Misophonia reactions in the general population are correlated with strong emotional reactions to other everyday sensory-emotional experiences.

Misophonic experiences are common in the general population, and they may shed light on everyday emotional reactions to multi-modal stimuli. We performed an online study of a non-clinical sample to understand the extent to which adults who have misophonic reactions are generally reactive to a range of audio-visual emotion-inducing stimuli. We also hypothesized that musicality might be predictive of one's emotional reactions to these stimuli because music is an activity that involves strong connections between sensory processing and meaningful emotional experiences. Participants completed self-report scales of misophonia and musicality. They also watched videos meant to induce misophonia, autonomous sensory meridian response (ASMR) and musical chills, and were asked to click a button whenever they had any emotional reaction to the video. They also rated the emotional valence and arousal of each video. Reactions to misophonia videos were predicted by reactions to ASMR and chills videos, which could indicate that the frequency with which individuals experience emotional responses varies similarly across both negative and positive emotional contexts. Musicality scores were not correlated with measures of misophonia. These findings could reflect a general phenotype of stronger emotional reactivity to meaningful sensory inputs. This article is part of the theme issue 'Sensing and feeling: an integrative approach to sensory processing and emotional experience'.

Utility of shaking chills as a diagnostic sign for bacteremia in adults: a systematic review and meta-analysis.

BACKGROUND: Accurate prediction of bacteremia is essential for guiding blood culture collection and optimal antibiotic treatment. Shaking chills, defined as a subjective chill sensation with objective body shivering, have been suggested as a potential predictor of bacteremia; however, conflicting findings exist. To address the evidence gap, we conducted a systematic review and meta-analysis of studies to assess the diagnostic accuracy of shaking chills for predicting bacteremia among adult patients. METHODS: We included studies reporting the diagnostic accuracy of shaking chills or chills for bacteremia. Adult patients with suspected bacteremia who underwent at least one set of blood cultures were included. Our main analysis focused on studies that assessed shaking chills. We searched these studies through CENTRAL, MEDLINE, Embase, the World Health Organization ICTRP Search Portal, and ClinicalTrials.gov. Study selection, data extraction, evaluation for risk of bias, and applicability using the QUADAS-2 tool were conducted by two independent investigators. We estimated a summary receiver operating characteristic curve and a summary point of sensitivity and specificity of the index tests, using a hierarchical model and the bivariate model, respectively. RESULTS: We identified 19 studies with a total of 14,641 patients in which the accuracy of shaking chills was evaluated. The pooled sensitivity and specificity of shaking chills were 0.37 (95% confidence interval [CI], 0.29 to 0.45) and 0.87 (95% CI, 0.83 to 0.90), respectively. Most studies had a low risk of bias in the index test domain and a high risk of bias and a high applicability concern in the patient-selection domain. CONCLUSIONS: Shaking chills are a highly specific but less sensitive predictor of bacteremia. Blood cultures and early initiation of antibiotics should be considered for patients with an episode of shaking chills; however, the absence of shaking chills must not lead to exclusion of bacteremia and early antibiotic treatment.

Individuals lack the ability to accurately detect emotional piloerection.

Piloerection (e.g., goosebumps) is an essential thermoregulatory and social signaling mechanism in non-human animals. Although humans also experience piloerection-often being perceived as an indicator of profound emotional experiences-its comparatively less effective role in thermoregulation and communication might influence our capacity to monitor its occurrence. We present three studies (total N = 617) demonstrating participants' general inability to detect their own piloerection events and their lack of awareness that piloerection occurs with a similar frequency on multiple anatomical locations. Self-reported goosebumps were more frequent than observed piloerection. However, only 31.8% of self-reports coincided with observable piloerection, a bias unrelated to piloerection intensity, anatomical location, heart-rate variability, or interoceptive awareness. We also discovered a self-report bias for the forearm, contradicting the observation that piloerection occurs with equal frequency on multiple anatomical locations. Finally, there was low correspondence between self-reports of being "emotionally moved" and observed piloerection. These counterintuitive findings not only highlight a disconnect between an obvious physiological response and our capacity for self-monitoring, but they underscore a fascinating divergence between human and non-human species. Although piloerection is vital in non-human organisms, the connection between piloerection and psychological experience in humans may be less significant than previously assumed, possibly due to its diminished evolutionary relevance.

