provide valuable clues to guide therapeutic clinical applications.

Serum-Derived Neuronal Exosomal miRNAs as Biomarkers of Acute Severe Stress

Stress is the physical and psychological tension felt by an individual while adapting to difficult situations. Stress is known to alter the expression of stress hormones and cause neuroinflammation in the brain. In this study, miRNAs in serum-derived neuronal exosomes (nEVs) were analyzed to determine whether differentially expressed miRNAs could be used as biomarkers of acute stress. Specifically, acute severe stress was induced in Sprague-Dawley rats via electric foot-shock treatment. In this acute severe-stress model, time-dependent changes in the expression levels of stress hormones and neuroinflammation-related markers were analyzed. In addition, nEVs were isolated from the serum of control mice and stressed mice at various time points to determine when brain damage was most prominent; this was found to be 7 days after foot shock. Next-generation sequencing was performed to compare neuronal exosomal miRNA at day 7 with the neuronal exosomal miRNA of the control group. From this analysis, 13 upregulated and 11 downregulated miRNAs were detected. These results show that specific miRNAs are differentially expressed in nEVs from an acute severe-stress animal model. Thus, this study provides novel insights into potential stress-related biomarkers.

Toxic stress and burnout: John Henryism and social dominance in the laboratory and STEM workforce

Persons Excluded from science because of Ethnicity and Race (PEERs) face chronic exposure to interpersonal stressors, such as social discrimination, throughout their scientific careers, leading to a long-term decline in physical and mental health. Many PEERs exhibit John Henryism, a coping mechanism to prolonged stress where an individual expends higher levels of effort and energy at the cost of their physical and mental health. In this article, we discuss how social dominance may increase John Henryism within the STEM community; the causes, effects and costs of John Henryism; and highlight solutions to combat these social adversity stressors within the academic institution.

Influence of Non-Occupational Physical Activity on Burnout Syndrome, Job Satisfaction, Stress and Recovery in Fitness Professionals

BACKGROUND

This study aimed (1) to analyse the effect of non-occupational physical activity (NOPA) on the stress levels of fitness professionals, and (2) to apply a questionnaire to workers measuring burnout syndrome, working conditions and job satisfaction, and to compare the results with physiological stress and recovery measured objectively through heart rate variability (HRV).

METHODS

The HRV of 26 fitness instructors was recorded during 2-5 workdays using Firstbeat Bodyguard 2. Participants also completed a questionnaire (CESQT) measuring working conditions and job satisfaction variables and occupational burnout syndrome.

RESULTS

NOPA showed a negative association with both the percentage of stress (p < 0.05) and stress-recovery ratio (p < 0.01), and a positive association with the percentage of recovery (p < 0.05). Better work conditions (working hours, salary satisfaction and length of service) were associated with lower stress in fitness professionals.

CONCLUSION

NOPA appears to improve the stress levels of fitness instructors in this study cohort. Self-reported burnout levels measured through the CESQT questionnaire do not coincide with the physiological stress responses measured through HRV. Better working conditions appear to reduce the stress response in fitness professionals.

Physiological biomarkers of chronic stress: A systematic review

OBJECTIVE

The basic objective of this systematic review was to identify potential biomarkers for chronic stress.

METHODS

A systematic review of studies linking biomarkers in people with chronic stress was conducted using PRISMA guidelines. The last 40 years' studies were included in the systematic review with no age restrictions; animal studies were excluded from the study. Electronic databases including PubMed, Embase, and Google Scholar were searched for the study purpose. The studies were searched using the combinations of search terms that comprised chronic stress together with the keywords hypothalamic-pituitary-adrenal axis (HPA axis), autonomic nervous system (ANS), immune system, metabolic biomarkers, cortisol, hair cortisol, salivary cortisol, urinary cortisol, epinephrine, norepinephrine, adrenocorticotropic hormone (ACTH), brain-derived neurotropic factor (BDNF), metabolic biomarkers, antioxidants, glucose, hemoglobin, C-reactive protein (CRP), cytokines, pro-inflammatory cytokines, anti-inflammatory cytokines, and tumor necrosis factor (TNF).

RESULTS

A total of 37 studies out of 671 studies met the eligibility criteria and were included in this review. Potential diagnostic biomarkers of chronic stress included cortisol, ACTH, BDNF, catecholamines, glucose, HbA1c, triglycerides, cholesterol, prolactin, oxytocin, dehydroepiandrosterone sulfate (DHEA-S), CRP, and interleukin - 6 and 8. While the others including antioxidants and natural killer (NK) cells require further validation. Taken together, addition, these stress biomarkers have critical prognostic capacities for stress-associated diseases and therapeutic guidance.

