The effect of stress on core and peripheral body temperature in humans

The effect of SSRIs on unconditioned anxiety: a systematic review and meta-analysis of animal studies

RATIONALE

Selective serotonin reuptake inhibitors (SSRIs) are the first choice of treatment for anxiety-like disorders. However, which aspects of anxiety are affected by SSRIs is not yet fully understood.

OBJECTIVE

We aimed to systematically review the effect of six clinically effective SSRIs on four aspects of unconditioned anxiety: approach-avoidance behaviour (elevated plus maze), repetitive behaviour (marble burying), distress behaviour (ultrasonic vocalization), and activation of the autonomous nervous system (stress-induced hyperthermia).

METHODS

We identified publications by searching Medline and Embase databases and assessed the risk of bias. A random effects meta-analysis was performed and moderator effects were analysed with Bayesian penalized meta-regression.

RESULTS

Our search yielded 105 elevated plus maze, 63 marble burying, 11 ultrasonic vocalization, and 7 stress-induced hyperthermia articles. Meta-analysis suggested that SSRIs reduce anxiety-like behaviour in the elevated plus maze, marble burying and ultrasonic vocalization test and that effects are moderated by pre-existing stress conditions (elevated plus maze) and dose dependency (marble burying) but not by duration of treatment or type of SSRI. The reporting quality was low, publication bias was likely, and heterogeneity was high.

CONCLUSION

SSRIs seem to reduce a broad range of unconditioned anxiety-associated behaviours. These results should be interpreted with caution due to a high risk of bias, likely occurrence of publication bias, substantial heterogeneity and limited moderator data availability. Our review demonstrates the importance of including bias assessments when interpreting meta-analysis results. We further recommend improving the reporting quality, the conduct of animal research, and the publication of all results regardless of significance.

Hypothermic sepsis in time since death estimation - a case report

Both hyper- and hypothermia are problematic in temperature based forensic time since death estimation. Hyperthermia may occur in infection, traumatic brain injury, and intoxication. Hypothermia is encountered predominantly in exposure. Sepsis may present itself clinically as hypothermic. Sepsis is not uncommon in the forensic setting and mostly occurs in the context of malpractice accusations. There is usually little overlap between sepsis and typical forensic time since death estimation scenarios of violent or otherwise suspicious deaths. In the presented case, hypothermia and time since death estimations did collide. An inmate was found dead in his jail cell. Wardens claimed they had visually approached him alive relatively shortly prior. Rectal temperature measurements, using two separate crime scene thermometers as well as temperature loggers, revealed low rectal temperature at relatively high ambient temperature. These findings suggested a much longer postmortem interval and consequently raised doubts about the stated timeline. The wardens' claims were however confirmed by camera recordings, which also allowed a reasonable estimate of the true time of death. The cause of death was confirmed as septic organ failure at autopsy, which explained low rectal temperature. The presence of WISCHNEWSKI-spots was noted. When the PRISM-method was applied to the temperature recordings, low rectal temperature at the time of death was detected successfully. However, adaptation of the underlying equation for lower "starting temperature" did not produce satisfactory results. It is concluded that even though hypothermia at the time of death may possibly be detected from temperature data, attempts at time since death estimation for cases of hypothermia by adaptation of the equation should be avoided.

Physiological Profiling of Agitation in Dementia: Insights From Wearable Sensor Data

Background and Objectives

The number of people with dementia is expected to triple to 152 million in 2050, with 90% having accompanying behavioral and psychological symptoms (BPSD). Agitation is among the most critical BPSD and can lead to decreased quality of life for people with dementia and their caregivers. This study aims to explore objective quantification of agitation in people with dementia by analyzing the relationships between physiological and movement data from wearables and observational measures of agitation.

Research Design and Methods

The data presented here is from 30 people with dementia, each included for 1 week, collected following our previously published multimodal data collection protocol. This observational protocol has a cross-sectional repeated measures design, encompassing data from both wearable and fixed sensors. Generalized linear mixed models were used to quantify the relationship between data from different wearable sensor modalities and agitation, as well as motor and verbal agitation specifically.

Results

Several features from wearable data are significantly associated with agitation, at least the p < .05 level (absolute β: 0.224-0.753). Additionally, different features are informative depending on the agitation type or the patient the data were collected from. Adding context with key confounding variables (time of day, movement, and temperature) allows for a clearer interpretation of feature differences when a person with dementia is agitated.

Discussion and Implications

The features shown to be significantly different, across the study population, suggest possible autonomic nervous system activation when agitated. Differences when splitting the data by agitation type point toward a need for future detection models to tailor to the primary type of agitation expressed. Finally, patient-specific differences in features indicate a need for patient- or group-level model personalization. The findings reported in this study both reinforce and add to the fundamental understanding of and can be used to drive the objective quantification of agitation.

The Prediction of Stress in Radiation Therapy: Integrating Artificial Intelligence with Biological Signals

This study aimed to predict stress in patients using artificial intelligence (AI) from biological signals and verify the effect of stress on respiratory irregularity. We measured 123 cases in 41 patients and calculated stress scores with seven stress-related features derived from heart-rate variability. The distribution and trends of stress scores across the treatment period were analyzed. Before-treatment information was used to predict the stress features during treatment. AI models included both non-pretrained (decision tree, random forest, support vector machine, long short-term memory (LSTM), and transformer) and pretrained (ChatGPT) models. Performance was evaluated using 10-fold cross-validation, exact match ratio, accuracy, recall, precision, and F1 score. Respiratory irregularities were calculated in phase and amplitude and analyzed for correlation with stress score. Over 90% of the patients experienced stress during radiation therapy. LSTM and prompt engineering GPT4.0 had the highest accuracy (feature classification, LSTM: 0.703, GPT4.0: 0.659; stress classification, LSTM: 0.846, GPT4.0: 0.769). A 10% increase in stress score was associated with a 0.286 higher phase irregularity (p < 0.025). Our research pioneers the use of AI and biological signals for stress prediction in patients undergoing radiation therapy, potentially identifying those needing psychological support and suggesting methods to improve radiotherapy effectiveness through stress management.

Design of a Remote Multiparametric Tool to Assess Mental Well-Being and Distress in Young People (mHealth Methods in Mental Health Research Project): Protocol for an Observational Study

BACKGROUND

Mental health conditions have become a substantial cause of disability worldwide, resulting in economic burden and strain on the public health system. Incorporating cognitive and physiological biomarkers using noninvasive sensors combined with self-reported questionnaires can provide a more accurate characterization of the individual's well-being. Biomarkers such as heart rate variability or those extracted from the electrodermal activity signal are commonly considered as indices of autonomic nervous system functioning, providing objective indicators of stress response. A model combining a set of these biomarkers can constitute a comprehensive tool to remotely assess mental well-being and distress.

OBJECTIVE

This study aims to design and validate a remote multiparametric tool, including physiological and cognitive variables, to objectively assess mental well-being and distress.

METHODS

This ongoing observational study pursues to enroll 60 young participants (aged 18-34 years) in 3 groups, including participants with high mental well-being, participants with mild to moderate psychological distress, and participants diagnosed with depression or anxiety disorder. The inclusion and exclusion criteria are being evaluated through a web-based questionnaire, and for those with a mental health condition, the criteria are identified by psychologists. The assessment consists of collecting mental health self-reported measures and physiological data during a baseline state, the Stroop Color and Word Test as a stress-inducing stage, and a final recovery period. Several variables related to heart rate variability, pulse arrival time, breathing, electrodermal activity, and peripheral temperature are collected using medical and wearable devices. A second assessment is carried out after 1 month. The assessment tool will be developed using self-reported questionnaires assessing well-being (short version of Warwick-Edinburgh Mental Well-being Scale), anxiety (Generalized Anxiety Disorder-7), and depression (Patient Health Questionnaire-9) as the reference. We will perform correlation and principal component analysis to reduce the number of variables, followed by the calculation of multiple regression models. Test-retest reliability, known-group validity, and predictive validity will be assessed.

