Cognitive Stress Research Articles

Impact Anxiety on Quality of Life and Clinical Outcomes of Patients with Acute Coronary Syndrome

Acute coronary syndromes (ACS) are a common ischemic heart disease (IHD) with high morbidity and mortality. Anxiety is common among cardiac patients, has potentially serious consequences if untreated, and is infrequently assessed or managed appropriately. The co-occurrence of anxiety symptoms and ACS is responsible for decreasing the quality of life (QoL) of patients with ACS. Anxiety is a common emotional response among acute coronary syndrome (ACS) patients. Anxiety is frequently encountered in ACS. It is believed that the prevalence of anxiety among cardiac patients is between 15 and 50%. Patients with ACS often experience anxiety due to the sudden onset of symptoms, the potential severity of their condition, and the uncertainty of their prognosis. Anxiety can also be a risk factor for adverse cardiac events and may interfere with treatment adherence and rehabilitation efforts. Therefore, it is important for healthcare providers to recognize and address anxiety in patients with ACS. This can involve a combination of pharmacological interventions, such as benzodiazepines or selective serotonin reuptake inhibitors (SSRIs), and non-pharmacological interventions, such as cognitive behavioural therapy, relaxation techniques, and stress management strategies. Additionally, healthcare providers can provide education and support to help patients better understand their condition and manage their symptoms. The importance of increased awareness and treatment of anxiety among patients with cardiac disease is stressed.

Continuous real-time assessment of acute cognitive stress from cardiac mechanical signals captured by a skin-like patch

The inability to objectively quantify cognitive stress in real-time with wearable devices is a crucial unsolved problem with serious negative consequences for dementia and mental disability patients and those seeking to improve their quality of life. Here, we introduce a skin-like, wireless sternal patch that captures changes in cardiac mechanics due to stress manifesting in the seismocardiogram (SCG) signals. Judicious optimization of the device's micro-structured interconnections and elastomer integration yields a device that sufficiently matches the skin's mechanics, robustly yet gently adheres to the skin without aggressive tapes, and captures planar and longitudinal SCG waves well. The device transmits SCG beats in real-time to a user's device, where derived features relate to the heartbeat's mechanical morphology. The signals are assessed by a series of features in a support vector machine regressor. Controlled studies, compared to gold standard cortisol and following the validated imaging test, show an R-squared correlation of 0.79 between the stress prediction and cortisol change, significantly improving over prior works. Likewise, the system demonstrates excellent robustness to external temperature and physical recovery status while showing excellent accuracy and wearability in full-day use.

Evaluating the Protective Effects of Melatonin Against Chronic Iron Administration in Male Wistar Rats: a Comparative Analysis of Affective, Cognitive, and Oxidative Stress with EDTA Chelator.

Iron is the dominant metal in the brain and is distributed widely. However, it can lead to various neuropathological and neurobehavioral abnormalities as well as oxidative stress. On the other hand, melatonin, a pineal hormone, is known for its neuroprotective properties, as well as its ability to act as a natural chelator against oxidative stress. It has also been used as an antidepressant and anxiolytic. The study investigated the potential of melatonin and EDTA treatment to prevent anxiety, depressive behavior, and memory impairment in male rats induced by chronic iron administration, and its connection to oxidative stress regulation in the hippocampus and prefrontal cortex. The rats were divided into six groups and intraperitoneally injected for 8weeks with NaCl solution (control), iron sulfate (1mg/kg), melatonin (4mg/kg), EDTA (4mg/kg), 1mg/kg of iron + 4mg/kg of melatonin, or 1mg/kg of iron + 4mg/kg of EDTA. In this study, we performed a neurobehavioral assessment and biochemical determinations of oxidative stress levels in the hippocampus and prefrontal cortex of each animal. The results indicate that chronic exposure to iron sulfate induced anxiety-like depressive behavior, and cognitive impairment also increased the levels of lipid peroxidation and nitric oxide, and reduced the activity of catalase in the hippocampus and prefrontal cortex in male Wistar rats, suggesting the induction of oxidative stress. In contrast, these alterations were reversed by melatonin better than EDTA. The results of this study show that melatonin protects against the neurobehavioral changes caused by iron, which may be associated with decreasing oxidative stress in the hippocampus and prefrontal cortex.

