Physiological Measures Research Articles

The Effects of Music Therapy on Patients Undergoing Colonoscopy in a Tertiary Care Hospital at Karachi, Pakistan: A Comparative Study

A colonoscopy is a procedure commonly used for the diagnosis of colorectal diseases but may be associated with high levels of anxiety and discomfort, which can lead to complications during sedation and decreased patient comfort and cooperation. This study was conducted at a tertiary care hospital in Karachi to assess the effectiveness of music therapy on pre-procedural anxiety, sedation requirements, pain, and procedure duration among patients undergoing colonoscopies. This comparative study included 110 outpatients. The intervention arm received non-lyrical soft music through earphones before and during the colonoscopy procedure, while the control group did not receive any music. In the intervention arm, significant reductions were seen in pre-procedural anxiety scores (p < 0.001), physiological measures (p < 0.001), sedation doses (p < 0.001), and procedure durations (p < 0.05). Control arm showed an increase in heart rate and systolic blood pressure (p < 0.001). Pain scores were similar for both groups. Music therapy is an effective tool to reduce patient anxiety pre- procedure. It is a simple, safe, and noninvasive relaxing intervention that could be used as an adjunct to sedative medications before and during the colonoscopy procedure.

Using Wearable Digital Devices to Screen Children for Mental Health Conditions: Ethical Promises and Challenges.

In response to a burgeoning pediatric mental health epidemic, recent guidelines have instructed pediatricians to regularly screen their patients for mental health disorders with consistency and standardization. Yet, gold-standard screening surveys to evaluate mental health problems in children typically rely solely on reports given by caregivers, who tend to unintentionally under-report, and in some cases over-report, child symptomology. Digital phenotype screening tools (DPSTs), currently being developed in research settings, may help overcome reporting bias by providing objective measures of physiology and behavior to supplement child mental health screening. Prior to their implementation in pediatric practice, however, the ethical dimensions of DPSTs should be explored. Herein, we consider some promises and challenges of DPSTs under three broad categories: accuracy and bias, privacy, and accessibility and implementation. We find that DPSTs have demonstrated accuracy, may eliminate concerns regarding under- and over-reporting, and may be more accessible than gold-standard surveys. However, we also find that if DPSTs are not responsibly developed and deployed, they may be biased, raise privacy concerns, and be cost-prohibitive. To counteract these potential shortcomings, we identify ways to support the responsible and ethical development of DPSTs for clinical practice to improve mental health screening in children.

Assembly complexity and physiological response in human-robot collaboration: Insights from a preliminary experimental analysis

Industry 5.0 paradigm has renewed interest in the human sphere, emphasizing the importance of workers’ well-being in manufacturing activities. In such context, collaborative robotics originated as a technology to support humans in tiring and repetitive tasks. This study investigates the effects of assembly complexity in Human-Robot collaboration using physiological indicators of cognitive effort. In a series of experiments, participants performed assembly processes of different products with varying complexity, in two modalities: manually and with cobot assistance. Physiological measures, including skin conductance, heart rate variability and eye-tracking metrics were collected. The analysis of physiological signals showed trends suggesting the impact of assembly complexity and cobot support. One key finding of the study is that a single physiological signal usually may not provide a complete understanding of cognitive load. Therefore, a holistic approach should be followed. This approach highlighted the importance of considering multiple measures simultaneously to accurately assess workers’ well-being in industrial environments.

Electrophysiological impact of mental fatigue on brain activity during a bike task: A wavelet analysis approach