RESULTS

Participant recruitment is being carried out on a university campus and in mental health services. Recruitment commenced in October 2022 and is expected to be completed by June 2024. As of July 2023, we have recruited 41 participants. Most participants correspond to the group with mild to moderate psychological distress (n=20, 49%), followed by the high mental well-being group (n=13, 32%) and those diagnosed with a mental health condition (n=8, 20%). Data preprocessing is currently ongoing, and publication of the first results is expected by September 2024.

CONCLUSIONS

This study will establish an initial framework for a comprehensive mental health assessment tool, taking measurements from sophisticated devices, with the goal of progressing toward a remotely accessible and objectively measured approach that maintains an acceptable level of accuracy in clinical practice and epidemiological studies.

TRIAL REGISTRATION

OSF Registries N3GCH; https://doi.org/10.17605/OSF.IO/N3GCH.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/51298.

Your blush gives you away: detecting hidden mental states with remote photoplethysmography and thermal imaging

Multimodal emotion recognition techniques are increasingly essential for assessing mental states. Image-based methods, however, tend to focus predominantly on overt visual cues and often overlook subtler mental state changes. Psychophysiological research has demonstrated that heart rate (HR) and skin temperature are effective in detecting autonomic nervous system (ANS) activities, thereby revealing these subtle changes. However, traditional HR tools are generally more costly and less portable, while skin temperature analysis usually necessitates extensive manual processing. Advances in remote photoplethysmography (r-PPG) and automatic thermal region of interest (ROI) detection algorithms have been developed to address these issues, yet their accuracy in practical applications remains limited. This study aims to bridge this gap by integrating r-PPG with thermal imaging to enhance prediction performance. Ninety participants completed a 20-min questionnaire to induce cognitive stress, followed by watching a film aimed at eliciting moral elevation. The results demonstrate that the combination of r-PPG and thermal imaging effectively detects emotional shifts. Using r-PPG alone, the prediction accuracy was 77% for cognitive stress and 61% for moral elevation, as determined by a support vector machine (SVM). Thermal imaging alone achieved 79% accuracy for cognitive stress and 78% for moral elevation, utilizing a random forest (RF) algorithm. An early fusion strategy of these modalities significantly improved accuracies, achieving 87% for cognitive stress and 83% for moral elevation using RF. Further analysis, which utilized statistical metrics and explainable machine learning methods including SHapley Additive exPlanations (SHAP), highlighted key features and clarified the relationship between cardiac responses and facial temperature variations. Notably, it was observed that cardiovascular features derived from r-PPG models had a more pronounced influence in data fusion, despite thermal imaging's higher predictive accuracy in unimodal analysis.

Elevated body temperature is associated with depressive symptoms: results from the TemPredict Study

Correlations between altered body temperature and depression have been reported in small samples; greater confidence in these associations would provide a rationale for further examining potential mechanisms of depression related to body temperature regulation. We sought to test the hypotheses that greater depression symptom severity is associated with (1) higher body temperature, (2) smaller differences between body temperature when awake versus asleep, and (3) lower diurnal body temperature amplitude. Data collected included both self-reported body temperature (using standard thermometers), wearable sensor-assessed distal body temperature (using an off-the-shelf wearable sensor that collected minute-level physiological data), and self-reported depressive symptoms from > 20,000 participants over the course of ~ 7 months as part of the TemPredict Study. Higher self-reported and wearable sensor-assessed body temperatures when awake were associated with greater depression symptom severity. Lower diurnal body temperature amplitude, computed using wearable sensor-assessed distal body temperature data, tended to be associated with greater depression symptom severity, though this association did not achieve statistical significance. These findings, drawn from a large sample, replicate and expand upon prior data pointing to body temperature alterations as potentially relevant factors in depression etiology and may hold implications for development of novel approaches to the treatment of major depressive disorder.

Sex differences in body temperature and neural power spectra in response to repeated restraint stress

Repeated stress is associated with an increased risk of developing psychiatric illnesses such as post-traumatic stress disorder (PTSD), which is more common in women, yet the neurobiology behind this sex difference is unknown. Habituation to repeated stress is impaired in PTSD, and recent preclinical studies have shown that female rats do not habituate as fully as male rats to repeated stress, which leads to impairments in cognition and sleep. Further research should examine sex differences after repeated stress in other relevant measures, such as body temperature and neural activity. In this study, we analyzed core body temperature and EEG power spectra in adult male and female rats during restraint, as well as during sleep transitions following stress. We found that core body temperature of male rats habituated to repeated restraint more fully than female rats. Additionally, we found that females had a higher average beta band power than males on both days of restraint, indicating higher levels of arousal. Lastly, we observed that females had lower delta band power than males during sleep transitions on Day 1 of restraint, however, females demonstrated higher delta band power than males by Day 5 of restraint. This suggests that it may take females longer to initiate sleep recovery compared with males. These findings indicate that there are differences in the physiological and neural processes of males and females after repeated stress. Understanding the way that the stress response is regulated in both sexes can provide insight into individualized treatment for stress-related disorders.

Severity of depressive symptoms moderates the sympathoinhibitory effect of local skin warming following exposure to a social stressor

Depression is the leading cause of disease burden globally. Existing antidepressant treatments that target the central nervous system have limited efficacy and come at the cost of significant side effects. Thus, there is growing interest in novel therapeutic interventions for the prevention and treatment of depression, including interventions that target interoceptive signaling. The thermosensory system may hold particular promise, given evidence that depression is associated with impairments in thermosensory functioning, and that whole-body hyperthermia produces an antidepressant effect in patients with major depressive disorder. In this study, we investigated whether the severity of depressive symptoms in a non-clinical population moderated the effect of local skin warming on subjective and physiological stress responses following exposure to an acute social stressor. Following exposure to the stressor, participants (N = 90) rested their arm on a heat blanket that was either turned on (local skin warming condition) or left off (control condition). We demonstrate that local skin warming increased fingertip temperature, a marker of reduced sympathetic nervous system activity, but only for participants with high levels of depressive symptoms. While local skin warming also inhibited salivary alpha amylase, severity of depressive symptoms did not moderate this effect, and no effect was found for electrodermal activity. These data highlight the importance of incorporating peripheral physiology in our conceptualization of the pathophysiology of depression and show that changes in sympathetic nervous system activity may underpin the antidepressant effect of warm stimuli.

Effects of wearing medical gowns at different temperatures on the physiological responses of female healthcare workers during the COVID-19 pandemic

BACKGROUND

Using medical gowns with high protection against COVID-19 among healthcare workers (HCWs) may limit heat exchange, resulting in physiological challenges.

OBJECTIVE

This study aimed to compare the physiological and neurophysiological responses of female HCWs when using two typical medical gowns at different temperatures during the COVID-19 pandemic.

METHODS

Twenty healthy female HCWs participated in this study. Participants wore two types of medical gowns: Spunbond gown (SG) and laminate gown (LG). They walked on a treadmill in a controlled climate chamber for 30 minutes at three different temperatures (24, 28, and 32°C). Heart rate (HR), skin surface temperature (ST), clothing surface temperature (CT), ear temperature (ET), blood oxygen percentage (SaO2), galvanic skin response (GSR), and blood pressure were measured before and after walking on a treadmill. The study's results were analyzed using SPSS26.

RESULTS

The study found that LG led to an average increase of 0.575°C in CT compared to SG at the same temperatures (P < 0.03). The average HR increased by 6.5 bpm in LG at 28°C compared to SG at a comfortable temperature (P = 0.01). The average ET in SG and GSR in LG at 32°C increased by 0.39°C and 0.25μS, respectively, compared to the comfortable temperature (P < 0.02).

CONCLUSION

The study recommends maintaining a comfortable temperature range in hospitals to prevent physiological challenges among HCWs wearing medical gowns with high protection against COVID-19. This is important because using LG, compared to SG, at high temperatures can increase HR, ET, CT, and GSR.