CONCLUSION

This systematic review provides an update to the literature by highlighting the role of physiological biomarkers in chronic stress and describing their prognostic and therapeutic values.

Changes in parameters of biochemical and oxidative stress in university students during and after examinations

The study aimed to evaluate the parameters of lipid peroxidation and antioxidant protection, biochemical parameters, and cortisol and adrenaline content in the blood of students depending on the effect of exam stress. A total of 135 healthy students (72 female (53.3%) and 63 male (46.7%)) aged from 19 to 21 years (mean age 20.16 ± 0.42 years) of the experimental group underwent detailed medical screening and examination before the inclusion in the study. The control group consisted of 30 healthy students (17 female (56.7%) and 13 male (43.3%)) of corresponding age (mean age 20.23 ± 0.54 years), whose medical examination was performed during breaks in the absence of any stress factors. The blood parameters of the experimental group were investigated 1 h before, 1 h after, and 24 h after the exam. The cortisol content in the blood of experimental group students significantly increased 1.37 times (p < 0.05) an hour before the exam and 1.32 times (p < 0.05) an hour after; adrenalin content in blood increased 1.76 times (p < 0.05) and 1.49 times (p < 0.05), respectively. Compared to the control group, intensification of lipid peroxidation processes with a 1.51-fold (p < 0.05) increase in erythrocyte malonic aldehyde content in blood 1 h before and 1.42-fold (p < 0.05) increase an hour after the exam was observed in students due to the effect of exam stress.. Changes in hormonal homeostasis, activation of lipoperoxidation processes with the development of oxidative stress, and the disintegration of antioxidant protection factors are typical for academic stress in students.

Influence of mental stress on intraocular pressure and visual field testing: is there a white coat syndrome in glaucoma?

PURPOSE

To investigate the effects of mental stress stimulus on intraocular pressure (IOP) measurement and visual field (VF) testing.

METHODS

Patients with open angle glaucoma underwent a baseline IOP measurement and VF testing. Afterwards, they completed a computerized mental stress test (Stroop test) which is a known standardized method to induce mental stress. After test completion, patients underwent a second IOP measurement and VF testing.

RESULTS

Seventy-two eyes of 36 patients were enrolled. Mean age was 67.0 ± 9.5 years (range 47-84 years). The mean baseline IOP was 15.0 mmHg, and after the Stroop mental stress test, IOP increased to 16.0 mm Hg (P < 0.001). There was a trend towards significant mean deviation decreased from -6.9 dB to -8.0 dB (P = 0.054, t-test) following the stress test. This difference became significant using the Wilcoxon nonparametric test (P = 0.008). Correlation was found between glaucoma severity and change in IOP (P = 0.02) and PSD (P < 0.01).

CONCLUSIONS

We found a small but statistically significant increase in IOP and a trend towards deterioration of visual field mean deviation, following a short mental stress test. Patients with more severe glaucoma showed more pronounced changes. Our results suggest that mental stress could affect IOP measurement in the clinic.

Association between common stressful life events and coping strategies in adults

BACKGROUND

As shown in previous persons that used the effective coping strategies are more aware to recent stressful life events in their live, this study conducted to investigate the main stressful life events and common coping styles in adult's population.

MATERIALS AND METHODS

This cross-sectional study was conducted in 2018. In overall, 345 persons aged 18 years and more by stratified cluster sampling were enrolled in the study. The valid questionnaires including the coping inventory for stressful situations-21, the Holmes-Rahe Stress Inventory, and 28-item General Health Questionnaire (GHQ-28) were used to interview. The analysis of variance and t-student (t-test) was used to determine the association between the two variables. The statistical significance level was considered <0.05.

RESULTS

The top three importance events among 43 stressful items in our study were change in financial state, gain of a new family member, and death of close family member. We found that task-oriented coping (P < 0.001) and avoidance-oriented coping (P = 0.021) significantly more used in males compered to females. According to Holmes-Rahe life stress inventory instructions only 4.7% of participants are prone to getting ill in next 2 years.

CONCLUSION

The results of this study showed a positive relationship between coping styles and lower risk of mental health problems and stressful life events. Hence, activities and training programs aiming to enhance personal approach coping skills is important to reduce of side effects of stressful life events especially those recently exposed to negative life events and stresses.