This study explored how mental fatigue affects brain activity during a low-intensity bike task utilising a continuous wavelet transformation in electroencephalography (EEG) analysis. The aim was to examine changes in brain activity potentially linked to central motor commands and to investigate their relationship with ratings of perceived exertion (RPE). In this study, sixteen participants (age: 21 ± 6 y, 7 females, 9 males) underwent one familiarization and two experimental trials in a randomised, blinded, cross-over study design. Participants executed a low-intensity bike task (9 min; 45 rpm; intensity (W): 10 % below aerobic threshold) after performing a mentally fatiguing (individualized 60-min Stroop task) or a control (documentary) task. Physiological (heart rate, EEG) and subjective measures (self-reported feeling of mental fatigue, RPE, cognitive load, motivation) were assessed prior, during and after the bike task. Post-Stroop, self-reported feeling of mental fatigue was higher in the intervention group (EXP) (74 ± 16) than in the control group (CON) (37 ± 17; p < 0.001). No significant differences in RPE during the bike task were observed between conditions. EEG analysis revealed significant differences (p < 0.05) in beta frequency (13–30 Hz) during the bike task, with EXP exhibiting more desynchronization during the pedal push phase and synchronization during the pedal release phase. These results suggest that mental fatigue, confirmed by both subjective and neurophysiological markers, did not significantly impact RPE during the bike task, possibly due to the use of the CR100 scale or absence of a performance outcome. However, EEG data did reveal significant beta band alterations during the task, indicating increased neural effort under mental fatigue. These findings reveal, for the first time, how motor-related brain activity at the motor cortex is impacted during a low-intensity bike task when mentally fatigued.

Hematological and physiological responses in polo ponies with different field-play positions during low-goal polo matches.

Strenuous exercise in traditional polo matches creates enormous stress on horses. Hematological and physiological measures may vary across different field-play positions. This study aimed to investigate the effort intensity and the impact of exertion on hematology and heart rate variability (HRV) in polo ponies with different positions. Thirty-two ponies, divided equally into eight teams, were studied. Each comprises forwards (number 1), midfielders (numbers 2 and 3), and defenders (number 4). Team pairs played the first chukka in four low-goal polo matches. Percent maximum heart rate (%HRmax), indicating ponies' effort intensity, was classified into five zones, including zones 1 (<70%), 2 (70-80%), 3 (80-90%), 4 (90-95%) and 5 (>95%). Hematological and HRV parameters were determined before, immediately after, and at 30-minute intervals for 180 minutes after chukkas; HRV variables were also obtained during warm-up and exercise periods. Results indicated that the number two ponies spent more time in zone 4 (p < 0.05) but less in zone 2 (p < 0.01) than the number four ponies. Cortisol levels increased immediately and 30 minutes afterward (p < 0.0001 for both) and then returned to baseline 60-90 minutes after exertion. Other measures (Hct, Hb, RBC, WBC, neutrophils, and CK enzyme) increased immediately (p < 0.0001 for all) and lasted at least 180 minutes after exertion (p < 0.05-0.0001). HRV decreased during the chukka until approximately 90 minutes afterward (p < 0.05-0.0001). The stress index increased during the chukka and declined to baseline at 60 minutes in number 1-3 ponies but lasted 90 minutes in those at number four. Effort intensity distribution differed among field-play positions. Decreased HRV indicated reduced parasympathetic activity during exercise, extending to 90 minutes after exertion in polo ponies. Defenders seem to experience more stress than those in other positions.

Six-minute walk test in healthy British service personnel

IntroductionThe 6 min walk test (6MWT) is a widely used, safe and effective submaximal exercise test. The primary outcome is the distance walked, but additional physiological and patient-reported metrics can...

Effect of interface design on cognitive workload in unmanned aerial vehicle control

Unmanned Aerial Vehicle (UAV) control interfaces are critical channels for transferring information between the vehicle and an operator. Research on system performance has focused on enhancing vehicle automation and some work has evaluated cognitive workload for existing UAV interfaces. The potential for usable interface design to reduce cognitive workload during the early design phase has been largely overlooked. This study addresses these gaps by: (1) evaluating the effectiveness of a contemporary UAV interface design tool (the Modified GEDIS-UAV) to moderate user workload; (2) examining the effectiveness of various UAV interface designs for minimizing cognitive workload under different control task pacing; and (3) exploring the use of eye tracking measures, traditionally applied in other domains, as indicators of cognitive workload in UAV operations. We prototyped three different interface designs, classified as “baseline”, “enhanced” and “degraded” interfaces. Cognitive workload in UAV operation was manipulated in terms of levels of vehicle speed (“low” and “high”). Physiological and subjective measures of workload were collected for all combinations of interface design and task demand. Results revealed the “enhanced” interface to yield the lowest operator cognitive workload and supported operator resilience to increased control task demand, as compared to the “baseline” and “degraded” interfaces. In addition, task demand was found to elevate operator cognitive workload, particularly in terms of "mental" and "temporal" demands and operator perceptions of "performance". The study also demonstrated utility of eye-tracking technology for detecting cognitive workload in UAV operations. This research provides practical guidance for UAV control interface design to manage operator workload. The methods employed in the study are applicable to interface evaluation for various types of UAVs and other unmanned systems to enhance human-automation interaction.