Physiological Signals and Affect as Predictors of Advertising Engagement

This study investigated the use of affect and physiological signals of heart rate, electrodermal activity, pupil dilation, and skin temperature to classify advertising engagement. The ground truth for the affective and behavioral aspects of ad engagement was collected from 53 young adults using the User Engagement Scale. Three gradient-boosting classifiers, LightGBM (LGBM), HistGradientBoostingClassifier (HGBC), and XGBoost (XGB), were used along with signal fusion to evaluate the performance of different signal combinations as predictors of engagement. The classifiers trained on the fusion of skin temperature, valence, and tiredness (features n = 5) performed better than those trained on all signals (features n = 30). The average AUC ROC scores for the fusion set were XGB = 0.68 (0.10), LGBM = 0.69 (0.07), and HGBC = 0.70 (0.11), compared to the lower scores for the set of all signals (XGB = 0.65 (0.11), LGBM = 0.66 (0.11), HGBC = 0.64 (0.10)). The results also show that the signal fusion set based on skin temperature outperforms the fusion sets of the other three signals. The main finding of this study is the role of specific physiological signals and how their fusion aids in more effective modeling of ad engagement while reducing the number of features.

Recent Advances in Multiplexed Wearable Sensor Platforms for Real-Time Monitoring Lifetime Stress: A Review

Researchers are interested in measuring mental stress because it is linked to a variety of diseases. Real-time stress monitoring via wearable sensor systems can aid in the prevention of stress-related diseases by allowing stressors to be controlled immediately. Physical tests, such as heart rate or skin conductance, have recently been used to assess stress; however, these methods are easily influenced by daily life activities. As a result, for more accurate stress monitoring, validations requiring two or more stress-related biomarkers are demanded. In this review, the combinations of various types of sensors (hereafter referred to as multiplexed sensor systems) that can be applied to monitor stress are discussed, referring to physical and chemical biomarkers. Multiplexed sensor systems are classified as multiplexed physical sensors, multiplexed physical-chemical sensors, and multiplexed chemical sensors, with the effect of measuring multiple biomarkers and the ability to measure stress being the most important. The working principles of multiplexed sensor systems are subdivided, with advantages in measuring multiple biomarkers. Furthermore, stress-related chemical biomarkers are still limited to cortisol; however, we believe that by developing multiplexed sensor systems, it will be possible to explore new stress-related chemical biomarkers by confirming their correlations to cortisol. As a result, the potential for further development of multiplexed sensor systems, such as the development of wearable electronics for mental health management, is highlighted in this review.

Thermoregulatory responses, heart rate, and the susceptibility to anxiety in obese animals subjected to stress

Obesity and stress are related to cardiovascular diseases. Rats fed a high-fat diet (HFD) show increased cardiovascular reactivity to emotional stress and altered defensive behavioral responses. Indeed, changes in thermoregulatory responses in an aversive environment are observed in these animals. However, studies aimed at clarifying the physiological mechanisms linking obesity, stress hyperreactivity and behavioral changes are needed. The aim of this study was to evaluate the changes in thermoregulatory responses, heart rate, and the susceptibility to anxiety in obese animals subjected to stress. Nine-week high-fat diet protocol was effective in inducing obesity by increasing weight gain, fat mass, adiposity index, white epididymal, retroperitoneal, inguinal and brown adipose tissue. Animals induced to obesity and subjected to stress (HFDS group) by the intruder animal method showed increases in heart rate (HR), core body temperature and tail temperature. HFDS showed an increase in the first exposure to the closed arm (anxiety-like behavior) in elevated T-Maze (ETM). The groups did not differ with respect to panic behavior assessed in the ETM and locomotor activity in the open field test. Our study shows that HFDS animals presented increased reactivity to stress with higher stress hyperthermia and anxious behavior. Thus, our results present relevant information regarding stress responsiveness and behavioral changes in obese animals.

Dynamic fluctuations in ascending heart-to-brain communication under mental stress

Dynamical information exchange between central and autonomic nervous systems, as referred to functional brain-heart interplay, occurs during emotional and physical arousal. It is well documented that physical and mental stress lead to sympathetic activation. Nevertheless, the role of autonomic inputs in nervous system-wise communication under mental stress is yet unknown. In this study, we estimated the causal and bidirectional neural modulations between electroencephalogram (EEG) oscillations and peripheral sympathetic and parasympathetic activities using a recently proposed computational framework for a functional brain-heart interplay assessment, namely the sympathovagal synthetic data generation model. Mental stress was elicited in 37 healthy volunteers by increasing their cognitive demands throughout three tasks associated with increased stress levels. Stress elicitation induced an increased variability in sympathovagal markers, as well as increased variability in the directional brain-heart interplay. The observed heart-to-brain interplay was primarily from sympathetic activity targeting a wide range of EEG oscillations, whereas variability in the efferent direction seemed mainly related to EEG oscillations in the γ band. These findings extend current knowledge on stress physiology, which mainly referred to top-down neural dynamics. Our results suggest that mental stress may not cause an increase in sympathetic activity exclusively as it initiates a dynamic fluctuation within brain-body networks including bidirectional interactions at a brain-heart level. We conclude that directional brain-heart interplay measurements may provide suitable biomarkers for a quantitative stress assessment and bodily feedback may modulate the perceived stress caused by increased cognitive demand.

Exploring digital biomarkers of illness activity in mood episodes: hypotheses generating and model development study

BACKGROUND

Depressive and manic episodes within bipolar disorder (BD) and major depressive disorder (MDD) involve altered mood, sleep, and activity alongside physiological alterations that wearables can capture.

OBJECTIVE

We explored whether physiological wearable data could predict: (aim 1) the severity of an acute affective episode at the intra-individual level, (aim 2) the polarity of an acute affective episode and euthymia among different individuals. Secondarily, we explored which physiological data were related to the prior predictions, generalization across patients, and associations between affective symptoms and physiological data.

METHODS

We conducted a prospective exploratory observational study including patients with BD and MDD on acute affective episodes (manic, depressed, and mixed) whose physiological data were recorded with a research-grade wearable (Empatica E4) across three consecutive timepoints (acute, response, and remission of episode). Euthymic patients and healthy controls (HC) were recorded during a single session (∼48 hours). Manic and depressive symptoms were assessed with standardized psychometric scales. Physiological wearable data included the following channels: acceleration (ACC), temperature (TEMP), blood volume pulse (BVP), heart rate (HR), and electrodermal activity (EDA). For data pre-processing, invalid physiological data were removed using a rule-based filter, channels were time-aligned at 1 second time units and then segmented window lengths of 32 seconds, since those parameters showed the best performances. We developed deep learning predictive models, assessed channels' individual contribution using permutation feature importance analysis, and computed physiological data to psychometric scales' items normalized mutual information (NMI). We present a novel fully automated method for analysis of physiological data from a research-grade wearable device, including a rule-based filter for invalid data and a viable supervised learning pipeline for time-series analyses.

RESULTS

35 sessions (1,512 hours) from 12 patients (manic, depressed, mixed, and euthymic) and 7 HC (age 39.7±12.6; 31.6% female) were analyzed. (aim 1) The severity of mood episodes was predicted with moderate (62%-85%) accuracies. (aim 2) The polarity of episodes was predicted with moderate (70%) accuracy. The most relevant features for the former tasks were ACC, EDA, and HR. Kendall W showed fair agreement (0.383) in feature importance across classification tasks. Generalization of the former models were of overall low accuracy, with better results for the intra-individual models. "Increased motor activity" was associated with ACC (NMI>0.55), "aggressive behavior" with EDA (NMI=1.0), "insomnia" with ACC (NMI∼0.6), "motor inhibition" with ACC (NMI∼0.75), and "psychic anxiety" with EDA (NMI=0.52).

CONCLUSIONS

Physiological data from wearables show potential to identify mood episodes and specific symptoms of mania and depression quantitatively, both in BD and MDD. Motor activity and stress-related physiological data (EDA and HR) stand out as potential digital biomarkers for predicting mania and depression respectively. These findings represent a promising pathway towards personalized psychiatry, in which physiological wearable data could allow early identification and intervention of mood episodes.