Predicting individual differences in peak emotional response.

Why does the same experience elicit strong emotional responses in some individuals while leaving others largely indifferent? Is the variance influenced by who people are (personality traits), how they feel (emotional state), where they come from (demographics), or a unique combination of these? In this 2,900+ participants study, we disentangle the factors that underlie individual variations in the universal experience of aesthetic chills, the feeling of cold and shivers down the spine during peak experiences. Here, we unravel the interplay of psychological and sociocultural dynamics influencing self-reported chills reactions. A novel technique harnessing mass data mining of social media platforms curates the first large database of ecologically sourced chills-evoking stimuli. A combination of machine learning techniques (LASSO and SVM) and multilevel modeling analysis elucidates the interacting roles of demographics, traits, and states factors in the experience of aesthetic chills. These findings highlight a tractable set of features predicting the occurrence and intensity of chills-age, sex, pre-exposure arousal, predisposition to Kama Muta (KAMF), and absorption (modified tellegen absorption scale [MODTAS]), with 73.5% accuracy in predicting the occurrence of chills and accounting for 48% of the variance in chills intensity. While traditional methods typically suffer from a lack of control over the stimuli and their effects, this approach allows for the assignment of stimuli tailored to individual biopsychosocial profiles, thereby, increasing experimental control and decreasing unexplained variability. Further, they elucidate how hidden sociocultural factors, psychological traits, and contextual states shape seemingly "subjective" phenomena.

The neurobiology of aesthetic chills: How bodily sensations shape emotional experiences.

The phenomenon of aesthetic chills-shivers and goosebumps associated with either rewarding or threatening stimuli-offers a unique window into the brain basis of conscious reward because of their universal nature and simultaneous subjective and physical counterparts. Elucidating the neural mechanisms underlying aesthetic chills can reveal fundamental insights about emotion, consciousness, and the embodied mind. What is the precise timing and mechanism of bodily feedback in emotional experience? How are conscious feelings and motivations generated from interoceptive predictions? What is the role of uncertainty and precision signaling in shaping emotions? How does the brain distinguish and balance processing of rewards versus threats? We review neuroimaging evidence and highlight key questions for understanding how bodily sensations shape conscious feelings. This research stands to advance models of brain-body interactions shaping affect and may lead to novel nonpharmacological interventions for disorders of motivation and pleasure.

Aesthetic chills mitigate maladaptive cognition in depression.

BACKGROUND: Depression is a major global health challenge, affecting over 300 million people worldwide. Current pharmacological and psychotherapeutic interventions have limited efficacy, underscoring the need for novel approaches. Emerging evidence suggests that peak emotional experiences characterized by awe, transcendence, and meaning hold promise for rapidly shifting maladaptive cognitive patterns in depression. Aesthetic chills, a peak positive emotion characterized by physical sensations such as shivers and goosebumps, may influence reward-related neural pathways and hold promise for modifying core maladaptive beliefs rooted in early adverse experiences. METHODS: We enrolled 96 patients diagnosed with major depressive disorder. A validated database of multimedia known to elicit chills responses (ChillsDB) was used for stimulus presentation. Participants' emotional responses were assessed using the Emotional Breakthrough Inventory (EBI), while shifts in self-schema were measured via the Young Positive Schema Questionnaire (YSPQ). RESULTS: The study found that chill-inducing stimuli have the potential to positively influence the core schema of individuals with depression, impacting areas of self-related beliefs. The associated phenomenology triggered by chills appears to share similarities with the altered states of consciousness induced by psychedelic substances like psilocybin. CONCLUSIONS: These preliminary results suggest that the biological processes involved in aesthetic chills could be harnessed as a non-pharmacological intervention for depression. However, further investigation is necessary to comprehensively understand the neurophysiological responses to chills and to evaluate the practicality, effectiveness, and safety of utilizing aesthetic chills as a preventive measure in mental health care.

