Effects of psychosocial and physical stress on lactate and anxiety levels

Impact of lifetime stressor exposure on neuroenergetics in schizophrenia spectrum disorders

N-acetylasparate and lactate are two prominent brain metabolites closely related to mitochondrial functioning. Prior research revealing lower levels of NAA and higher levels of lactate in the cerebral cortex of patients with schizophrenia suggest possible abnormalities in the energy supply pathway necessary for brain function. Given that stress and adversity are a strong risk factor for a variety of mental health problems, including psychotic disorders, we investigated the hypothesis that stress contributes to abnormal neuroenergetics in patients with schizophrenia. To test this hypothesis, we used the Stress and Adversity Inventory (STRAIN) to comprehensively assess the lifetime stressor exposure profiles of 35 patients with schizophrenia spectrum disorders and 33 healthy controls who were also assessed with proton magnetic resonance spectroscopy at the anterior cingulate cortex using 3 Tesla scanner. Consistent with the hypothesis, greater lifetime stressor exposure was significantly associated with lower levels of N-acetylasparate (β = -0.36, p = .005) and higher levels of lactate (β = 0.43, p = .001). Moreover, these results were driven by patients, as these associations were significant for the patient but not control group. Though preliminary, these findings suggest a possible role for stress processes in the pathophysiology of abnormal neuroenergetics in schizophrenia.

A physicochemical-sensing electronic skin for stress response monitoring

Approaches to quantify stress responses typically rely on subjective surveys and questionnaires. Wearable sensors can potentially be used to continuously monitor stress-relevant biomarkers. However, the biological stress response is spread across the nervous, endocrine, and immune systems, and the capabilities of current sensors are not sufficient for condition-specific stress response evaluation. Here we report an electronic skin for stress response assessment that non-invasively monitors three vital signs (pulse waveform, galvanic skin response and skin temperature) and six molecular biomarkers in human sweat (glucose, lactate, uric acid, sodium ions, potassium ions and ammonium). We develop a general approach to prepare electrochemical sensors that relies on analogous composite materials for stabilizing and conserving sensor interfaces. The resulting sensors offer long-term sweat biomarker analysis of over 100 hours with high stability. We show that the electronic skin can provide continuous multimodal physicochemical monitoring over a 24-hour period and during different daily activities. With the help of a machine learning pipeline, we also show that the platform can differentiate three stressors with an accuracy of 98.0%, and quantify psychological stress responses with a confidence level of 98.7%.

A molecularly imprinted screen-printed carbon electrode for electrochemical epinephrine, lactate, and cortisol metabolites detection in human sweat

This study presents a novel approach to the detection of epinephrine, lactate, and cortisol biomarkers in human sweat using molecularly-imprinted polymers (MIP) embedded screen printed carbon electrode (SPCE) sensors. The epinephrine and lactate MIP SPCE sensors were fabricated by epinephrine or lactate-imprinted polyaniline co-polymerized with 3-aminophenylboronic acid and gold nanoparticles (PANI-co-PBA/AuNP) selective membrane on a commercial SPCE. The cortisol sensor was comprised of a cortisol-imprinted poly(glycidyl methacryate-co-ethylene glycol dimethacrylate) (poly (GMA-co-EGDMA)@AuNP selective membrane deposited on a SPCE. Both cyclic voltammetry (CV) and differential pulse voltammetry (DPV) were used as modes of analysis for the MIP SPCE sensors. All sensors exhibited a rapid (∼1 min) and selective response to the epinephrine, lactate, and cortisol target analytes, with excellent precision between scans for both CV and DPV analysis modes. For CV, the LOD for epinephrine, lactate, and cortisol was 8.2 nM, 13 mM, and 0.042 μM, respectively. The LOD for DPV were 0.60 nM, 2.2 mM, and 0.025 μM for epinephrine, lactate, and cortisol, respectively. The MIP SPCE sensor platforms were further validated through the successful quantification of epinephrine, lactate, and cortisol in human sweat.

Sensors for in situ monitoring of oral and dental health parameters in saliva

OBJECTIVES

The oral cavity is an easily accessible unique environment and open system which is influenced by the oral fluids, microbiota, and nutrition. Little is known about the kinetics and dynamics of metabolic processes at the intraoral surfaces. Real-time monitoring of salivary biomarkers, e.g., glucose, lactate, fluoride, calcium, phosphate, and pH with intraoral sensors is therefore of major interest. The aim of this review is to overview the existing literature for intraoral saliva sensors.