CLINICALTRIAL

Infrared thermography as a tool for the measurement of negative emotions in dairy cows

In commercial dairy cows, the conditions in which they are kept may lead to negative emotional states associated with the development of chronic physiological and behavioural abnormalities that may compromise their health, welfare and productivity. Such states include fear, stress or anxiety. Behavioural rather than physiological tests are more likely to be used to indicate these states but can be limited by their subjectivity, need for specialised infrastructure and training (of the operator and sometimes the animal) and the time-consuming nature of data collection. Popularly used physiological measures such as blood cortisol may be more appropriate for acute rather than chronic assessments but are easily confounded, for example by a response to the act of measurement per se. More sophisticated physiological measures such as functional magnetic resonance imaging (fMRI) and electroencephalography (EEG) may be impractical due to cost and time and, like blood cortisol, have the confounding associated with the act of measurement. By contrast, infrared thermography of external body surfaces is remote, non-invasive, easily repeated and follows an objective methodology, allowing longitudinal data acquisition for the inference of changes in chronic emotional state over time. The objective of this review was to investigate the potential of infrared thermography to measure cow emotions. In lactating dairy cows, maximum IRT of the eyes and coronary band of the limbs seem to be most representative of thermoregulatory changes, which are repeatable and correlate with behavioural and physiological indicators of emotional state. IRT methodologies have the potential to become a fundamental tool for the objective assessment of welfare state in dairy cows.

Assessment of chronic limb threatening ischemia using thermal imaging

OBJECTIVES

Current chronic limb threatening ischemia (CLTI) diagnostics require expensive equipment, using ionizing radiation or contrast agents, or summative surrogate methods lacking in spatial information. Our aim is to develop and improve contactless, non-ionizing and cost-effective diagnostic methods for CLTI assessment with high spatial accuracy by utilizing dynamic thermal imaging and the angiosome concept.

APPROACH

Dynamic thermal imaging test protocol was suggested and implemented with a number of computational parameters. Pilot data was measured from 3 healthy young subjects, 4 peripheral artery disease (PAD) patients and 4 CLTI patients. The protocol consists of clinical reference measurements, including ankle- and toe-brachial indices (ABI, TBI), and a modified patient bed for hydrostatic and thermal modulation tests. The data was analyzed using bivariate correlation.

RESULTS

The thermal recovery time constant was on average higher for the PAD (88%) and CLTI (83%) groups with respect to the healthy young subjects. The contralateral symmetry was high for the healthy young group and low for the CLTI group. The recovery time constants showed high negative correlation to TBI (ρ = -0.73) and ABI (ρ = -0.60). The relation of these clinical parameters to the hydrostatic response and absolute temperatures (|ρ|<0.3) remained unclear.

CONCLUSION

The lack of correlation for absolute temperatures or their contralateral differences with the clinical status, ABI and TBI disputes their use in CLTI diagnostics. Thermal modulation tests tend to augment the signs of thermoregulation deficiencies and accordingly high correlations were found with all reference metrics. The method is promising for establishing the connection between impaired perfusion and thermography. The hydrostatic modulation test requires more research with stricter test conditions.

Machine learning in biosignals processing for mental health: A narrative review

Machine Learning (ML) offers unique and powerful tools for mental health practitioners to improve evidence-based psychological interventions and diagnoses. Indeed, by detecting and analyzing different biosignals, it is possible to differentiate between typical and atypical functioning and to achieve a high level of personalization across all phases of mental health care. This narrative review is aimed at presenting a comprehensive overview of how ML algorithms can be used to infer the psychological states from biosignals. After that, key examples of how they can be used in mental health clinical activity and research are illustrated. A description of the biosignals typically used to infer cognitive and emotional correlates (e.g., EEG and ECG), will be provided, alongside their application in Diagnostic Precision Medicine, Affective Computing, and brain-computer Interfaces. The contents will then focus on challenges and research questions related to ML applied to mental health and biosignals analysis, pointing out the advantages and possible drawbacks connected to the widespread application of AI in the medical/mental health fields. The integration of mental health research and ML data science will facilitate the transition to personalized and effective medicine, and, to do so, it is important that researchers from psychological/ medical disciplines/health care professionals and data scientists all share a common background and vision of the current research.

Psychosomatic response to acute emotional stress in healthy students

The multidimensionality of the stress response has shown the complexity of this phenomenon and therefore the impossibility of finding a unique biomarker among the physiological variables related to stress. An experimental study was designed and performed to guarantee the correct synchronous and concurrent measure of psychometric tests, biochemical variables and physiological features related to acute emotional stress. The population studied corresponds to a group of 120 university students between 20 and 30 years of age, with healthy habits and without a diagnosis of chronic or psychiatric illnesses. Following the protocol of the experimental pilot, each participant reached a relaxing state and a stress state in two sessions of measurement for equivalent periods. Both states are correctly achieved evidenced by the psychometric test results and the biochemical variables. A Stress Reference Scale is proposed based on these two sets of variables. Then, aiming for a non-invasive and continuous approach, the Acute Stress Model correlated to the previous scale is also proposed, supported only by physiological signals. Preliminary results support the feasibility of measuring/quantifying the stress level. Although the results are limited to the population and stimulus type, the procedure and methodological analysis used for the assessment of acute stress in young people can be extrapolated to other populations and types of stress.

Contextual and environmental factors that influence health: A within-subjects field experiment protocol

Background

Despite the growing research on environment-physical activity (PA) relationships, field experimental studies are limited. Such studies offer opportunities to focus on real-world environmental exposure and related PA and health outcomes, allowing researchers to better isolate the causal effect of exposures/interventions. Focusing on the street/pedestrian environment as a routine setting for people's daily activities, this research aims to develop and test a field experiment protocol that integrates instantaneous assessments of the environment, PA, and health outcomes. The protocol involves the use of state-of-the-art environmental monitoring and biosensing techniques and focuses on physically active road users (pedestrians and bicyclists) who are more directly exposed to their surrounding environment than others such as drivers.

Methods/Design

An interdisciplinary research team first identified the target measurement domains for the health outcomes (e.g., stress, thermal comfort, PA) and the street-level environmental exposures (e.g., land use, greenery, infrastructure conditions, air quality, weather) guided by the previous literature which was primarily observational. Portable or wearable measurement instruments (e.g., GPS, accelerometer, biosensor, mini camera, smartphone app, weather station, air quality sensor) were identified, pilot tested, and selected for the identified measures. We ensured that these measures are readily linkable using the time stamp and include eye-level exposures as they impact the users' experiences more directly yet missing in most prior studies relying on secondary, aerial-level measures. A 50-min experimental route was then determined to include typical everyday environments in park and mixed-use settings and to engage participants in three common modes of transportation (walking, bicycling, and driving). Finally, a detailed staff protocol was developed, pilot-tested, and used in a 36-participant within-subject field experiment in College Station, TX. The experiment was successfully executed, showing its potential to support future field experiments that can provide more accurate real-time, real-environment, and multi-dimensional information.

Discussion

Our study demonstrates the feasibility of capturing the multifold health benefits/harms related to walking and bicycling in varying urban environments by combining field experiments with environmental, behavioral, and physiological sensing. Our study protocol and reflections can be helpful for a broad spectrum of research addressing the complex and multi-level pathways between the environment, behavior, and health outcomes.

Combining multiple human physiological signals using fuzzy logic to determine stress caused by battle dress uniforms

Abstract

This study presents a novel stress index for clothing using physiological signals to estimate stress induced by battle dress uniforms (BDU) during physical activity. The approach uses a fuzzy logic-based nonlinear mapping to compute the stress from physiological signals. Ten healthy men performed a battery of physical activities in a controlled environment. Heart rate (HR), respiration rate (RR), skin temperature (ST), and galvanic skin response (GSR) were measured continuously for the participants during activity wearing three kinds of clothing (two BDUs and a control garment). The individual physiological responses were combined using a fuzzy-logic system to derive a stress measure called Clothed Activity Stress Index (CASI). Repeated measures ANOVA showed that the garments significantly (α = .05) affected the HR (p < .001) and RR (p < .001). In addition, interactions between the activity and garment were significant for HR, RR, and ST (p < .001, p < .001, p < .036). The physiological measures differed significantly between rest and activity for the two uniforms. The stress indices (ranging between 0 and 1) during rest and activity were 0.24 and 0.35 for control, 0.27 and 0.43 for BDU-1, and 0.33 and 0.44 for BDU-2. It is shown here that clothing systems impact human stress levels to a measurable level. This computational approach is applicable to measure stress caused by protective wear under different operational conditions and can be suitable for sports and combat gears.