Clinical factors associated with peripherally inserted central catheters (PICC) related bloodstream infections: a single centre retrospective cohort.

BACKGROUND: Despite their spread in daily practice, few data is available on clinical factors associated with peripherally inserted central catheter (PICC)-related bloodstream infections (PR-BSI). We aimed to assess the PR-BSI incidence, microbiology, and factors associated with PR-BSI with a focus on clinical symptoms. METHODS: We conducted a retrospective cohort study in a French university hospital. We screened all PICC insertions performed from April 1st, 2018, to April 1st, 2019, and included PICC insertions in adult patients. We assessed the PR-BSI incidence, the factors associated with PR-BSI using a Cox model, and negative and positive predictive values (NPVs and PPVs) of each clinical sign for PR-BSI. RESULTS: Of the 901 PICCs inserted in 783 patients (38,320 catheters days), 214 PICCs (24%) presented with a complication. The most prevalent complication was PR-BSI (1.9 per 1000 catheter days; 8.1% of inserted PICCs ). Enterobacterales (N = 27, 37%) and coagulase negative Staphylococci (N = 24, 33%), were the main microorganisms responsible for PR-BSI. Factors independently associated with occurrence of PR-BSI were fever (hazard ratio 13.21, 95% confidence interval 6.00-29.11, p < 0.001) and chills (HR 3.66, 95%CI 1.92-6.99, p < 0.001). All clinical signs and a duration of PICC maintenance ≥ 28 days, had a low PPVs (≤ 67.1%) but high NPVs (≥ 92.5%) for PR-BSI. CONCLUSIONS: Monitoring of clinical signs, especially fever and chills, with caution and limitation of device maintenance duration, could improve PICC management.

Aesthetic chills cause an emotional drift in valence and arousal.

Aesthetic chills are an embodied peak emotional experience induced by stimuli such as music, films, and speeches and characterized by dopaminergic release. The emotional consequences of chills in terms of valence and arousal are still debated and the existing empirical data is conflicting. In this study, we tested the effects of ChillsDB, an open-source repository of chills-inducing stimuli, on the emotional ratings of 600+ participants. We found that participants experiencing chills reported significantly more positive valence and greater arousal during the experience, compared to participants who did not experience chills. This suggests that the embodied experience of chills may influence one's perception and affective evaluation of the context, in favor of theoretical models emphasizing the role of interoceptive signals such as chills in the process of perception and decision-making. We also found an interesting pattern in the valence ratings of participants, which tended to harmonize toward a similar mean after the experiment, though initially disparately distributed. We discuss the significance of these results for the diagnosis and treatment of dopaminergic disorders such as Parkinson's, schizophrenia, and depression.

Neural Correlates of Music Listening: Does the Music Matter?

The last decades have seen a proliferation of music and brain studies, with a major focus on plastic changes as the outcome of continuous and prolonged engagement with music. Thanks to the advent of neuroaesthetics, research on music cognition has broadened its scope by considering the multifarious phenomenon of listening in all its forms, including incidental listening up to the skillful attentive listening of experts, and all its possible effects. These latter range from objective and sensorial effects directly linked to the acoustic features of the music to the subjectively affective and even transformational effects for the listener. Of special importance is the finding that neural activity in the reward circuit of the brain is a key component of a conscious listening experience. We propose that the connection between music and the reward system makes music listening a gate towards not only hedonia but also eudaimonia, namely a life well lived, full of meaning that aims at realizing one's own "daimon" or true nature. It is argued, further, that music listening, even when conceptualized in this aesthetic and eudaimonic framework, remains a learnable skill that changes the way brain structures respond to sounds and how they interact with each other.

Music in Noise: Neural Correlates Underlying Noise Tolerance in Music-Induced Emotion.