MATERIALS AND METHODS

A comprehensive literature search was performed to review the most relevant studies on intraoral saliva sensor technology.

RESULTS

There is limited literature about the in situ saliva monitoring of salivary biomarkers. Bioadhesion and biofouling processes at the intraoral surfaces limit the performances of the sensors. Real-time, long-term, and continuous intraoral measurement of salivary metabolites remains challenging and needs further investigation as only few well-functioning sensors have been developed until today. Until now, there is no sensor that measures reliably beyond hours for any analyte other than glucose.

CONCLUSIONS

Saliva's complex and dynamic structure as well as bioadhesion are key challenges and should be addressed in the future developments. Consequently, more studies that focus particularly on biofouling processes and interferential effects of the salivary matrix components on sensor surfaces are required.

CLINICAL RELEVANCE

By monitoring fluids in the oral cavity, as the entrance to the digestive system, extensive information can be obtained regarding the effects of foods and preventive agents on the oral microbiota and the tooth surfaces. This may lead to a better understanding of strategies to modulate oral and general health.

Recent Developments in Protein Lactylation in PTSD and CVD: Novel Strategies and Targets

In 1938, Corneille Heymans received the Nobel Prize in physiology for discovering that oxygen sensing in the aortic arch and carotid sinus was mediated by the nervous system. The genetics of this process remained unclear until 1991 when Gregg Semenza while studying erythropoietin, came upon hypoxia-inducible factor 1, for which he obtained the Nobel Prize in 2019. The same year, Yingming Zhao found protein lactylation, a posttranslational modification that can alter the function of hypoxia-inducible factor 1, the master regulator of cellular senescence, a pathology implicated in both post-traumatic stress disorder (PTSD) and cardiovascular disease (CVD). The genetic correlation between PTSD and CVD has been demonstrated by many studies, of which the most recent one utilizes large-scale genetics to estimate the risk factors for these conditions. This study focuses on the role of hypertension and dysfunctional interleukin 7 in PTSD and CVD, the former caused by stress-induced sympathetic arousal and elevated angiotensin II, while the latter links stress to premature endothelial cell senescence and early vascular aging. This review summarizes the recent developments and highlights several novel PTSD and CVD pharmacological targets. They include lactylation of histone and non-histone proteins, along with the related biomolecular actors such as hypoxia-inducible factor 1α, erythropoietin, acid-sensing ion channels, basigin, and Interleukin 7, as well as strategies to delay premature cellular senescence by telomere lengthening and resetting the epigenetic clock.

A molecularly imprinted electrochemical microneedle sensor for multiplexed metabolites detection in human sweat

This article demonstrates an array of inexpensive molecularly imprinted microneedle platforms for the multiplexed electrochemical detection of pH, epinephrine, dopamine, and lactate biomarkers in human sweat. The multiplexed sensors were fabricated via layer-by-layer (LbL) assembly on a polydimethylsiloxane (PDMS) microneedle platform coated with a conductive PDMS/carbon nanotube (CNT)/cellulose nanocrystal (CNC) composite (PDMS/CNT/CNC@PDMS). The pH sensor was comprised of a pH-responsive polyaniline (PANI)/CNT/CNC/silver nanoparticle (AgNP) composite layer. The epinephrine, dopamine, and lactate sensors consisted of an additional epinephrine, dopamine, or lactate-imprinted PANI-co-3-aminophenylboronic acid (PBA)/gold nanoparticle (AuNP) layer atop the PANI/CNT/CNC/AgNP composite layer. Each sensor rapidly (∼2 min) and selectively responded to their target analytes, with excellent precision between scans. The limits of detection (LOD) for the epinephrine, dopamine, and lactate sensors were 0.0007 ± 0.0002 μM, 2.11 ± 0.05 nM, and 0.07 ± 0.07 mM, respectively. The pH sensor accurately responded to a pH range of 4.25-10. The applicability of the sensor platforms were successfully verified through quantification of pH, epinephrine, dopamine, and lactate in a human sweat sample, showing promise for use as a wearable, point of need (PON) sensor for sweat analytics.