Article Highlights

Thermoregulatory dynamics reveal sex-specific inflammatory responses to experimental autoimmune encephalomyelitis in mice: Implications for multiple sclerosis-induced fatigue in females

The course of multiple sclerosis (MS) is characterized by striking sex differences in symptoms such as fatigue and impaired thermal regulation, which are associated with aggravated systemic pro-inflammatory processes. The purpose of this study was to replicate these symptoms in experimental autoimmune encephalomyelitis (EAE) in C57BL/6 mice in the quest to advance the preclinical study of non-motor symptoms of MS. Male and female C57BL/6 mice exposed to a mild form of EAE were evaluated for the progression of clinical, behavioural, thermal, and inflammatory processes. We show higher susceptibility in females to EAE than males based on greater clinical score and cumulative disease index (CDI), fatigue-like and anxiety-like behaviours. Accordingly, infrared (IR) thermography indicated higher cutaneous temperatures in females from post-induction days 12-23. Females also responded to EAE with greater splenic and adrenal gland weights than males as well as sex-specific changes in pro- and anti-inflammatory cytokines. These findings provide the first evidence of a sex-specific thermal response to immune-mediated demyelination, thus proposing a non-invasive assessment approach of the psychophysiological dynamics in EAE mice. The results are discussed in relation to the thermoregulatory correlates of fatigue and how endogenously elevated body temperature without direct heat exposure may be linked to psychomotor inhibition in patients with MS.

Real-time extended psychophysiological analysis of financial risk processing

We study the relationships between the real-time psychophysiological activity of professional traders, their financial transactions, and market fluctuations. We collected multiple physiological signals such as heart rate, blood volume pulse, and electrodermal activity of 55 traders at a leading global financial institution during their normal working hours over a five-day period. Using their physiological measurements, we implemented a novel metric of trader’s “psychophysiological activation” to capture affect such as excitement, stress and irritation. We find statistically significant relations between traders’ psychophysiological activation levels and such as their financial transactions, market fluctuations, the type of financial products they traded, and their trading experience. We conducted post-measurement interviews with traders who participated in this study to obtain additional insights in the key factors driving their psychophysiological activation during financial risk processing. Our work illustrates that psychophysiological activation plays a prominent role in financial risk processing for professional traders.

Core body temperatures during final stages of life-an evaluation of data from in-hospital decedents

Temperature-based methods are widely accepted as the gold standard for death time estimation. In the absence of any other information, the nomogram method generally assumes that a person died with a core body temperature of approximately 37.2 °C. Nevertheless, several external and internal factors may alter the body temperature during agony. A retrospective medical record analysis was carried out on in-hospital death cases from two consecutive years of surgical intensive care units to determine the effects of factors influencing the core body temperature at the point of death. Data from 103 case files were included in the statistical data evaluation. The body temperature fluctuated between and within individuals over time. No clear correlation to certain death groups was observed. Even primary cardiac deaths showed broad intervals of temperatures at the point of death. Men seem to die with higher body temperatures than women. The presented data highlight potential biases for death time estimations when generally assuming a core body temperature of 37.2 °C. In conclusion, the estimation of the time of death should include various methods, including a non-temperature-dependent method. Any uncertainties regarding the body temperature at point of death need to be resolved (e.g. by identifying fever constellations) and elucidated if elimination is not possible.

Eye surface infrared thermography usefulness as a noninvasive method of measuring stress response in sheep during shearing: Correlations with serum cortisol and rectal temperature values

During shearing, animals' welfare is adversely affected and acute stress occurs. Once animal perceives a threat, it develops behavioral, autonomic, endocrine or immune responses to maintain homeostasis. This study aimed to investigate the usefulness of eye temperature assessment by infrared thermography (IRT) to evaluate acute stress response in sheep undergoing a shearing procedure. From each animal, blood sampling, rectal and eye temperature assessment were performed before shearing (T_PRE), 5 (T_POST5) and 60 (T_POST60) minutes after the end of shearing procedure. On blood samples the serum cortisol concentrations were evaluated. Rectal temperature (T_RECTAL) was measured using a digital thermometer. Thermographic acquisitions of eye temperature were performed from the eye total area (T_EYE) and from three regions of interest (lateral canthus, T_ROI-1; central cornea, T_ROI-2; medial canthus, T_ROI-3). One-way analysis of variance showed a significant increase of serum cortisol concentration, T_RECTAL, T_EYE and T_ROI-3 (p < 0.001). Serum cortisol was positively correlated with T_RECTAL and T_ROI-3 at T_POST5 and T_POST60. T_RECTAL resulted positively correlated with T_ROI-3 at T_PRE, T_POST5 and T_POST60. Agreement between T_RECTAL and each eye temperature considered (T_EYE, T_ROI-1, T_ROI-2, T_ROI-3) has been shown by Bland-Altman plots at each time point of monitoring period. The findings obtained in the current survey suggest that the medial canthus is the most suitable region for eye temperature measurement to asses stress response in animals. Moreover, this study highlighted the usefulness of IRT as an immediate and non-invasive physiological measure to assess stress response in sheep.

Differences in the Course of Physiological Functions and in Subjective Evaluations in Connection With Listening to the Sound of a Chainsaw and to the Sounds of a Forest

We explored differences in the course of physiological functions and in the subjective evaluations in response to listening to a 7-min recording of the sound of a chainsaw and to the sounds of a forest. A Biofeedback 2000x-pert apparatus was used for continual recording of the following physiological functions in 50 examined persons: abdominal and thoracic respiration and their amplitude and frequency, electrodermal activity (skin conductance level), finger skin temperature, heart rate (pulse, blood volume pulse and blood volume pulse amplitude) and heart rate variability (HRV). The group of 25 subjects listening to the sound of a chainsaw exhibited significantly lower values of blood volume pulse amplitude, lower values in peak alpha frequency HRV and higher values in peak high-frequency HRV. In the time interval from 80 s to 209 s, in which the two groups showed the greatest differences, lower values of blood volume pulse were also recorded while listening to the sound of a chainsaw. Listening to the sound of a chainsaw is associated with a greater feeling of fatigue and higher tension, while listening to the sounds of a forest is even considered to elicit feelings of improved learning abilities. The assumption that listening to the sound of a chainsaw results in higher defense arousal was confirmed. The greater variability which is exhibited by a majority of physiological functions while listening to the forest sounds may also be an innovative finding. It seems that there are two types of arousal (sympathetic and parasympathetic) following from correlations between physiological functions and subjective assessment. Low values of blood volume pulse amplitude are especially important from the health perspective. They correspond to the amount of vasoconstriction which occurs in the endothelial dysfunction related to increased mortality, incidence of myocardial infarction, leg atherosclerosis and topically to COVID-19.

Eye Region Surface Temperature and Corticosterone Response to Acute Stress in a High-Arctic Seabird, the Little Auk

Measuring changes in surface body temperature (specifically in eye-region) in vertebrates using infrared thermography is increasingly applied for detection of the stress reaction. Here we investigated the relationship between the eye-region temperature (TEYE; measured with infrared thermography), the corticosterone level in blood (CORT; stress indicator in birds), and some covariates (ambient temperature, humidity, and sex/body size) in a High-Arctic seabird, the Little Auk Alle alle. The birds responded to the capture-restrain protocol (blood sampling at the moment of capturing, and after 30 min of restrain) by a significant TEYE and CORT increase. However, the strength of the TEYE and CORT response to acute stress were not correlated. It confirms the results of a recent study on other species and all together indicates that infrared thermography is a useful, non-invasive measure of hypothalamic-pituitary-adrenal (HPA) axis reactivity under acute activation, but it might not be a suitable proxy for natural variation of circulating glucocorticoid levels.

Quantifying Occupational Stress in Intensive Care Unit Nurses: An Applied Naturalistic Study of Correlations Among Stress, Heart Rate, Electrodermal Activity, and Skin Temperature

OBJECTIVE

To identify physiological correlates to stress in intensive care unit nurses.

BACKGROUND

Most research on stress correlates are done in laboratory environments; naturalistic investigation of stress remains a general gap.