Do deficits in subjective stress recovery predict subsequent stress sensitivity and symptoms in schizophrenia spectrum disorders?

High levels of stress play a crucial role in the development of psychotic symptoms, such as paranoia, and may stem in part from recovery deficits after stress exposure. However, it remains unclear whether deficient recovery causes a build-up of heightened stress levels that increases stress sensitivity and symptoms when exposed to another stressor. To test this, we investigated the effect of subjective stress recovery on the response to a subsequent stressor and paranoia.We applied two consecutive runs of the same combined physical and cognitive stressor separated by a recovery phase of 60 min in individuals with schizophrenia spectrum disorders (n = 49). We repeatedly assessed self-reported stress, negative affect, heart rate, heart rate variability, salivary cortisol, and paranoia. Recovery of self-reported stress was defined as the geometric mean of the percentage changes of self-reported stress during recovery after the first stressor, and was regressed on the response to the second stressor controlling for self-reported stress during the first stressor.Lower subjective stress recovery predicted higher levels of self-reported stress, negative affect, and paranoia in response to the second stressor. The subjective stress recovery was not predictive of the physiological stress response (heart rate, heart rate variability, or salivary cortisol).Taken together, the findings indicate that recovery deficits could contribute to high levels of self-reported stress, negative affect, and paranoia in schizophrenia spectrum disorders and that the improvement of stress recovery could be a promising approach for interventions.

COGNITIVE ASPECTS OF MANAGING STRESS AND UNWANTED EMOTION SUCCESSFULLY IN OLD AGE

Abstract The ability to cope with stressors and manage unwanted emotion is central to health-related outcomes across adulthood. Prominent models of adult development suggest there may be age-related shifts in motivational strivings and accumulated knowledge that help support emotional well-being in old age. At the same time, older adults have cognitive and physical vulnerabilities that may offset some of these strengths. This session will showcase new work leveraging experimental and experiencing sampling methods to examine how people of varying ages and resource levels manage their emotions. These studies provide new insights into how older adults respond to stressors and adverse stimuli in controlled settings and daily life contexts. The first talk centers on how individuals are negatively impacted by cognitive stressors regardless of age, but older adults show more resilience than younger adults after stressor exposure. The second talk focuses on how a cognitive process known as affective labeling (or naming one’s emotions) can create emotion regulation difficulties, especially in old age. The third talk examines emotion regulation success and the benefits of instructional support for cognitively normal older adults compared to those with mild cognitive impairment (MCI). The fourth talk extends this work by tracking emotion regulation motives in daily life, showing that cognitively diverse older adults report fewer attempts to manage their emotions, but similar reasons for doing so, compared to relatively younger adults. Together these presentations delineate age-related similarity and differences in emotion regulation, highlighting avenues through which coping capacity may be maintained and improve in late life.

AGE DIFFERENCES IN STRESSOR REACTIVITY AND RECOVERY

Abstract Strength and vulnerability integration theory (SAVI; Charles, 2010) posits that age differences in emotional experiences vary based on the distance from an emotionally eliciting event. Before and after a stressor, SAVI predicts that older age is related to motivational strivings that often result in higher levels of well-being. During stressor exposure, however, age effects are predicted to be attenuated or disappear completely. The present study examined how younger (n = 85; M age = 22.56 years) and older (n = 85; M age = 71.05 years) adults reacted to and recovered from a cognitive stressor using repeated positive and negative emotion probes. Results showed that both age groups were negatively impacted by the stressor, and both reported an initial boost in recovery afterward. However, older adults continued to recover across the recovery period compared to younger adults. This work elucidates that older adults are significantly impacted by stress but exhibit a resounding recovery.