Increased maternal non-oxidative energy metabolism mediates association between prenatal di-(2-ethylhexyl) phthalate (DEHP) exposure and offspring autism spectrum disorder symptoms in early life: A birth cohort study

Prenatal phthalate exposure has previously been linked to the development of autism spectrum disorder (ASD). However, the underlying biological mechanisms remain unclear. We investigated whether maternal and child central carbon metabolism is involved as part of the Barwon Infant Study (BIS), a population-based birth cohort of 1,074 Australian children. We estimated phthalate daily intakes using third-trimester urinary phthalate metabolite concentrations and other relevant indices. The metabolome of maternal serum in the third trimester, cord serum at birth and child plasma at 1 year were measured by nuclear magnetic resonance. We used the Small Molecule Pathway Database and principal component analysis to construct composite metabolite scores reflecting metabolic pathways. ASD symptoms at 2 and 4 years were measured in 596 and 674 children by subscales of the Child Behavior Checklist and the Strengths and Difficulties Questionnaire, respectively. Multivariable linear regression analyses demonstrated (i) prospective associations between higher prenatal di-(2-ethylhexyl) phthalate (DEHP) levels and upregulation of maternal non-oxidative energy metabolism pathways, and (ii) prospective associations between upregulation of these pathways and increased offspring ASD symptoms at 2 and 4 years of age. Counterfactual mediation analyses indicated that part of the mechanism by which higher prenatal DEHP exposure influences the development of ASD symptoms in early childhood is through a maternal metabolic shift in pregnancy towards non-oxidative energy pathways, which are inefficient compared to oxidative metabolism. These results highlight the importance of the prenatal period and suggest that further investigation of maternal energy metabolism as a molecular mediator of the adverse impact of prenatal environmental exposures such as phthalates is warranted.

The regulatory effects of lactic acid on neuropsychiatric disorders

Lactic acid is produced mainly in astrocytes in the brain and serves as a substance that supplies energy to neurons. In recent years, numerous studies identified the potential effects of lactic acid on the central nervous system and demonstrated its role in regulating brain function as an energy metabolism substrate or cellular signaling molecule. Both deficiency and accumulation of lactic acid cause neurological dysfunction, which further lead to the development of neuropsychiatric disorders, such as Major depressive disorder, Schizophrenia, Alzheimer's disease, and Multiple sclerosis. Although an association between lactic acid and neuropsychiatric disorders was reported in previous research, the underlying pathogenic mechanisms remain unclear. Therefore, an in-depth understanding of the molecular mechanisms by which lactic acid regulates brain function is of significance for the early diagnosis and prevention of neuropsychiatric disorders. In this review, we summarize evidence that is focused on the potential mechanisms of lactic acid as a signaling molecule involved in the pathogenesis of neuropsychiatric disorders and propose a new mechanism by which lactic acid regulates brain function and disease through the microbiota-gut-brain axis to offer new insight into the prevention and treatment of neuropsychiatric diseases.

Acute Effects of Esports on the Cardiovascular System and Energy Expenditure in Amateur Esports Players

Introduction

Esports is practiced by millions of people worldwide every day. On a professional level, esports has been proven to have a high stress potential and is sometimes considered equivalent to traditional sporting activities. While traditional sports have health-promoting effects through muscle activity and increased energy expenditure, amateur esports could represent a purely sedentary activity, which would carry potentially harmful effects when practiced regularly. Therefore, this study aims to investigate the acute effects of esports on the cardiovascular system and energy expenditure in amateur esports players to show whether esports can be considered as physical strain or mental stress or whether amateur esports has to be seen as purely sedentary behavior.

Methods

Thirty male subjects participated in a 30-min gaming session, playing the soccer simulation game FIFA 20 or the tactical, first-person multiplayer shooter Counter-Strike: Global Offensive. Respiratory and cardiovascular parameters, as well as energy expenditure, blood glucose, lactate, and cortisol, were determined pre-, during, and post-gaming.

Results

There were no significant changes in oxygen uptake, carbon dioxide output, energy expenditure, stroke volume, or lactate levels. Heart rate, blood glucose and cortisol decreased through the intervention until reaching their minimum levels 10 min post-gaming (Cortisolpre: 3.1 ± 2.9 ng/ml, Cortisolpost: 2.2 ± 2.3 ng/ml, p < 0.01; HRmin0.5: 82 ± 11 bpm, HRpost: 74 ± 13 bpm, p < 0.01).

Conclusion

A 30-min esports intervention does not positively affect energy expenditure or metabolism in amateur esports players. Therefore, it cannot provide the same health-promoting effects as traditional sports participation, but could in the long-term rather cause the same potentially health-damaging effects as purely sedentary behavior. However, it does not trigger a negative stress response in the players. Deliberate physical activity and exercise routines adapted to these demands should therefore be part of the daily life of amateur esports players.