Music can be experienced in various acoustic qualities. In this study, we investigated how the acoustic quality of the music can influence strong emotional experiences, such as musical chills, and the neural activity. The music's acoustic quality was controlled by adding noise to musical pieces. Participants listened to clear and noisy musical pieces and pressed a button when they experienced chills. We estimated neural activity in response to chills under both clear and noisy conditions using functional magnetic resonance imaging (fMRI). The behavioral data revealed that compared with the clear condition, the noisy condition dramatically decreased the number of chills and duration of chills. The fMRI results showed that under both noisy and clear conditions the supplementary motor area, insula, and superior temporal gyrus were similarly activated when participants experienced chills. The involvement of these brain regions may be crucial for music-induced emotional processes under the noisy as well as the clear condition. In addition, we found a decrease in the activation of the right superior temporal sulcus when experiencing chills under the noisy condition, which suggests that music-induced emotional processing is sensitive to acoustic quality.

The Relationship Between Valence and Chills in Music: A Corpus Analysis.

Chills experienced in response to music listening have been linked to both happiness and sadness expressed by music. To investigate these conflicting effects of valence on chills, we conducted a computational analysis on a corpus of 988 tracks previously reported to elicit chills, by comparing them with a control set of tracks matched by artist, duration, and popularity. We analysed track-level audio features obtained with the Spotify Web API across the two sets of tracks, resulting in confirmatory findings that tracks which cause chills were sadder than matched tracks and exploratory findings that they were also slower, less intense, and more instrumental than matched tracks on average. We also found that the audio characteristics of chills tracks were related to the direction and magnitude of the difference in valence between the two sets of tracks. We discuss these results in light of the current literature on valence and chills in music, provide a new interpretation in terms of personality correlates of musical preference, and review the advantages and limitations of our computational approach.

'Defrosting' music chills with naltrexone: The role of endogenous opioids for the intensity of musical pleasure.

The endogenous opioid system has been implicated during experiences of pleasure (i.e., from food or sex). Music can elicit intense emotional and bodily sensations of pleasure, called 'Chills'. We investigated the effects of an opioid antagonist (50 mg naltrexone) or placebo (40 µg d3-vitamin) while listening to self-selected music or other 'control' music selected by another participant. We used a novel technique of continuous measurement of pleasantness with an eye tracker system, where participants shifted their eyes along a visual analogue scale, in the semblance of a thermometer so that, as the music unfolded, gaze positions indicated the self-reported hedonic experience. Simultaneously, we obtained pupil diameters. Self-reported pleasure remained unchanged by naltrexone, which - however - selectively decreased pupillary diameters during 'Chills'. Hence, the endogenous µ-opioid signaling is not necessary for subjective enjoyment of music but an opioid blockade dampens pupil responses to peak pleasure, consistent with decreased arousal to the music.

Being emotionally moved is associated with phasic physiological calming during tonic physiological arousal from pleasant tears.

The experience of being emotionally "moved" is considered a valuable emotional experience. Although pleasant chills (goosebumps and shivers) and tears (weeping and a lump in the throat) are commonly associated with the experience of being emotionally moved, no previous studies have examined which of these psychophysiological responses is the most intrinsic to the phenomenon of being moved. We conducted two music listening experiments to examine this question. Both experiments revealed that, when chills and tears were reliably separated, chills evoked phasic increases in electrodermal activity, whereas tears induced phasic decreases in heart and respiration rate during tonic physiological arousal. Importantly, whereas tears predicted the experience of being moved, experiencing chills did not. Furthermore, psychoacoustic features of music did not explain the physiological response of chills and tears. The results demonstrated that the experience of being moved involved a sense of pleasure coupled with psychophysiological relief from tension. Based on extended attachment theory, the sequential process of physiological arousal to physiological calming, which is derived from abstract life-guiding ideas via the combination of sound and lyrics, may be important for evoking the experience of being emotionally moved. These psychophysiological characteristics could explain why people seek to be moved.