Data-efficient multimodal human action recognition for proactive human–robot collaborative assembly: A cross-domain few-shot learning approach

With the recent vision of Industry 5.0, the cognitive capability of robots plays a crucial role in advancing proactive human–robot collaborative assembly. As a basis of the mutual empathy, the understanding of a human operator’s intention has been primarily studied through the technique of human action recognition. Existing deep learning-based methods demonstrate remarkable efficacy in handling information-rich data such as physiological measurements and videos, where the latter category represents a more natural perception input. However, deploying these methods in new unseen assembly scenarios requires first collecting abundant case-specific data. This leads to significant manual effort and poor flexibility. To deal with the issue, this paper proposes a novel cross-domain few-shot learning method for data-efficient multimodal human action recognition. A hierarchical data fusion mechanism is designed to jointly leverage the skeletons, RGB images and depth maps with complementary information. Then a temporal CrossTransformer is developed to enable the action recognition with very limited amount of data. Lightweight domain adapters are integrated to further improve the generalization with fast finetuning. Extensive experiments on a real car engine assembly case show the superior performance of proposed method over state-of-the-art regarding both accuracy and finetuning efficiency. Real-time demonstrations and ablation study further indicate the potential of early recognition, which is beneficial for the robot procedures generation in practical applications. In summary, this paper contributes to the rarely explored realm of data-efficient human action recognition for proactive human–robot collaboration.

Relationships between subjective experience, electroencephalogram, and heart rate variability during a series of cosmetic behavior.

Cosmetic behavior is an important daily activity, especially for women, because it increases visual attractiveness, self-confidence, and positive emotions. However, it is unknown whether a relationship exists between physiological measures and subjective experiences during the series of cosmetic behaviors. Electroencephalograms (EEG) and electrocardiograms (ECG) from thirty female participants who were asked to look in a mirror after applying skincare, as well as base, eye, cheek, and lip makeup were recorded. The price range of cosmetic products was also considered. Subjective evaluations of the skin surface, emotions, and self-confidence were equally measured after looking in the mirror at each step of the cosmetic behavior. Linear mixed models were fitted to examine whether the subjective experience could be explained by the variety of cosmetic products and/or physiological responses. The subjective evaluation was summarized into the following three factors using a factor analysis: self-confidence, hedonic perception, and negative emotion. Each theta-band (4-6 Hz) power, alpha-band (8-13 Hz) power of the EEG, and heart rate variability measures were subjected to a principal component analysis separately. The linear mixed models indicated that the variation in the self-confidence score and the negative emotion score was explained only by the steps of cosmetic behaviors, that is, self-confidence increased while negative emotions decreased as the steps of cosmetic behaviors proceeded. On the other hand, the hedonic perception score was explained by the interaction of the steps of cosmetic behaviors and price, indicating that positive tactile perception and positive emotion were higher when luxury cosmetic products were applied than when affordable products were applied. Furthermore, the model indicated that the hedonic perception score was positively associated with the alpha-band power over occipital sites whereas sympathetic nervous system activity was negatively associated with the alpha-band power over lateral central sites. These results suggest that positive perceptual and emotional experiences are associated with greater attention to somatosensory information than to visual information and sympathetic autonomic nervous system activities. The current results also emphasize the possibility of using physiological measurements as objective measures of cosmetic behavior.