The Effects of Physical Exercise on Saliva Composition: A Comprehensive Review

Saliva consists of organic and inorganic constituents. During exercise, analysis of the saliva can provide valuable information regarding training stress, adaptation and exercise performance. The objective of the present article was to review the effect of physical exercise on saliva composition. The shift in the composition of the saliva, during and after a workout, reflects the benefits of exercise, its potential risks and the capability of the saliva to serve as a health indicator. The type and the frequency of training, the physical condition and the athletes’ general health influence the hormones, immunoglobulins and saliva enzymes. The correlation between saliva and physical exercise has to be further investigated and the available knowledge to be applied for the benefit of the athletes during sports activities.

Biomarker monitoring and long-acting insulin treatment in a stress model to facilitate personalized diabetic control

Diabetes is a chronic disease involving elevated blood glucose levels. Controlled insulin delivery is an ideal method to achieve glycemic control. However, glucose levels vary as a result of changes in the body's physiological conditions resulting from different daily events, such as meals, exercise and stress. It is essential to develop and to monitor appropriate biomarkers for these natural physiological perturbations in order to achieve a holistic understanding of metabolic changes in diabetic patients to facilitate optimal glucose management and make possible personalized medicine for this very debilitating disease. The novel aspects of the current research include the combination of the tail suspension stress animal model and microdialysis for stress biomarker monitoring. A tail suspension test was optimized and used as a stress inducer for different groups of model rats (normal, untreated diabetic and insulin-treated diabetic rats). The levels of multiple metabolic analytes in the subcutaneous tissue were monitored continuously using subcutaneous microdialysis analysis. Different analytes, including pH, glucose and lactate were monitored and analyzed. Another important and original aspect of the reported work is that revelation that the pH, lactate and glucose levels increased under the stress conditions and the changes tended to be more pronounced in diabetic rats (both untreated and long-acting insulin-treated) compared to normal rats. Long-acting insulin treatment was shown to shorten the duration of the pH and glucose changes in response to stress when compared to the untreated diabetic rats. An additional novel aspect of the research is that subcutaneous pH was shown to be a sensitive stress biomarker for diabetic rats as pH changes rapidly after stress initiation. This research provides insight into the importance of accurate glycemic control and diabetes management for individual patients through highlighting stress management and appropriate biomarker monitoring, especially the value of combining pH and lactate monitoring with typical glucose monitoring. This research will pave the way for individualized medicine for diabetic patients through helping to obtain a holistic understanding of the various important biomarkers, rather than solely depending on glucose monitoring to determine appropriate insulin dosing.

Influence of the physical activity in the elderly people diagnosed with knee osteoarthritis during the pandemic period caused by COVID-19

Introduction. Knee osteoarthritis is considered to be a chronic disease that affects the joints by causing pain, joint stiffness and decreased functional capacity. Regular physical activity can keep and increase functional capacity, it can reduce pain by improving movement behavior. The disruption of the sedentary behavior of the elderly patients with knee osteoarthritis can lead to improved physical function and general health. The purpose of this paper is to point out the role of physical activity in the elderly people diagnosed with knee osteoarthritis during the COVID-19 pandemic. Material and method. A total of 155 patients diagnosed (clinical and imaging) with knee ostoarthritis, who were treated on an outpatient basis, from May to September 2020, were studied. The parameters assessed in the study were pain, joint stiffness, the ability to carry out daily activities, anxiety and quality of life. Results and discussion.The studied group of patients was homogeneous in terms of the weight by age group and gender. Higher values were recorded in the study group in the evaluation of patients based on scales, the results being statistically significant, with value for p<0.05, which means that the hypothesis was validated. Conclusions. Patients of the study group recorded improvementin of functional capacity, joint stability and static and dynamic balance, which allowed a faster reintegration into the family and society. Keywords: physical activity, pain, elderly people, knee osteoarthritis,

Raw and wine processed Schisandra chinensis attenuate anxiety like behavior via modulating gut microbiota and lipid metabolism pathway

ETHNOPHARMACOLOGICAL RELEVANCE

In traditional Chinese medicine, the fruit of Schisandra chinensis (Turcz.) Baill (SC) is used to treat various nervous system diseases, such as dysphoria, anxiety, insomnia and many dreams. It is worthy to be noted that wine processed Schisandra chinensis (WSC) has been applied in clinic for thousands of years.

AIM OF STUDY

This study aimed to investigate the possible mechanism and related metabolism of SC and WSC ameliorating anxiety behavior through modulating gut microbiota.