Cortical Patterns of Pleasurable Musical Chills Revealed by High-Density EEG.

Music has the capacity to elicit strong positive feelings in humans by activating the brain's reward system. Because group emotional dynamics is a central concern of social neurosciences, the study of emotion in natural/ecological conditions is gaining interest. This study aimed to show that high-density EEG (HD-EEG) is able to reveal patterns of cerebral activities previously identified by fMRI or PET scans when the subject experiences pleasurable musical chills. We used HD-EEG to record participants (11 female, 7 male) while listening to their favorite pleasurable chill-inducing musical excerpts; they reported their subjective emotional state from low pleasure up to chills. HD-EEG results showed an increase of theta activity in the prefrontal cortex when arousal and emotional ratings increased, which are associated with orbitofrontal cortex activation localized using source localization algorithms. In addition, we identified two specific patterns of chills: a decreased theta activity in the right central region, which could reflect supplementary motor area activation during chills and may be related to rhythmic anticipation processing, and a decreased theta activity in the right temporal region, which may be related to musical appreciation and could reflect the right superior temporal gyrus activity. The alpha frontal/prefrontal asymmetry did not reflect the felt emotional pleasure, but the increased frontal beta to alpha ratio (measure of arousal) corresponded to increased emotional ratings. These results suggest that EEG may be a reliable method and a promising tool for the investigation of group musical pleasure through musical reward processing.

A mixed-methods examination of autonomous sensory meridian response: Comparison to frisson.

Autonomous Sensory Meridian Response (ASMR) is a pleasurable, head-oriented tingling sensation, typically induced by exposure to audiovisual triggers, producing feelings of relaxation and euphoria. This article explores the induction of ASMR experiences in a laboratory setting amongst non-specialised participants, as well as the relationship between ASMR and frisson, or 'musical chills'. In previous work, the ASMR-15 was found to be a reliable measure of ASMR propensity, however, the predictive validity of the measure has yet to be determined. The aim of this study was to assess whether ASMR-15 scores predict greater ASMR induction in an experimental setting. To address this, N = 100 undergraduate psychology students completed the ASMR-15 and a measure of frisson, before viewing ASMR stimuli under controlled conditions. Mixed-methods analyses indicated the successful induction of ASMR amongst some participants, convergence between ASMR-15 scores and video ratings, as well as divergence between ASMR and frisson scores.

A Case of a COVID-19-positive Patient.

The coronavirus (COVID-19), discovered in 2019, has been creating havoc since it first emerged in China and is now spreading worldwide. Its presentation is somewhat similar to influenza. We hereby discuss the salient features of the coronavirus and present the case of a 33-year-old male who was tested positive for COVID-19.

Oral Candida Mannan Concentrations Correlate with Symptoms/Signs of Ill Health and the Immune Status.

BACKGROUND: A relationship has been proposed between increases in oral Candida concentrations and host immunity. Therefore, the present study was conducted to investigate the relationship between oral Candida mannan concentrations and symptoms/signs of ill health and the immune status and also to examine whether health/the immune status may be evaluated based on oral Candida mannan concentrations. PATIENTS AND METHODS: The health conditions of 25 healthy individuals and 10 cancer patients receiving cytotoxic chemotherapy were assessed using a questionnaire and oral rinse solutions collected on consecutive days. Candida mannan concentrations in oral rinse solutions were measured using a commercial sandwich ELISA kit. RESULTS: The use of dentures was identified as a significant independent factor increasing Candida mannan concentrations. In a stratified analysis based on the use of dentures, significantly increased Candida mannan concentrations were detected in healthy volunteers with chills and in cancer patients with slight/moderate fever (37.5-38.4 °C) (multivariate analysis, p < 0.01) who were non-denture users. These symptoms/signs may be associated with (pre-)infection, during which the immune system is activated and needs to function well. CONCLUSIONS: The present results suggest that oral Candida mannan concentrations are a predictive marker for health/the immune status.