Memory support training and lifestyle modifications to promote healthy aging in persons at risk for Alzheimer's disease: a digital application supported intervention (Brain Boosters)

BackgroundEvidence-based interventions to protect against cognitive decline among older adults at risk for Alzheimer’s disease and related dementias (ADRD) are urgently needed. Rehabilitation approaches to support memory and behavioral/lifestyle interventions are recognized as promising strategies for preserving or improving cognitive health, although few previous interventions have combined both approaches. This paper describes the protocol of the Brain Boosters intervention, which synergistically combines training in compensatory and healthy lifestyle behaviors and supports implementation and tracking of new behaviors with a digital application.MethodsThe study utilizes a single-site, single-blinded, randomized controlled design to compare a structured lifestyle and compensatory aid intervention to an education-only self-guided intervention. We plan to enroll 225 community-dwelling adults (25% from underrepresented groups) aged 65 + who endorse subjective cognitive decline (SCD) and low baseline levels of healthy lifestyle behaviors. Both interventions will be administered in group format, consisting of 15 two-hour classes that occur weekly for ten weeks and taper to bi-monthly and monthly, for an intervention duration of 6 months. Participants in both interventions will receive education about a variety of memory support strategies and healthy lifestyle behaviors, focusing on physical and cognitive activity and stress management. The structured intervention will also receive support in adopting new behaviors and tracking set goals aided by the Electronic Memory and Management Aid (EMMA) digital application. Primary outcomes include global cognition (composite of memory, attention, and executive function tests) and everyday function (Everyday Cognition Questionnaire). Data will be collected at baseline and outcome visits, at approximately 6, 12, and 18 months. Qualitative interviews, self-report surveys (e.g., indicators of self-determination, health literacy) and EMMA data metrics will also be used to identify what components of the intervention are most effective and for whom they work.DiscussionSuccessful project completion will provide valuable information about how individuals with SCD respond to a compensation and preventative lifestyle intervention assisted by a digital application, including an understanding of factors that may impact outcomes, treatment uptake, and adherence. The work will also inform development, scaling, and personalization of future interventions that can delay disability in individuals at risk for ADRD.Trial RegistrationClinicalTrials.gov. (NCT05027789, posted 8/30/2021).

Lateral prefrontal cortex thickness is associated with stress but not cognitive fatigue in exhaustion disorder.

Impaired executive functioning, including cognitive fatigue, is a core feature of the long-term stress-related condition exhaustion disorder (ED). Recent research suggests that a key area for executive control, the lateral prefrontal cortex (LPFC), may be mechanistically linked to cognitive fatigue due to stress. Here, we therefore asked if and how stress, the LPFC and cognitive fatigue may be related in ED. We used a multimodal cross-sectional study design with high-resolution structural magnetic resonance imaging (MRI), self-reported measures, and path analysis modeling in 300 participants with ED. We found positive associations between stress and cognitive fatigue, and stress and LPFC thickness,but no association between LPFC thickness and cognitive fatigue. Furthermore, LPFC thickness did not mediate or moderate the association between stress and cognitive fatigue. These findings suggest that LPFC brain morphology is related to perceived stress levels but not cognitive fatigue, expanding previous research on the role of the LPFC in executive functioning. Moreover, the results support the notion that the LPFC may be mechanistically involved in stress-related executive function impairment but prompt further research into if and how this may be related to cognitive symptoms in ED.