Burnout of Physicians, Pharmacists and Nurses in the Course of the COVID-19 Pandemic: A Serbian Cross-Sectional Questionnaire Study

This research was a prospective, cross-sectional observational study of 128 health workers in the central part of the Republic of Serbia. The study surveyed health workers (physicians, pharmacists and nurses) who worked during peaks of the COVID-19 pandemic in the Republic of Serbia in June and November 2020. The Maslach Burnout Survey for Medical Personnel addresses three scales: (a) emotional exhaustion (EE) measures feelings of being emotionally overextended and exhausted by one’s work; (b) depersonalization (DP) measures an unfeeling and impersonal response toward recipients of one’s service, care treatment, or instruction; and (c) personal accomplishment (PA) measures feelings of competence and successful achievement in one’s work. Linear regression and the chi-square test were used to test a relationship between the input variables (x) and the single output variable (y). We can conclude that most health workers had a high degree of emotional exhaustion, but also a low degree of depersonalization and a high degree of sense of personal achievement. Nurses and physicians had similar answers on the pandemic during their work, but pharmacists had different answers.

The effect of marital and insurance status on the survival of elderly patients with stage M1b colon cancer: a SEER-based study

BACKGROUND

Colon cancer is largely implicated in elderly patients (age ≥ 60 years). The prognosis of patients diagnosed with the M1b stage is vastly poor. Marital and insurance status has been considered important prognostic factors in various cancer types. However, how these factors influence elderly patients with stage M1b colon cancer remains to be explored. This study aims to uncover the role of marital and insurance status in the survival of elderly patients with stage M1b colon cancer.

METHODS

We retrieved data for patients diagnosed with stage M1b colon cancer between 2010 and 2016 from the Surveillance, Epidemiology, and End Results (SEER) database. Our analysis of the clinicopathological features, overall survival (OS), and cancer-specific survival (CSS) was based on the marital and insurance status, respectively.

RESULTS

In sum, 5709 stage M1b colon cancer patients with complete information from SEER were enrolled for analysis. The OS and CSS of the Non-married group were poorer compared to that of the Married group. The OS and CSS of the Uninsured group were poorer than both of the Insured group and Medicaid group. However, OS was comparable between Uninsured group and Medicaid groups. The findings allude that marital and insurance status potentially impact the long-term survival of elderly patients with M1b colon cancer. The subgroup survival analyses revealed the lowest risk for death among the Insured Married group based on the comparison of the OS and CSS across all other groups. Moreover, Univariate and multivariate analyses revealed race, marital status, surgery, and chemotherapy as independent predictors for OS, whereas insurance status, surgery,and chemotherapy were independent predictors for CSS in elderly patients with M1b colon cancer.

CONCLUSION

The marital and insurance status greatly impact the survival of elderly patients with M1b colon cancer. Therefore, it is imperative to provide more support to this vulnerable patient group who are lonely and uninsured, particularly in the psychological and health insurance aspect.

Efficient methods for acute stress detection using heart rate variability data from Ambient Assisted Living sensors

Background

Using Ambient Assisted Living sensors to detect acute stress could help people mitigate the harmful effects of everyday stressful situations. This would help both the healthy and those affected more by sudden stressors, e.g., people with diabetes or heart conditions. The study aimed to develop a method for providing reliable stress detection based on heart rate variability features extracted from portable devices.

Methods

Features extracted from portable electrocardiogram sensor recordings were used for training various classification algorithms for stress detection purposes. Data were recorded in a clinical trial with 7 participants and two stressors, the Trier Social Stress Test and the Stroop colour word test, both validated by standardised questionnaires. Different heart rate variability feature sets (all, time-domain and non-linear only, frequency-domain only) were tested to investigate how classification performance is affected, in addition to various time window length setups and participant-wise training sessions. The accuracy and F1 score of the trained models were compared and analysed.

Results

The best results were achieved with models using time-domain and non-linear heart rate variability features with 5-min-long overlapping time windows, yielding 96.31% accuracy and 96.26% F1 score. Shorter overlapping windows had slightly lower performance, with 91.62–94.55% accuracy and 91.77–94.55% F1 score ranges. Non-overlapping window configurations were less effective, with both accuracy and F1 score below 88%. For participant-wise learning, average F1 scores of 99.47%, 98.93% and 96.1% were achieved for feature sets using all, time-domain and non-linear, and frequency-domain features, respectively.