Effects of hearing acuity on psychophysiological responses to effortful speech perception

In recent studies, psychophysiological measures have been used as markers of listening effort, but there is limited research on the effect of hearing loss on such measures. The aim of the current study was to investigate the effect of hearing acuity on physiological responses and subjective measures acquired during different levels of listening demand, and to investigate the relationship between these measures. A total of 125 participants (37 males and 88 females, age range 37–72 years, pure-tone average hearing thresholds at the best ear between -5.0 to 68.8 dB HL and asymmetry between ears between 0.0 and 87.5 dB) completed a listening task. A speech reception threshold (SRT) test was used with target sentences spoken by a female voice masked by male speech. Listening demand was manipulated using three levels of intelligibility: 20 % correct speech recognition, 50 %, and 80 % (IL20 %/IL50 %/IL80 %, respectively). During the task, peak pupil dilation (PPD), heart rate (HR), pre-ejection period (PEP), respiratory sinus arrhythmia (RSA), and skin conductance level (SCL) were measured. For each condition, subjective ratings of effort, performance, difficulty, and tendency to give up were also collected. Linear mixed effects models tested the effect of intelligibility level, hearing acuity, hearing asymmetry, and tinnitus complaints on the physiological reactivity (compared to baseline) and subjective measures. PPD and PEP reactivity showed a non-monotonic relationship with intelligibility level, but no such effects were found for HR, RSA, or SCL reactivity. Participants with worse hearing acuity had lower PPD at all intelligibility levels and showed lower PEP baseline levels. Additionally, PPD and SCL reactivity were lower for participants who reported suffering from tinnitus complaints. For IL80 %, but not IL50 % or IL20 %, participants with worse hearing acuity rated their listening effort to be relatively high compared to participants with better hearing. The reactivity of the different physiological measures were not or only weakly correlated with each other. Together, the results suggest that hearing acuity may be associated with altered sympathetic nervous system (re)activity. Research using psychophysiological measures as markers of listening effort to study the effect of hearing acuity on such measures are best served by the use of the PPD and PEP.

Effectiveness of Preoperative Alpha Wave Entrainment in Pediatric Dental Patients: A Randomized Controlled Trial.

Background Pediatric dental anxiety is a significant barrier to effective dental care, necessitating non-pharmacological interventions. Alpha wave entrainment has shown promise in adult studies for reducing procedural anxiety and pain perception, but its effectiveness in pediatric dental settings remains underexplored. Objective This study aims to evaluate the effectiveness of preoperative alpha wave entrainment in alleviating anxiety in gender-specific participants to the interventions. Methods We conducted a randomized controlled trial involving 252 pediatric patients (aged 7-12) with cooperative dispositions. Participants were randomly assigned to either an experimental group receiving alpha wave entrainment or a control group receiving conventional behavior management techniques. The experimental interventioninvolved 10-minute sessions of binaural beats with visualstimulation designed to induce alpha-wave synchronization. Anxiety levels were assessed using physiological measures (heart rate and blood pressure), both pre- and post-interventions. Results The intervention group demonstrated a significant reduction in heart rate and systolic blood pressure post-intervention compared to the control group. These changes indicate a decrease in anxiety levels, with no significant gender differences in the response to the intervention. Conclusion Alpha wave entrainment effectively reduces dental anxiety in pediatric patients, with similar efficacy observed across genders. This study supports the incorporation of alpha wave entrainment into pediatric dental practices as a viable alternative to traditional anxiety management techniques.

Personalideer: A comprehensive review of personality studies in cervids

Understanding animal personality, that is, consistent behavioural variation among individuals, is essential for elucidating the evolutionary origins of human personality. Despite extensive research on personality in diverse taxa, its significance in deer (i.e. cervids, family Cervidae), a taxon with diverse socioecological strategies, remains largely unexplored. This review summarizes the deer personality literature and highlights the knowledge gap in the studied species, personality assessment methods and traits, the general goal of the study, and implications for human personality research. We identified 32 eligible studies on seven species of deer, representing only a small portion of existing deer taxonomic diversity. More than half of the articles focused on three common deer species, roe deer ( Capreolus capreolus), fallow der ( Dama dama), and elk ( Cervus canadensis). Most studies evaluated reactions to capture, handling, and approaching humans, interpreting these behaviours as ‘Boldness’ or a ‘Coping style’. Also, most articles investigated the personality links to ecological variables, followed by physiological measures, and management applications. We advise researchers to move beyond measuring single traits and adopt a multitrait–multimethod approach, as is common in human personality research. Finally, deer and other animal models might be viable alternatives for studying adaptive value and genetic and environmental underpinnings of personality when research on humans is complicated.