The relationship between mental workload and nurse stress levels in hospitals

High mental workload implies significant mental resources and can lead to increased cognitive stress and fatigue. Nurses have the responsibility of managing a wide range of nursing care tasks, which frequently involve addressing anxiety, handling patient complaints, and managing patient defense mechanisms, all of which can lead to increased stress levels. This study aimed to identify the relationship between mental workload and the stress level of nurses in the Hospital Malang City. The research utilized a cross-sectional study design. The sampling technique employed was Total Sampling, involving 96 inpatient nurses at the hospital. Data collection involved the use of two questionnaires: the National Aeronautics and Space Administration Task Load Index (NASA-TLX) and the Perceived Stress Scale (PSS-10). Data analysis in this study was conducted using Pearson Correlation. The results indicated a positive relationship between mental workload and nurses' stress levels, supported by a significant p-value of 0.002 and a correlation coefficient of 0.312. A high mental workload can impact the level of job-related stress experienced by nurses. Effective stress management skills can help individuals mitigate this impact.

Evaluation of tracheostomy suctioning procedure among nursing and respiratory therapy students: wearable manikin vs. standard manikin.

This study aims to evaluate cognitive load (CL), emotional levels (EL), and stress levels (SL) of students when using a wearable manikin vs. a standard manikin for tracheostomy suctioning (TS). This study was approved by the Institutional Review Board. Subjects were recruited by email. Subjects completed a baseline demographics questionnaire, then they were randomized into two groups: wearable manikin group (WMG) or standard manikin group (SMG). For the WMG, an actor simulated a patient by wearing the device. In phase I, both groups were educated on how to perform TS by video and offered hands-on practice. Then I put through a tracheostomy suctioning clinical simulation and completed a post sim-survey. In phase II, the same survey was repeated after encountering a real patient as part of their clinical rotation. A total of 30 subjects with a mean age 26.0 ± 5.5 years participated. 20 (66.7%) were respiratory care students and 10 (33.3%) were nursing students. In the WMG, the median stress level dropped significantly post phase II compared to post phase I [2(1,4) vs.3(1,5), p = 0.04]. There were no significant changes in median CL, confidence, and satisfaction levels between post phase II and post phase I (p > 0.05). In the SMG, the satisfaction level increased significantly post phase II compared to post phase I [5(4,5) vs.4(2,5), p = 0.004], but there were no significant changes in CL, SL, and confidence levels between post phase I and phase II. There was no significant difference in mean EL scores over time and these changes did not differ by group. Subjects in the WMG showed a higher mean competency score than those in the SMG (85.5 ± 13.6 vs. 78.5 ± 20.8, p = 0.14, Cohen's d = 0.4), yet not significant. Our results showed that the WMG is beneficial in helping bridge the gap of learning TS from the sim setting to the real-world clinical setting. More studies with higher sample size and use of other CL scales that assesses the different types of CL are needed to validate our findings.

Explainable stress type classification captures physiologically relevant responses in the Maastricht Acute Stress Test.

Current stress detection methods concentrate on identification of stress and non-stress states despite the existence of various stress types. The present study performs a more specific, explainable stress classification, which could provide valuable information on the physiological stress reactions. Physiological responses were measured in the Maastricht Acute Stress Test (MAST), comprising alternating trials of cold pressor (inducing physiological stress and pain) and mental arithmetics (eliciting cognitive and social-evaluative stress). The responses in these subtasks were compared to each other and to the baseline through mixed model analysis. Subsequently, stress type detection was conducted with a comprehensive analysis of several machine learning components affecting classification. Finally, explainable artificial intelligence (XAI) methods were applied to analyze the influence of physiological features on model behavior. Most of the investigated physiological reactions were specific to the stressors, and the subtasks could be distinguished from baseline with up to 86.5% balanced accuracy. The choice of the physiological signals to measure (up to 25%-point difference in balanced accuracy) and the selection of features (up to 7%-point difference) were the two key components in classification. Reflection of the XAI analysis to mixed model results and human physiology revealed that the stress detection model concentrated on physiological features relevant for the two stressors. The findings confirm that multimodal machine learning classification can detect different types of stress reactions from baseline while focusing on physiologically sensible changes. Since the measured signals and feature selection affected classification performance the most, data analytic choices left limited input information uncompensated.