MATERIALS AND METHODS

The ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-QTOF-MS) was used for the quality control of chemical components in SC and WSC. Chronic unpredictable stress procedure (CUSP)-induced anxiety rats were administrated with SC and WSC via gavage for five weeks. An untargeted UPLC/LTQ-Orbitrap MS metabolomic analysis of plasma was conducted to understand the effects of long-term intake of WSC and SC extracts on anxious rats. 16S rRNA microbial sequencing technology was applied to investigate gut microbiota structure. Expression of GPR81, TNF-α, S1PR2 as well as molecules in cAMP pathway was assayed by immunohistochemistry staining, RT-qPCR, or Western blot, respectively.

RESULTS

12 compounds were identified using UPLC-QTOF-MS technology, all of which are lignans. Results demonstrate that the amounts of 6-O-Benzoylgomisin O, Schisandrin, Gomisin D, Schizandrin A, Gomisin T, Schizandrin B, Schisandrin C were higher in wine-processed samples than in raw samples. Furthermore, both SC and WSC significantly ameliorated anxiety- and depression-like behavior and lipid metabolism dysfunction and attenuated hippocampal neuritis in anxiety rats. After WSC treatment, the structure and composition of gut microbiota in anxiety rats changed significantly, and gut microbiota derivatives lactate level was significantly lower in the plasma and feces. WSC treatment help restore gut microbial ecosystem dysbiosis and reverse the changes in Lachnospiraceae, Lactobacillus, Alloprevotella, and Bacteroidales in anxiety rat. In addition, the expression of liver GPR81 was decreased, and the molecules in cAMP pathway were increased in SC and WSC-treated anxiety rat.

CONCLUSION

Raw and wine processed Schisandra chinensis treatment improved anxiety- and depression-like behavior through modulating gut microbiota derivatives in association with GPR81 receptor-mediated lipid metabolism pathway. And WSC has more exhibition than SC.

How to Exercise During Coronavirus Quarantine?

The COVID-19 pandemic caused stress and anxiety in many people that can be reduced by regular physical activity. Regular physical exercise is essential for health. In the absence of COVID-19 symptoms, no limitation in physical activity is recommended. However, parameters such as frequency, intensity, type, and time need to be considered to prescribe the program and obtain the best results. Consequently, the level of physical activity that should be done during the outbreak has always been one of the most important and common questions.

Comparison of maximal lactate steady state with anaerobic threshold determined by various methods based on graded exercise test with 3-minute stages in elite cyclists

Background

The maximal lactate steady state (MLSS) is defined as the highest workload that can be maintained for a longer period of time without continued blood lactate (LA) accumulation. MLSS is one of the physiological indicators of aerobic performance. However, determination of MLSS requires the performance of a series of constant-intensity tests during multiple laboratory visits. Therefore, attempts are made to determine MLSS indirectly by means of anaerobic threshold (AT) evaluated during a single graded exercise test (GXT) until volitional exhaustion. The aim of our study was to verify whether AT determined by maximal deviation (D_max), modified maximal deviation (ModD_max), baseline LA concentration + 1 mmol/l (+ 1 mmol/l), individual anaerobic threshold (IAT), onset of blood lactate accumulation (OBLA_4mmol/l) and V-slope methods based on GXT with 3-min stages provide valid estimates of MLSS in elite cyclists.

Methods

Twelve elite male cyclists (71.3 ± 3.6 ml/kg/min) completed GXT (the increase by 40 W every 3 min) to establish the AT (by D_max, ModD_max, + 1 mmol/l, IAT, OBLA_4mmol/l and V-slope methods). Next, a series of 30-min constant-load tests to determine MLSS was performed. Agreement between the MLSS and workload (WR) at AT was evaluated using the Bland–Altman method.

Results

The analysis revealed a very high (r_s > 0.90, p < 0.001) correlation between WR_MLSS and WR_Dmax and WR_IAT. The other AT methods were highly (r_s > 0.70) correlated with MLSS except for OBLA_4mmol/l (r_s = 0.67). The Bland-Altman analysis revealed the highest agreement with MLSS for the D_max, IAT and + 1 mmol/l methods. Mean difference between WR_MLSS and WR_Dmax, WR_IAT and WR_+1mmol/l was 1.7 ± 3.9 W, 4.3 ± 7.9 W and 6.7 ± 17.2 W, respectively. Furthermore, the WR_Dmax and WR_IAT had the lowest limits of agreement with the WR_MLSS. The ModD_max and OBLA_4mmol/l methods overestimated MLSS by 31.7 ± 18.5 W and 43.3 ± 17.8 W, respectively. The V-slope method underestimated MLSS by 36.2 ± 10.9 W.