Conclusion

The tested stress detector models based on heart rate variability data recorded by a single electrocardiogram sensor performed just as well as those published in the literature working with multiple sensors, or even better. This suggests that once portable devices such as smartwatches provide reliable hear rate variability recordings, efficient stress detection can be achieved without the need for additional physiological measurements.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12938-021-00911-6.

Cardiorespiratory Fitness, Blood Pressure and Ethnicity Are Related to Salivary Cortisol Responses after an Exercise Test in Children: The ExAMIN Youth SA Study

BACKGROUND

Childhood elevated circulatory stress mediators such as cortisol seem to play an important role in the development of hypertension and metabolic disorders later in life. Little is known about the association of body composition, cardiorespiratory fitness (CRF), blood pressure (BP) and ethnicity with cortisol reactivity in young children.

METHODS

In this cross-sectional study, 324 black and 227 white school children (aged 7.4 ± 1.0 years) were screened for salivary cortisol reactivity, body mass index, BP and CRF (shuttle run) by standardised assessments for children.

RESULTS

Children in the lower cortisol reactivity percentile (<25th) had a higher heart rate (87.0 ± 12.9 bpm) and a lower CRF (3.1 ± 1.3 stages) compared to children in the upper (>25th) percentile (86.2 ± 11.5 bpm and 3.5 ± 1.7 stages, respectively). At baseline, children of black ethnicity had a higher cortisol level (p < 0.001). Immediately before the exercise test, no associations of obesity, BP, CRF and ethnicity with cortisol levels were found. In analysis of covariance (ANCOVA) we found that low CRF, high BP and black ethnicity were independently associated with lower cortisol reactivity by performing the shuttle run test (p < 0.01).

CONCLUSION

Low CRF and high BP were associated with lower cortisol reactivity after a cardiorespiratory exercise test. Black children showed a lower cortisol reactivity which may contribute to the earlier onset of hypertension reported in black compared to white populations. Primary prevention programs need to focus on improving physical fitness to reduce the growing prevalence of cardiometabolic disorders during childhood.

The dark side of teamwork–the relationship between social stressors, social resources and team member well-being in monocultural and multicultural work teams

Purpose

The purpose of this paper is to explore the relationship between cultural diversity in teams and team members' individual well-being. The paper further explores the relationship between social resources, social stressors, team member well-being and the influence of the type of team individuals are working in (mono- vs. multicultural), gender and individualism/collectivism (IC).

Design/methodology/approach

Using data collected via an online survey, the authors analyzed 659 responses from individuals working in mono- and multicultural work teams. A theoretical model explaining the influence of social stressors, social resources, and social and demographic variables was proposed and tested using structural equation modeling.

Findings

The results indicate that members of multicultural work teams perceive significantly more social stressors and lower levels of social resources than do members of monocultural teams. Higher levels of social stressors suggest decreased psychological well-being, while social resources have an indirect positive effect on psychological well-being. Furthermore, personal characteristics, namely, individualism and gender, have direct effects on the perception of social stressors and indirect effects on team member well-being.

Originality/value

This paper demonstrates that cultural diversity in teams can influence the social stressors and resources that individual team members experience. Moreover, the pivotal role of social resources in the facilitation of team member well-being is highlighted primarily through its direct effect on social stressors and its concomitant indirect effect on well-being.

Temporomandibular Myofascial Pain Syndrome-Aetiology and Biopsychosocial Modulation. A Narrative Review

This review elaborates on the aetiology, diagnosis, and treatment of temporomandibular (TMD) myofascial pain syndrome (MPS) regulated by psychosocial factors. MPS impairs functioning in society due to the accompanying pain. Directed and self-directed biopsychosocial profile modulation may be beneficial in the treatment of MPS. Moreover, nutrition is also a considerable part of musculoskeletal system health. A fruit and vegetable diet contributes to a reduction in chronic pain intensity because of its anti-inflammatory influence. Cannabidiol (CBD) oils may also be used in the treatment as they reduce stress and anxiety. A promising alternative treatment may be craniosacral therapy which uses gentle fascia palpation techniques to decrease sympathetic arousal by regulating body rhythms and release fascial restrictions between the cranium and sacrum. MPS is affected by the combined action of the limbic, autonomic, endocrine, somatic, nociceptive, and immune systems. Therefore, the treatment of MPS should be deliberated holistically as it is a complex disorder.