The relationship between Structural, PET, and Plasma Alzheimer’s Disease Biomarkers and neuropsychological composites among Latino bilinguals and monolinguals

AbstractBackgroundEstimates from the Alzheimer’s Association indicate that approximately one in ten older adults in the US have Alzheimer’s disease (AD) dementia while 15 to 20% have mild cognitive impairment (MCI), projecting that about a third of those will develop dementia within five years. The Cognitive Reserve/ Resilience (CR/R) theory postulates that complex mental activity throughout the lifetime builds resilience to cognitive decline despite the biological risk (a neurodegenerative disease). Emerging evidence shows that bilingualism may be one of these neuroprotective factors in the aging brain, but results in bilingualism and CR/R remain inconsistent.MethodsWe studied 238 Latino older adults (age 71.8 ± 8.0 years old, 65% female) from the 1Florida Alzheimer’s Disease Research Center who were diagnosed as clinically normal, MCI, or dementia. Of these, 158 were Spanish‐English bilinguals and 80 were Spanish monolinguals. Bilingualism was assessed by a proficiency questionnaire. Six cognitive composites were developed (Figure 1). We investigated cognitive test correlates of plasma P‐tau181 (Quanterix simoa), hippocampal volume, and amyloid PET (Centiloid) biomarkers in both language groups, using 2×3 ANCOVAs (controlling for age and level of education). We analyzed correlations between biomarkers and cognition and performed multiple regression analyses within each language group.ResultsThe main effect of the diagnostic group was significant for all biomarkers (ps < .001). There was no main effect of the language group and no significant interactions. The correlations between biomarkers were equally significant for both language groups but differences in the association of biomarkers with cognitive tests emerged between language groups. Bilinguals showed a stronger negative association between hippocampal volume and cognitive test scores than monolinguals. In bilinguals, higher PTau181 was associated with lower visuomotor composite scores, while amyloid PET positivity and lower hippocampal volume were associated with cognitive stress and working memory. In monolinguals, higher PTau181 was associated with worse inhibitory control, and amyloid PET positivity and lower hippocampal volume were associated with worse memory.ConclusionResults demonstrated discrepancies between bilingual and monolingual Latinos in the associations between cognitive composites and AD biomarkers. Further exploring the relationship between bilingualism, cognitive test scores, and biomarker patterns is warranted, especially longitudinally.

Impact of Listening to Indian Classical Music, or Rāgas, on the Electroencephalogram: A Meta-Analysis.

Ancient Indian classical music (ICM) has long been lauded and recognized for influencing emotional responses by influencing the human body's resonance. A meta-analysis of prospective case studies published in the last ten years on the effect of ancient Indian music rāgas on brain waves is investigated. This meta-analysis aimed to analyze published prospective studies investigating the effect of ancient Indian rāgas on EEG in healthy subjects. The present study included prospective studies published since 2012. Studies were obtained by searching four databases, such as PsychINFO, PubMed, Google Scholar, and JSTOR, and searching related journals. Eligibility criteria included studies assessing the impact of listening to Indian classical music on the EEG. Primary outcomes were changes in the brain waves, frequency, and power and their relationship to activity-related arousal, attention, and mental tasks. The studies were analyzed according to the PRISMA guidelines. There were a total of five included studies with 71 participants in the age range of 19-30, and the conditions for the test groups were generally similar except for varying types of rāgas used and time of day. Analysis of the data collected from 71 participants revealed that music interventions had statistically significant effects on increasing alpha activity and attention scores. Fractal analysis was sensitive enough to detect EEG brainwave changes while and after listening to the rāga musical intervention. Rāgas stimulate arousal in different areas of the brain, depending on the emotions they are designed to evoke. However, the synchronized studies together could not highlight a significant relationship between rāgas and EEG fractal dimension values. Although the meta-analysis failed to reproduce the same results from the individual studies, potentially due to the small sample size and study variation, the meta-analysis opens doors to the potential of rāgas to elicit distinct emotions and serve as robust predictors of emotional response. Future studies can explore the therapeutic potential of various rāgas in the clinical setting, such as in the management of cognitive disorders and stress or in modulating heart rate variability and cognitive performance.