METHOD

Electrodermal activity, heart rate, and skin temperatures were recorded continuously for 12-hr nursing shifts (23 participants) using a wrist-worn wearable technology (Empatica E4).

RESULTS

Positive correlations included stress and heart rate (ρ = .35, p < .001), stress and skin temperature (ρ = .49, p < .05), and heart rate and skin temperatures (ρ = .54, p = .0008).

DISCUSSION

The presence and direction of some correlations found in this study differ from those anticipated from prior literature, illustrating the importance of complementing laboratory research with naturalistic studies. Further work is warranted to recognize nursing activities associated with a high level of stress and the underlying reasons associated with changes in physiological responses.

APPLICATION

Heart rate and skin temperature may be used for real-time detection of stress, but more work is needed to validate such surrogate measures.

Psychophysiology of positive and negative emotions, dataset of 1157 cases and 8 biosignals

Subjective experience and physiological activity are fundamental components of emotion. There is an increasing interest in the link between experiential and physiological processes across different disciplines, e.g., psychology, economics, or computer science. However, the findings largely rely on sample sizes that have been modest at best (limiting the statistical power) and capture only some concurrent biosignals. We present a novel publicly available dataset of psychophysiological responses to positive and negative emotions that offers some improvement over other databases. This database involves recordings of 1157 cases from healthy individuals (895 individuals participated in a single session and 122 individuals in several sessions), collected across seven studies, a continuous record of self-reported affect along with several biosignals (electrocardiogram, impedance cardiogram, electrodermal activity, hemodynamic measures, e.g., blood pressure, respiration trace, and skin temperature). We experimentally elicited a wide range of positive and negative emotions, including amusement, anger, disgust, excitement, fear, gratitude, sadness, tenderness, and threat. Psychophysiology of positive and negative emotions (POPANE) database is a large and comprehensive psychophysiological dataset on elicited emotions.

Central Taurine Attenuates Hyperthermia and Isolation Stress Behaviors Augmented by Corticotropin-Releasing Factor with Modifying Brain Amino Acid Metabolism in Neonatal Chicks

The objective of this study was to determine the effects of centrally administered taurine on rectal temperature, behavioral responses and brain amino acid metabolism under isolation stress and the presence of co-injected corticotropin-releasing factor (CRF). Neonatal chicks were centrally injected with saline, 2.1 pmol of CRF, 2.5 μmol of taurine or both taurine and CRF. The results showed that CRF-induced hyperthermia was attenuated by co-injection with taurine. Taurine, alone or with CRF, significantly decreased the number of distress vocalizations and the time spent in active wakefulness, as well as increased the time spent in the sleeping posture, compared with the saline- and CRF-injected chicks. An amino acid chromatographic analysis revealed that diencephalic leucine, isoleucine, tyrosine, glutamate, asparagine, alanine, β-alanine, cystathionine and 3-methylhistidine were decreased in response to taurine alone or in combination with CRF. Central taurine, alone and when co-administered with CRF, decreased isoleucine, phenylalanine, tyrosine and cysteine, but increased glycine concentrations in the brainstem, compared with saline and CRF groups. The results collectively indicate that central taurine attenuated CRF-induced hyperthermia and stress behaviors in neonatal chicks, and the mechanism likely involves the repartitioning of amino acids to different metabolic pathways. In particular, brain leucine, isoleucine, cysteine, glutamate and glycine may be mobilized to cope with acute stressors.

Autonomic changes as reaction to experimental social stress in an inpatient psychosomatic cohort

OBJECTIVES

Patients with psychosomatic disorders suffer from social isolation that might further lead to destabilization and exacerbation of bodily symptoms via autonomic pathways. We aimed to investigate the influence of controlled social stress (model of social ostracism) on the autonomic nerve system (ANS) in an inpatient cohort with psychosomatic disorders.

METHODS

We examined heart rate variability (HRV), skin conductance (SC) and skin temperature (ST) as well as ECG-derived respiration rate (EDR) and subjective reports on stress during exposure to experimental social stress (cyberball game). Data were collected from 123 participants (f:m = 88:35, 42.01 ± 13.54 years) on admission and upon discharge from the university psychosomatic clinic. All data were recorded during baseline, inclusion and exclusion phases of the cyberball game as well as during the recovery phase.

RESULTS

We found significant changes between admission and discharge with a decline in parasympathetic-related HRV parameters (SDRR -3.20 ± 1.30 ms, p = 0.026; RMSSD: -3.77 ± 1.28 ms, p = 0.007) as well as a decrease in SC (-0.04 ± 0.17 μS, p = 0.019) and EDR (-0.01 ± 0.01 Hz, p = 0.007), suggesting a drop in sympathetic tonus, with no changes in ST (p = 0.089) and subjective stress levels (p = 0.322). HRV parameters decreased during the cyberball game (SDRR p = 0.026; RMSSD p = 0.002; lnHF p < 0.001). In contrast, both SC (p < 0.001) and EDR (p < 0.001) increased during the game with SC being slightly lower during the exclusion phase. This can point toward a stimulation of sympathetic nervous system during game participation, which was concordant with the rise in subjective stress values (p < 0.001). ST showed a continuous, unspecific rise over time (p < 0.001).

CONCLUSION

Our data demonstrate the decrease of ANS parameters during experimental social stress when data upon discharge were compared to those upon admission. These results are partially contradictory to previous studies that showed a rise in HRV in a psychiatric cohort over the course of (outpatient) treatment. Further research is required to help attributing these differences to effects of treatment or acute states relating to admission to or discharge from a psychosomatic department.

Towards a Resilience to Stress Index Based on Physiological Response: A Machine Learning Approach

This study proposes a new index to measure the resilience of an individual to stress, based on the changes of specific physiological variables. These variables include electromyography, which is the muscle response, blood volume pulse, breathing rate, peripheral temperature, and skin conductance. We measured the data with a biofeedback device from 71 individuals subjected to a 10-min psychophysiological stress test. The data exploration revealed that features' variability among test phases could be observed in a two-dimensional space with Principal Components Analysis (PCA). In this work, we demonstrate that the values of each feature within a phase are well organized in clusters. The new index we propose, Resilience to Stress Index (RSI), is based on this observation. To compute the index, we used non-supervised machine learning methods to calculate the inter-cluster distances, specifically using the following four methods: Euclidean Distance of PCA, Mahalanobis Distance, Cluster Validity Index Distance, and Euclidean Distance of Kernel PCA. While there was no statistically significant difference (p>0.01) among the methods, we recommend using Mahalanobis, since this method provides higher monotonic association with the Resilience in Mexicans (RESI-M) scale. Results are encouraging since we demonstrated that the computation of a reliable RSI is possible. To validate the new index, we undertook two tasks: a comparison of the RSI against the RESI-M, and a Spearman correlation between phases one and five to determine if the behavior is resilient or not. The computation of the RSI of an individual has a broader scope in mind, and it is to understand and to support mental health. The benefits of having a metric that measures resilience to stress are multiple; for instance, to the extent that individuals can track their resilience to stress, they can improve their everyday life.

The agreement of rectal temperature with gingival, ocular and metacarpal pad temperatures in clinically healthy dogs

AIMS

To compare alternative methods of recording body temperature (BT) with rectal temperature (RT) in clinically healthy dogs.

METHODS

This prospective study included 97 healthy mixed-breed dogs (43 females and 54 males). The gingival temperature (GT) was collected by using a human non-contact, infrared forehead thermometer, while ocular temperature (OT) and metacarpal pad temperature (MPT) were obtained with an infrared thermal camera. The degree of agreement was determined using the Bland-Altman method, with RT considered as the reference temperature.

RESULTS

A total of 382 readings were obtained from four different anatomical regions. The mean difference and their 95% limits of agreement for the differences between RT-GT, RT-OT, and RT-MPT were 0.18°C (-0.95 to 1.32°C), 0.79°C (-0.45 to 2.04°C), and 0.50°C (-0.63 to 1.62°C), respectively. The GT, OT, and MPT values were within ±0.5°C of RT for 65.9, 19.5, and 52.5% of dogs, respectively.