Respiratory Health Associated With Systemic Metal Exposure in Post-9/11 Veterans in the Department of Veterans Affairs Toxic Embedded Fragment Registry.

Adverse respiratory outcomes in post-9/11 veterans with elevated urinary metal measures and enrolled in the VA's Toxic Embedded Fragment registry were compared to those without elevated urinary metals. Veterans completed questionnaires, underwent pulmonary physiology tests (pulmonary function and oscillometry), and provided urine samples for analysis of 13 metals. Respiratory symptoms, diagnoses, and physiology measures were compared in veterans with ≥1 urine metal elevation to those without metal elevations, adjusted for covariates, including smoking. Among 402 study participants, 24% had elevated urine metals, often just exceeding upper limits of reference values. Compared to veterans without elevated metals, those with elevated metals had had higher FEV 1 values but similar frequencies of respiratory symptoms and diagnoses and abnormalities on pulmonary physiology tests. Mild systemic metal elevations in post-9/11 veterans are not associated with adverse respiratory health outcomes.

Prognostic Value of Microvascular Resistance Reserve Measured Immediately After PCI in Stable Coronary Artery Disease.

Microvascular resistance reserve (MRR) has been proposed as a specific metric to quantify coronary microvascular function. The long-term prognostic value of MRR measured in stable patients immediately after percutaneous coronary intervention (PCI) is unknown. This study sought to determine the prognostic value of MRR measured immediately after PCI in patients with stable coronary artery disease. This study included 502 patients with stable coronary artery disease who underwent elective PCI and coronary physiological measurements, including pressure and flow estimation using a bolus thermodilution method after PCI. MRR was calculated as coronary flow reserve divided by fractional flow reserve times the ratio of mean aortic pressure at rest to that at maximal hyperemia induced by hyperemic agents. An abnormal MRR was defined as ≤2.5. Major adverse cardiac events (MACEs) were defined as a composite of all-cause mortality, any myocardial infarction, and target-vessel revascularization. During a median follow-up of 3.4 years, the cumulative MACE rate was significantly higher in the abnormal MRR group (12.5 versus 8.3 per 100 patient-years; hazard ratio 1.53 [95% CI, 1.10-2.11]; P<0.001). A higher all-cause mortality rate primarily drove this difference. On multivariable analysis, a higher MRR value was independently associated with lower MACE and lower mortality. When comparing 4 subgroups according to MRR and the index of microcirculatory resistance, patients with both abnormal MRR and index of microcirculatory resistance (≥25) had the highest MACE rate. An abnormal MRR measured immediately after PCI in patients with stable coronary artery disease is an independent predictor of MACE, particularly all-cause mortality.

Characterization of pulsations in the brain and cerebrospinal fluid using ultra-high field magnetic resonance imaging.

The development of innovative non-invasive neuroimaging methods and biomarkers is critical for studying brain disease. Imaging of cerebrospinal fluid (CSF) pulsatility may inform the brain fluid dynamics involved in clearance of cerebral metabolic waste. In this work, we developed a methodology to characterize the frequency and spatial localization of whole brain CSF pulsations in humans. Using 7 Tesla (T) human magnetic resonance imaging (MRI) and ultrafast echo-planar imaging (EPI), in-vivo images were obtained to capture pulsations of the CSF signal. Physiological data were simultaneously collected and compared with the 7 T MR data. The primary components of signal pulsations were identified using spectral analysis, with the most evident frequency bands identified around 0.3, 1.2, and 2.4 Hz. These pulsations were mapped spatially and temporally onto the MR image domain and temporally onto the physiological measures of electrocardiogram and respiration. We identified peaks in CSF pulsations that were distinct from peaks in grey matter and white matter regions. This methodology may provide novel in vivo biomarkers of disrupted brain fluid dynamics.

Patient and Provider Perspectives About the Use of Patient-Generated Health Data During Pregnancy: Qualitative Exploratory Study.