Environmental enrichment reverses stress-induced changes in the brain-gut axis to ameliorate chronic visceral and somatic hypersensitivity

IntroductionBehavioral therapies, including cognitive behavioral therapy, hypnotherapy and stress management activities, have emerged as effective treatments for irritable bowel syndrome (IBS), a female predominant disorder of the brain-gut axis. IBS, affecting over 10% of the global population, typically presents with abnormal bowel habits and abdominal pain due to visceral hypersensitivity. While the mechanisms underlying how behavioral therapies treat IBS are still elusive, we had previously shown that chronic stress alters gene expression in brain regions critical for stress processing and nociception. We found that exposure to an enriched environment (EE), the rodent analogue of behavioral therapies, prior to and during the stressor was sufficient to prevent stress-induced changes in glucocorticoid receptor (GR) expression in the central nucleus of the amygdala (CeA) and hippocampus. Pre-exposure to EE also inhibited stress-induced increased colonic permeability and was able to block the induction of stress-induced visceral and somatic hypersensitivity. However, it remains unknown if EE can reverse chronic viscerosomatic hypersensitivity that persists following exposure to stress. We hypothesized that EE after chronic stress would be sufficient to reverse stress-induced changes in i) GR expression in the CeA and hippocampus, ii) ameliorate stress-induced colonic hyperpermeability and iii) restore normal visceral and somatic sensitivity in male and female rats. MethodsMale and female rats were exposed to daily water avoidance stress (WAS). After confirming the rats had developed visceral hypersensitivity, 50% of the animals were housed in EE for 2 weeks while the other 50% remained in standard housing (SH). At the end of this period, we assessed visceral and somatic sensitivity. We also collected colon tissue to measure colonic permeability. Micro-punches of tissue from the CeA and hippocampus were isolated to measure GR expression. Control animals not exposed to WAS were kept in SH for the duration of the study (n = 8 per group). ResultsIn both male and female rats, EE reversed stress-induced visceral (p < 0.001) and somatic (p < 0.01) hypersensitivity when compared to WAS animals housed in SH to levels comparable to control animals. EE exposure also reversed changes in GR expression in both the hippocampus (p < 0.01) and CeA (p < 0.01), normalizing GR expression to control levels. EE exposure ameliorated stress-induced colonic hyperpermeability in both male (p < 0.01) and female (p < 0.01) rats compared to WAS rats in SH. ConclusionOur findings suggest that behavioral therapies are viable therapeutic options for IBS as they can counter the stress-induced pathophysiology underlying IBS symptoms including visceral hypersensitivity, increased colonic permeability and altered gene expression.

Description and Causes of Indonesian Health Workers' Anxiety During the COVID-19 Pandemic: A Mixed-Method Study

Introduction: The findings of a systematic review indicate that only a quantitative or qualitative approach was used in studies about the anxiety of health professionals during the COVID-19 pandemic. Research that aims to examine the level of anxiety experienced by Indonesian health workers during the COVID-19 pandemic, the signs and their causes will fill the scientific gap. Methods: A sequential explanatory design was used in this study. In the quantitative phase, the COVID-19 Anxiety Scale instrument was used to perform a survey on 731 healthcare workers, which was then descriptively examined. To further support its findings, 30 informants were involved to in-depth interviews, and qualitative content analysis was performed. Results: According to the poll, 15% of healthcare workers reported having high anxiety, 61% had moderate, 19% had low, and 5% had no anxiety at all. According to a qualitative content analysis, the signs of anxiety included overthinking, psychosomatic complaints, and worry about exposed to and transmit the virus at work. This is a result of managerial issues with managing pandemic, social changes, adjustments in interpersonal connection patterns, an unfriendly society, a large number of health workers who suffer with COVID-19, as well as personal variables. Conclusion: Preventive action for future health crisis situations is to improve systemic physical and non-physical preparedness in healthcare institutions. Psychosocial training programs such as cognitive coping and stress adaptation need to be carried out to improve the mental health condition of health workers so they don't ‘collapse’ when dealing crisis situations.