Conclusions

The AT determined by D_max and IAT methods based on the cycling GXT with 3-min stages provides a high agreement with the MLSS in elite cyclists. Despite the high correlation with MLSS and low mean difference, the AT determined by + 1 mmol/l method may highly overestimate or underestimate MLSS in individual subjects. The individual MLSS cannot be properly estimated by V-slope, ModD_max and OBLA_4mmol/l methods.

Predicting Health Care Workers' Tolerance of Personal Protective Equipment: An Observational Simulation Study

BACKGROUND

More recently, due to the coronavirus disease 2019 pandemic, health care workers have to deal with clinical situations wearing personal protective equipment (PPE); however, there is a question of whether everybody will tolerate PPE equally. The main objective of this study was to develop a risk model to predict whether health care workers will tolerate wearing PPE, C category, 4B/5B/6B type, during a 30-minute simulation.

METHODS

A nonexperimental simulation study was conducted at the Advanced Simulation Center, Faculty of Medicine, Valladolid University (Spain) from April 3rd to 28th, 2017. Health care students and professionals were equipped with PPE and performed a 30-minute simulation. Anthropometric, physiological, and analytical variables and anxiety levels were measured before and after simulation. A scoring model was constructed.

RESULTS

Ninety-six volunteers participated in the study. Half the sample presented metabolic fatigue in the 20 minutes after finishing the simulation. The predictive model included female sex, height, muscle and bone mass, and moderate level of physical activity. The validity of the main model using all the variables presented an area under the curve of 0.86 (95% confidence interval: 0.786-0.935), and the validity of the model had an area under the curve of 0.725 (95% confidence interval: 0.559-0.89).

CONCLUSIONS

Decision-making in biohazard incidents is a challenge for emergency team leaders. Knowledge of health care workers' physiological tolerance of PPE could improve their performance.

Psychophysiological respond in a swimming ultra-endurance event

BACKGROUND

Ultra-endurance events under critical environmental conditions represent unique stress, resulting in acute marked adaptations to the cardiovascular, respiratory, metabolic and neuromuscular systems of the organism. In line with this, no studies in swimming events were found thus far.

METHODS

This research aimed to analyze the psychophysiological response of swimmers in an ultra-endurance swimming event. Changes in the rate of perceived exertion, blood lactate concentration, 1000m swimming time and cortical arousal were measured in 19 male volunteer swimmers (28.0±5.6 years; 175.0±7.9 cm; 70.1±7.8 kg) in 3 moments during a 24h swimming event.

RESULTS

We found a significant increase in lactate concentration after series 1, decreasing the values in series 2 and series 3. Cortical arousal decreased significantly in series 3 respect the basal sample. Rate of perceived exertion significantly increased in the swimming ultra-endurance event and 1000m swimming time was maintained during the series analyzed.

CONCLUSIONS

An ultra-endurance swimming event produced an increase in blood lactate concentration and rated of perceived exertion and a decrease in cortical arousal, not affecting average swimming velocity along the event.

Do Rescuers' Physiological Responses and Anxiety Influence Quality Resuscitation under Extreme Temperatures?

Teaching and training cardiopulmonary resuscitation (CPR) through simulation is a priority in Health Sciences degrees. Although CPR is taught as a simulation, it can still be stressful for the trainees since it resembles a real-life circumstance. The aim of this study was to assess the physiological effects and anxiety levels of health sciences undergraduates when faced with CPR process in different temperatures (room temperature, extremely cold, or extremely warm). This was a descriptive cross-sectional before–after study conducted during the 2018/2019 academic year with 59 students registered in the Faculty of Health Sciences of the Castilla-La Mancha University (UCLM). State Trait Anxiety Inventory (STAI) questionnaires were distributed among the students before and after the CPR simulation. We found greater level of situational anxiety in undergraduates faced with extreme adverse temperature scenarios (extreme heat and cold), especially in conditions of extreme heat compared to controlled environment (at room temperature). We discovered differences regarding sex, in which men scored 6.4 ± 5.55 points (STAI after CPR score) and women scored 10.4 ± 7.89 points (STAI after CPR score). Furthermore, there was less lactate in blood, before and during the event in individuals with anxiety. In addition, beginning in Minute 7, we observed a remarkable decrease (but not significant) in the performance of rescuers with anxiety. Programs targeted at promoting coping mechanisms to reduce anxiety before a critical clinic situation should be implemented in academic training.