CONCLUSIONS AND CLINICAL RELEVANCE

Although GT, OT, and MPT were a quick way to estimate BT in dogs, these measurements were not comparable with RT. The GT measurement achieved the best agreement with RT measurement (lowest bias and the highest proportion of measurements within ±0.5°C). The GT could be considered an option for monitoring changes to body temperature in clinically healthy dogs where RT measurement is not possible.

Effect of Exposure Time on Thermal Behaviour: A Psychophysiological Approach

This paper presents the findings of a 6-week long, five-participant experiment in a controlled climate chamber. The experiment was designed to understand the effect of time on thermal behaviour, electrodermal activity (EDA) and the adaptive behavior of occupants in response to a thermal non-uniform indoor environment were continuously logged. The results of the 150 h-long longitudinal study suggested a significant difference in tonic EDA levels between “morning” and “afternoon” clusters although the environmental parameters were the same, suggesting a change in the human body’s thermal reception over time. The correlation of the EDA and temperature was greater for the afternoon cluster (r = 0.449, p < 0.001) in relation to the morning cluster (r = 0.332, p < 0.001). These findings showed a strong temporal dependency of the skin conductance level of the EDA to the operative temperature, following the person’s circadian rhythm. Even further, based on the person’s chronotype, the beginning of the “afternoon” cluster was observed to have shifted according to the person’s circadian rhythm. Furthermore, the study is able to show how the body reacts differently under the same PMV values, both within and between subjects; pointing to the lack of temporal parameter in the PMV model.

Use of wearable physiological sensors to predict cognitive workload in a visuospatial learning task

BACKGROUND

Increased cognitive workload, sometimes known as mental strain or mental effort, has been associated with reduced performance.

OBJECTIVE

The use of physiological monitoring was investigated to predict cognitive workload and performance.

METHODS

Twenty-one participants completed a 10-minute seated rest, a visuospatial learning task modeled after crane operation, and the Stroop test, an assessment that measures cognitive interference. Heart rate, heart rate variability, electrodermal activity, skin temperature, and electromyographic activity were collected.

RESULTS

It was found that participants' ability to learn the simulated crane operation task was inversely correlated with self-reported frustration. Significant changes were also found in physiological metrics in the simulation with respect to rest, including an increase in heart rate, electrodermal activity, and trapezius muscle activity; heart rate and muscle activity were also correlated with simulation performance. The relationship between physiological measures and self-reported workload was modeled and it was found that muscle activity and high frequency power, a measure of heart rate variability, were significantly associated with the workload reported.

CONCLUSIONS

The findings support the use of physiological monitoring to inform real time decision making (e.g., identifying individuals at risk of injury) or training decisions (e.g., by identifying individuals that may benefit from additional training even when no errors are observed).

Academic stress detection on university students during COVID-19 outbreak by using an electronic nose and the galvanic skin response

Academic stress is an emotion that students experience during their time at the university, sometimes causing physical and mental health effects. Because of the COVID-19 pandemic, universities worldwide have left the classroom to provide the method of teaching virtually, generating challenges, adaptations, and more stress in students. In this pilot study, a methodology for academic stress detection in engineering students at the University of Pamplona (Colombia) is proposed by developing and implementing an artificial electronic nose system and the galvanic skin response. For the study, the student's stress state and characteristics were taken into account to make the data analysis where a set of measurements were acquired when the students were presenting a virtual exam. Likewise, for the non-stress state, a set of measurements were obtained in a relaxation state after the exam date. To carry out the pre-processing and data processing from the measurements obtained previously by both systems, a set of algorithms developed in Python software were used to perform the data analysis. Linear Discriminant Analysis (LDA), K-Nearest Neighbors (K-NN), and Support Vector Machine (SVM) classification methods were applied for the data classification, where a 96 % success rate of classification was obtained with the E-nose, and 100 % classification was achieved by using the Galvanic Skin Response.

Implications of surgical mask use in physical education lessons

COVID-19 is being a huge challenge for education systems. Mandatory use of face masks in presential classes may lead to psychophysiological impairment of students, which affect lessons. Thus, the aim of the present research was to analyze the effect of mask use in basal psychophysiological status of physical education students prior to a physical education lesson. We analyzed 72 physical education students in two moments prior to two physical education lessons with 48 h between them. Blood oxygen saturation, body, temple and face temperatures, perceived stress and exertion, and heart rate variability were measured. Results showed that the use of surgical masks in physical education students produced a significant increase on subjective stress perception, sympathetic modulation, cardiovascular response, face, and temple temperature while decreasing blood oxygen saturation. We concluded that the use of surgical masks by physical education students induce modifications on the organic status, which could represent a handicap compromising the academic objectives of physical education lessons. This information can help teachers design efficient physical education lessons.

Prism - A novel approach to dead body cooling and its parameters

In temperature based death time estimation, the mathematical description by Marshall and Hoare is combined with the parameters defined and additional correction factors introduced by Henssge in the Nomogram method (summarized as MHH). Parameters and correction factors however leave room for subjectivity and disagreement. Elevation of rectal temperature at the time of death has been acknowledged as problematic for death time estimation in several studies, but has neither been solved nor systematically integrated into death time estimation methodology. Ambient temperature, when non-constant and/or unknown, may introduce additional errors. Further problems may arise if the fundamental relationship between torso dimensions and total body weight is not comparable to Henssge's dummy cooling model. In this study we present a novel methodological approach to temperature based death time estimation, in which relevant parameters for calculations may be evaluated, corrected and generated using brute-force calculations. Consistency of death time over the course of cooling is used as brute-force target. The calculations produce momentary cooling weights, which are graphed over time. Cooling weight graphs can be analyzed to draw conclusions related to different parameters. The method was used on artificial ideal cooling data which was generated according to MHH for known parameters. Correctness of assumed parameters was confirmed by a linear horizontal path of the cooling weight graph. However, controlled false value input resulted in characteristic graph variations. Elevated rectal temperature at the time of death was detectable from the curve shape until hours after cooling below regular temperature at death. False high and false low ambient temperature produced positive and negative curve slopes. Overall, the method acts much like a prism which breaks up light into its elemental colors. It holds potential for application both in scientific settings and practical case work.

Psychophysiology during exposure to trauma memories: Comparative effects of virtual reality and imaginal exposure for posttraumatic stress disorder

BACKGROUND

This investigation involved an in-depth examination of psychophysiological responses during exposure to the trauma memory across 10 sessions among active duty soldiers with combat-related posttraumatic stress disorder (PTSD) treated by Prolonged Exposure (PE) or Virtual Reality Exposure (VRE). We compared psychophysiological changes, session-by-session, between VRE and traditional imaginal exposure.

METHODS

Heart rate (HR), galvanic skin response (GSR), and peripheral skin temperature were collected every 5 min during exposure sessions with 61 combat veterans of Iraq/Afghanistan and compared to the PTSD Checklist (PCL-C) and Clinician-Administered PTSD Scale (CAPS) outcomes using multilevel modeling.

RESULTS

Over the course of treatment, participants in the PE group had higher HR arousal compared to participants in the VRE group. With reference to GSR, in earlier sessions, participants demonstrated a within-session increase, whereas, in later sessions, participants showed a within-session habituation response. A significant interaction was found for GSR and treatment assignment for within-session change, within-person effect, predicting CAPS (d = 0.70) and PCL-C (d = 0.66) outcomes.

CONCLUSION

Overall, these findings suggest that exposure to traumatic memories activates arousal across sessions, with GSR being most associated with reductions in PTSD symptoms for participants in the PE group.

The Concept of Advanced Multi-Sensor Monitoring of Human Stress

Many people live under stressful conditions which has an adverse effect on their health. Human stress, especially long-term one, can lead to a serious illness. Therefore, monitoring of human stress influence can be very useful. We can monitor stress in strictly controlled laboratory conditions, but it is time-consuming and does not capture reactions, on everyday stressors or in natural environment using wearable sensors, but with limited accuracy. Therefore, we began to analyze the current state of promising wearable stress-meters and the latest advances in the record of related physiological variables. Based on these results, we present the concept of an accurate, reliable and easier to use telemedicine device for long-term monitoring of people in a real life. In our concept, we ratify with two synchronized devices, one on the finger and the second on the chest. The results will be obtained from several physiological variables including electrodermal activity, heart rate and respiration, body temperature, blood pressure and others. All these variables will be measured using a coherent multi-sensors device. Our goal is to show possibilities and trends towards the production of new telemedicine equipment and thus, opening the door to a widespread application of human stress-meters.