Influence of Psychosocial Risks on the Quality of Life of Employees in a Higher Education Institution - A Critical Perspective

According to Muchinsky (2000), the activity in which humans are most involved in their lives is work. Thus, there is an increasing trend towards the humanization of work. Consequently, it is imperative to study the best ways to manage human resources in 21st-century organizations. The main objective of this study is to understand the influence that psychosocial risks in the workplace may have on the personal lives of employees in a Higher Education Institution (HEI), through the application of the Portuguese version of COPSOQ II. Both exploratory and confirmatory statistical analyses were conducted on the results to determine if factors related to work could influence aspects of personal life. It was concluded that great importance is given to employment and that factors related to the professional realm can indeed influence dimensions of these employees' personal lives. Among other things, it was observed that, in the case of the analyzed HEI, cognitive demands directly impact job satisfaction, quantitative demands have direct effects on work-family conflict, and job satisfaction directly influences somatic and cognitive stress. On the other hand, it was found that work-family conflict is primarily influenced by quantitative demands, highlighting the importance of a well-balanced distribution of workload among employees and the definition of concrete objectives.

Effect of dexmedetomidine on convalescence quality after general anesthesia and postoperative delirium, and on cognitive function in elderly patients undergoing lower limb surgery

Purpose: To investigate the effect of different doses of dexmedetomidine on the quality of postoperative recovery, incidence of postoperative delirium, and cognitive function in elderly patients undergoing lower limb surgery.&#x0D; Methods: A total of 112 patients who received treatment in the Department of Anesthesiology, Affiliated Hospital of Inner Mongolia Medical University, Hothot, China from January 2021 to January 2023 were divided into 3 groups, consisting of low-dose group (35 patients received 0.2 mg/kg), medium-dose group (39 patients received 0.4 mg/kg), and high-dose group (38 patients received 0.6 mg/kg). Parameters including, convalescence quality of general anesthesia, incidence of postoperative delirium, adverse reactions, Mini- mental State Examination (MMSE) scores, sedation effect (Ramsay), analgesia effect (visual analogue scale (VAS)), and stress indices, viz, norepinephrine (NE), epinephrine (E), and cortisol (COR) levels), were evaluated and compared.&#x0D; Results: There was no significant difference in tracheal extubation time, recovery time of spontaneous breathing, calling eye-opening time, or full awakening time among the three groups (p &gt; 0.05). However, MMSE score was significantly higher in low-dose group on days 1 and 3 after surgery (p &lt; 0.05) and VAS scores were significantly higher in low-dose group at 12 and 24 h after recovery compared to other groups (p &lt; 0.05). Ramsay score was significantly higher in high-dose group (p &lt; 0.05). Levels of NE, E, and COR were significantly lower in medium-dose group compared to other groups (p &lt; 0.05). Incidence of adverse reactions were significantly lower in low and medium-dose groups compared to high- dose group (p &lt; 0.05).&#x0D; Conclusion: Medium-dose dexmedetomidine demonstrates favorable sedative and analgesic effects with minimal impact on cognitive function and stress response in elderly patients undergoing lower limb surgery. Furthermore, it does not affect quality of postoperative recovery nor incidence of postoperative delirium. More large-scale, randomized controlled studies are needed to confirm these results.