There is increasing interest in using patient-generated health data (PGHD) to improve patient-centered care during pregnancy. However, little research has examined the perspectives of patients and providers as they report, collect, and use PGHD to inform obstetric care. This study aims to explore the perspectives of patients and providers about the use of PGHD during pregnancy, including the benefits and challenges of reporting, collecting, and using these data, as well as considerations for expanding the use of PGHD to improve obstetric care. We conducted one-on-one interviews with 30 pregnant or postpartum patients and 14 health care providers from 2 obstetrics clinics associated with an academic medical center. Semistructured interview guides included questions for patients about their experience and preferences for sharing PGHD and questions for providers about current processes for collecting PGHD, opportunities to improve or expand the collection of PGHD, and challenges faced when collecting and using this information. Interviews were conducted by phone or videoconference and were audio recorded, transcribed verbatim, and deidentified. Interview transcripts were analyzed deductively and inductively to characterize and explore themes in the data. Patients and providers described how PGHD, including physiologic measurements and experience of symptoms, were currently collected during and between in-person clinic visits for obstetric care. Both patients and providers reported positive perceptions about the collection and use of PGHD during pregnancy. Reported benefits of collecting PGHD included the potential to use data to directly inform patient care (eg, identify issues and adjust medication) and to encourage ongoing patient involvement in their care (eg, increase patient attention to their health). Patients and providers had suggestions for expanding the collection and use of PGHD during pregnancy, and providers also shared considerations about strategies that could be used to expand PGHD collection and use. These strategies included considering the roles of both patients and providers in reporting and interpreting PGHD. Providers also noted the need to consider the unintended consequences of using PGHD that should be anticipated and addressed. Acknowledging the challenges, suggestions, and considerations voiced by patients and providers can inform the development and implementation of strategies to effectively collect and use PGHD to support patient-centered care during pregnancy.

The effects of kettlebell training versus resistance training using the own body mass on physical fitness and physiological adaptations in obese adults: a randomized controlled trial

Aim of studyThis study aimed to explore the effects of different types of resistance training using kettlebells versus the own body mass, in comparison to a passive control, on key physical fitness and physiological parameters in young, obese adults.MethodsData from 60 sedentary, obese male college students, aged 17–26, were used for final analyses. Participants were randomly assigned to one of three groups: a control group (CG, n = 20, no training), a kettlebell resistance training group (KRTG, n = 20), or a bodyweight resistance training group (BWRTG, n = 20). Selected measures of physical fitness were tested using the 12-minutes run test, the push-up test, the sit-up test, and the sit-and-reach test. Physiological measures included vital capacity, resting and maximum heart rate (HRmax), mean arterial blood pressure, breath holding time, and respiratory rate. Biochemical variables were measured in the morning, in a fasted state, and comprised high and low density lipoprotein, total cholesterol, and triglycerides. The 12-weeks progressive KRTG and BWRTG were specifically tailored using sets, repetitions, and intensity levels.ResultsNotable findings include significant body fat reductions in BWRTG (p < 0.001; d = 1.53) and KRTG (p < 0.001; d = 1.43), and a substantial increase in VO2max for BWRTG (p < 0.001; d = 1.32) and KRTG (p < 0.001; d = 1.34) compared to CG. KRTG also showed significant improvements in vital capacity (p < 0.001; d = 1.61) and reductions in resting heart rate (p = 0.024, d = 1.05) and respiratory rate (p = 0.001, d = 1.55), with BWRTG showing similar trends (resting heart rate: p = 0.041, d = 1.35; respiratory rate: p = 0.001, d = 1.98). Both intervention groups significantly improved breath holding time (KRTG: p = 0.001, d = 1.58; BWRTG: p < 0.001, d = 1.98) and reduced total cholesterol and low-density lipoprotein levels compared to CG.ConclusionsThis study demonstrates that both KRTG and BWRTG are effective in improving body composition and selected fitness and physiological measures. Thus, resistance training using kettlebells or bodyweight training are recommended if the goal is to improve body composition and fitness in obese male adults.Trial RegistrationOSF, September, 28th 2023. https://doi.org/10.17605/OSF.IO/Z6Y9Gosf.io/2mb98

Risk prediction strategies using intraoperative physiological data in adults undergoing surgery: a systematic review study protocol