Detection of acute stress by smooth muscle electromyography: A translational study on rat and human

AIMS

Non-invasive and simultaneous recording of gastrointestinal (GI) activity during stress induction is still an unexplored field. In our previous investigation, the stress-induced alteration of the gastrointestinal tract was explored in rats. Our aims were to expand our previous rat experiment and to induce stress response in rats (Study 1) and humans (Study 2) to detect the GI tract activity, heart rate and body temperature.

MATERIALS AND METHODS

In the preclinical sample, acute stress was induced by immobilization in Sprague-Dawley rats (N = 10). Acute stress response was generated by the Trier Social Stress Test among healthy volunteers (N = 16). Detection of acute stress was measured by using smooth muscle electromyography, which recorded the myoelectric waves of the gastrointestinal tract (stomach, ileum and colon) simultaneously with heart rate and body temperature in rats and humans.

KEY FINDINGS

The myoelectric waves of the stomach, the cecum and the ileum increased during immobilization in rats, rising in parallel with heart rate and the dermal temperature of the abdominal surface. The same alterations were found during the stress period among humans, except in the case of the colon, where no change was detected.

SIGNIFICANCE

The crucial role of the GI tract in stress response was revealed by translating the outcome of basic research into human results. The similar GI alterations during stress in rats and humans underpin the robustness of our findings. In summary, our preliminary translational-based study can serve as an appropriate basis for further human studies.

A Review of Biophysiological and Biochemical Indicators of Stress for Connected and Preventive Healthcare

Stress is a known contributor to several life-threatening medical conditions and a risk factor for triggering acute cardiovascular events, as well as a root cause of several social problems. The burden of stress is increasing globally and, with that, is the interest in developing effective stress-monitoring solutions for preventive and connected health, particularly with the help of wearable sensing technologies. The recent development of miniaturized and flexible biosensors has enabled the development of connected wearable solutions to monitor stress and intervene in time to prevent the progression of stress-induced medical conditions. This paper presents a review of the literature on different physiological and chemical indicators of stress, which are commonly used for quantitative assessment of stress, and the associated sensing technologies.

Ultra-Short Window Length and Feature Importance Analysis for Cognitive Load Detection from Wearable Sensors

Human cognitive capabilities are under constant pressure in the modern information society. Cognitive load detection would be beneficial in several applications of human–computer interaction, including attention management and user interface adaptation. However, current research into accurate and real-time biosignal-based cognitive load detection lacks understanding of the optimal and minimal window length in data segmentation which would allow for more timely, continuous state detection. This study presents a comparative analysis of ultra-short (30 s or less) window lengths in cognitive load detection with a wearable device. Heart rate, heart rate variability, galvanic skin response, and skin temperature features are extracted at six different window lengths and used to train an Extreme Gradient Boosting classifier to detect between cognitive load and rest. A 25 s window showed the highest accury (67.6%), which is similar to earlier studies using the same dataset. Overall, model accuracy tended to decrease as the window length decreased, and lowest performance (60.0%) was observed with a 5 s window. The contribution of different physiological features to the classification performance and the most useful features that react in short windows are also discussed. The analysis provides a promising basis for future real-time applications with wearable sensors.

Pain and Stress Detection Using Wearable Sensors and Devices-A Review

Pain is a subjective feeling; it is a sensation that every human being must have experienced all their life. Yet, its mechanism and the way to immune to it is still a question to be answered. This review presents the mechanism and correlation of pain and stress, their assessment and detection approach with medical devices and wearable sensors. Various physiological signals (i.e., heart activity, brain activity, muscle activity, electrodermal activity, respiratory, blood volume pulse, skin temperature) and behavioral signals are organized for wearables sensors detection. By reviewing the wearable sensors used in the healthcare domain, we hope to find a way for wearable healthcare-monitoring system to be applied on pain and stress detection. Since pain leads to multiple consequences or symptoms such as muscle tension and depression that are stress related, there is a chance to find a new approach for chronic pain detection using daily life sensors or devices. Then by integrating modern computing techniques, there is a chance to handle pain and stress management issue.

Electronic Devices for Stress Detection in Academic Contexts during Confinement Because of the COVID-19 Pandemic

This article studies the development and implementation of different electronic devices for measuring signals during stress situations, specifically in academic contexts in a student group of the Engineering Department at the University of Pamplona (Colombia). For the research’s development, devices for measuring physiological signals were used through a Galvanic Skin Response (GSR), the electrical response of the heart by using an electrocardiogram (ECG), the electrical activity produced by the upper trapezius muscle (EMG), and the development of an electronic nose system (E-nose) as a pilot study for the detection and identification of the Volatile Organic Compounds profiles emitted by the skin. The data gathering was taken during an online test (during the COVID-19 Pandemic), in which the aim was to measure the student’s stress state and then during the relaxation state after the exam period. Two algorithms were used for the data process, such as Linear Discriminant Analysis and Support Vector Machine through the Python software for the classification and differentiation of the assessment, achieving 100% of classification through GSR, 90% with the E-nose system proposed, 90% with the EMG system, and 88% success by using ECG, respectively.

Roles of β-Endorphin in Stress, Behavior, Neuroinflammation, and Brain Energy Metabolism

β-Endorphins are peptides that exert a wide variety of effects throughout the body. Produced through the cleavage pro-opiomelanocortin (POMC), β-endorphins are the primarily agonist of mu opioid receptors, which can be found throughout the body, brain, and cells of the immune system that regulate a diverse set of systems. As an agonist of the body's opioid receptors, β-endorphins are most noted for their potent analgesic effects, but they also have their involvement in reward-centric and homeostasis-restoring behaviors, among other effects. These effects have implicated the peptide in psychiatric and neurodegenerative disorders, making it a research target of interest. This review briefly summarizes the basics of endorphin function, goes over the behaviors and regulatory pathways it governs, and examines the variability of β-endorphin levels observed between normal and disease/disorder affected individuals.

Pekin ducks are motivated to access their nest site and exhibit a stress-induced hyperthermia when unable to do so

The origins of floor-laying in ducks could be low motivation for a nest, or stress related to difficulties with accessing a nest (e.g. competition). Using a behavioural demand test, we investigated if increasing the work required to access their nest impacted ducks' behaviour and two indicators of stress: egg corticosterone concentration and elevation of core body temperature (stress-induced hyperthermia (SIH)). Twelve laying Pekin ducks previously trained in an operant push-door task were required to use a push-door to access their nest. The door was loaded with increasing weight (0-160% of individual BW, four nights per workload) and eventually blocked to prevent nest access. Before testing, temperature data loggers were implanted in the abdomen. Eggs were collected daily to measure corticosterone concentrations. Behaviour towards the push-door was quantified. Three birds were excluded from the experiment at an early stage. Five of the nine remaining birds pushed all workloads up to 160% BW and attempted to pass the blocked door, with another two birds pushing up to 80 and 140% BW. For those that pushed at all workloads (n = 5) the area under the curve (AUC) of hyperthermia was larger at workloads of 80% (P < 0.001), 120% (P < 0.01), 140% (P < 0.001), 160% (P < 0.001), and when the door was blocked (P < 0.001), compared with 0%. On the first night when the door was blocked, all five birds pushed more at the door, but no attempts were made to push on the following 3 nights, yet the AUC of hyperthermia did not differ between nights 2-4 of the blocked door, compared with the first night that the door was blocked. Increasing workload and inability to access the nest had no effect on corticosterone in egg albumen. It was concluded that laying Pekin ducks were motivated to access a nest. Although it was not possible to differentiate metabolic from psychogenic stress on the first night that nest access was denied, we suggest that the occurrence of hyperthermia on the subsequent nights was due to SIH resulting from frustration at their inability to use their preferred nest. Floor-laying therefore is unlikely due solely to low nest-seeking motivation. Egg corticosterone was not a relevant indicator of acute stress. Strategies to improve nest availability (e.g. decreasing competition) could improve the welfare of commercial ducks.