Stress and Emotion Detection System Using IoT and Machine Learning with a Fuzzy Inference-Based Mental Health Risk Assessment Module

This research paper describes the conceptualization, deployment, and application of a stress and emotion detection system (SEDS) that utilizes emerging technologies including machine learning, the Internet of Medical Things (IoMT), and fuzzy logic. Particle Photon microcontrollers were used to collect and analyze data from non-invasive biosensing devices, input switches for behavioral, emotional, and cognitive stress indicators, and input signals generated by the machine learning-based facial identification sub-module, which detects an individual's emotional states (happy, sad/upset, angry/irritable, or nervous/scared). The acquired parameters were stored and made readily accessible using IoT cloud services and dedicated mobile phone applications. The emotional condition of an individual was assessed by the utilization of the Personal Image Classifier tool within the MIT App Inventor, which involved the analysis of facial expressions. Furthermore, the SEDS was integrated with a module for mental health risk assessment which employs fuzzy logic to categorize the user's stress-related psychological health threat level as very low, low, moderate, high, or extremely high based on the data collected. The customized smartphone application provided users specific recommendations for effectively managing their mental health, based on stress level assessments. When the SEDS determined that the level of mental health risk posed by stress was high, it automatically generated a referral notification and transmitted it via text message to the mental health care professional, facilitating the provision of appropriate psychological counseling. Based on the collected data, the stress and emotion detection system produced results that were comparable to those from the DASS21 stress scale. The system demonstrated an improved accuracy of 90% in a test involving thirty individuals who volunteered to participate. The machine learning-based emotion detection system achieved a classification accuracy of 86.67% in correctly detecting happy, neutral, sad, angry, or nervous feelings through the analysis of facial expressions. This research is designed to provide mental health care professionals such as guidance counselors, psychologists, and psychiatrists with the resources essential to facilitate the evaluation and treatment of mental health issues. It also aims to raise people's understanding and detection of psychological conditions through enhanced awareness initiatives.

Multimodal Assessment of Cognitive Workload Using Neural, Subjective and Behavioural Measures in Smart Factory Settings.

Collaborative robots (cobots) have largely replaced conventional industrial robots in today's workplaces, particularly in manufacturing setups, due to their improved performance and intelligent design. In the framework of Industry 5.0, humans are working alongside cobots to accomplish the required level of automation. However, human-robot interaction has brought up concerns regarding human factors (HF) and ergonomics. A human worker may experience cognitive stress as a result of cobots' irresponsive nature in unpredictably occurring situations, which adversely affects productivity. Therefore, there is a necessity to measure stress to enhance a human worker's performance in a human-robot collaborative environment. In this study, factory workers' mental workload was assessed using physiological, behavioural, and subjective measures. Electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS) signals were collected to acquire brain signals and track hemodynamic activity, respectively. The effect of task complexity, cobot movement speed, and cobot payload capacity on the mental stress of a human worker were observed for a task designed in the context of a smart factory. Task complexity and cobot speed proved to be more impactful. As physiological measures are unbiased and more authentic means to estimate stress, eventually they may replace the other conventional measures if they prove to correlate with the results of traditional ones. Here, regression and artificial neural networks (ANN) were utilised to determine the correlation between physiological data and subjective and behavioural measures. Regression performed better for most of the targets and the best correlation (rsq-adj = 0.654146) was achieved for predicting missed beeps, a behavioural measure, using a combination of multiple EEG and fNIRS predictors. The k-nearest neighbours (KNN) algorithm was used to evaluate the accuracy of correlation between traditional measures and physiological variables, with the highest accuracy of 77.8% achieved for missed beeps as the target. Results show that physiological measures can be more insightful and have the tendency to replace other biased parameters.

Effects of a laboratory-based aerobic exercise intervention on brain volume and cardiovascular health markers: protocol for a randomised clinical trial

IntroductionPhysical activity (PA) has beneficial effects on brain health and cardiovascular disease (CVD) risk. Yet, we know little about whether PA-induced changes to physiological mediators of CVD risk influence brain...