Abstract Postoperative mortality accounts for 7.7% of all global deaths, while postoperative complications increase 1-year mortality by 60%. Risk prediction models for postoperative complications and mortality can facilitate tailored risk mitigation strategies. However, most models incorporate only preoperative patient-related factors as predictors and do not capture dynamic risks or intraoperative events. This systematic review seeks to evaluate the predictive capability of intraoperative physiology derived from routine anaesthetic monitoring and the feature extraction methods for these variables. This review will include both prospective and retrospective studies that incorporate intraoperative physiological measurements into the development, validation or updating of a statistical prediction model, to identify those at risk of major end-organ (cardiovascular, pulmonary, renal and neurological) complications and mortality up-to 90 days postoperatively. We will identify models developed in two settings: those undergoing cardiac surgery and heterogeneous adult patient cohorts undergoing non-cardiac surgery. The review will be reported according to the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. This review will evaluate the available literature on intraoperative physiology as predictor variables, to improve feature extraction methods for risk prediction models development while understanding how to capitalize on the vast routinely collected intraoperative physiological data sets that are increasingly available. This review is registered on PROSPERO, registration number CRD42023474384.

Biomarkers of Immersion in Virtual Reality Based on Features Extracted from the EEG Signals: A Machine Learning Approach.

Virtual reality (VR) enables the development of virtual training frameworks suitable for various domains, especially when real-world conditions may be hazardous or impossible to replicate because of unique additional resources (e.g., equipment, infrastructure, people, locations). Although VR technology has significantly advanced in recent years, methods for evaluating immersion (i.e., the extent to which the user is engaged with the sensory information from the virtual environment or is invested in the intended task) continue to rely on self-reported questionnaires, which are often administered after using the virtual scenario. Having an objective method to measure immersion is particularly important when using VR for training, education, and applications that promote the development, fine-tuning, or maintenance of skills. The level of immersion may impact performance and the translation of knowledge and skills to the real-world. This is particularly important in tasks where motor skills are combined with complex decision making, such as surgical procedures. Efforts to better measure immersion have included the use of physiological measurements including heart rate and skin response, but so far they do not offer robust metrics that provide the sensitivity to discriminate different states (idle, easy, and hard), which is critical when using VR for training to determine how successful the training is in engaging the user's senses and challenging their cognitive capabilities. In this study, electroencephalography (EEG) data were collected from 14 participants who completed VR jigsaw puzzles with two different levels of task difficulty. Machine learning was able to accurately classify the EEG data collected during three different states, obtaining accuracy rates of 86% and 97% for differentiating easy versus hard difficulty states and baseline vs. VR states. Building on these results may enable the identification of robust biomarkers of immersion in VR, enabling real-time recognition of the level of immersion that can be used to design more effective and translative VR-based training. This method has the potential to adjust aspects of VR related to task difficulty to ensure that participants are immersed in VR.

Short-term equine interaction for reducing test anxiety and facilitating coping skill development in college students during examination periods: A preliminary study

Mental health concerns are common among college students and more prevalent during examination periods when stress and anxiety are heightened. While the benefits of equine interaction have been reported, the impact of short-term equine interaction on coping skills valuable for managing test anxiety have yet to be studied. Therefore, the purpose of this preliminary study was to evaluate the impact of short-term equine interaction during the college examination period on development of coping skills and anxiety levels associated with testing, both self-reported and those reflected in physiological measures. Full-time college students engaged in a one-hour equine interaction session held on campus at the onset of final exam week. Participants completed a survey targeting perception of anxiety levels and coping skills. Heart rate and salivary cortisol measurements were collected pre- and post-session. Paired t-tests were performed between pre- and post- session measures and correlations between survey answers and physiological measures determined. Significant reductions were found in all areas of anxiety (Overall Academics P = 0.0003, Final Exam Preparation P = 0.0003, Taking Final Exam P = 0.0003). The reduction in exam-related anxiety was positively correlated to cortisol concentrations (r = 0.69, P = 0.03) with lower concentrations (P = 0.05) and increased heart rate (P = 0.003) post-session. Regarding coping skills, improvements were observed post-session in assertiveness (P = 0.008). Skill development coupled with reduced anxiety supports the potential benefits short-term equine interaction can offer students during the high stress periods, but these findings should be confirmed with more in-depth study.