Emotion perception through the nose: how olfactory emotional cues modulate the perception of neutral facial expressions in affective disorders.

Humans can decode emotional states from the body odors of the conspecifics and this type of emotional communication is particularly relevant in conditions in which social interactions are impaired, as in depression and social anxiety. The present study aimed to explore how body odors collected in happiness and fearful conditions modulate the subjective ratings, the psychophysiological response and the neural processing of neutral faces in individuals with depressive symptoms, social anxiety symptoms, and healthy controls (N = 22 per group). To this aim, electrocardiogram (ECG) and HD-EEG were recorded continuously. Heart Rate Variability (HRV) was extracted from the ECG as a measure of vagal tone, event-related potentials (ERPs) and event-related spectral perturbations (ERPSs) were extracted from the EEG. The results revealed that the HRV increased during the fear and happiness body odors conditions compared to clean air, but no group differences emerged. For ERPs data, repeated measure ANOVA did not show any significant effects. However, the ERPSs analyses revealed a late increase in delta power and a reduced beta power both at an early and a late stage of stimulus processing in response to the neutral faces presented with the emotional body odors, regardless of the presence of depressive or social anxiety symptoms. The current research offers new insights, demonstrating that emotional chemosignals serve as potent environmental cues. This represents a substantial advancement in comprehending the impact of emotional chemosignals in both individuals with and without affective disorders.

Habituation of Central and Electrodermal Responses to an Auditory Two-Stimulus Oddball Paradigm.

The orienting reaction (OR) towards a new stimulus is subject to habituation, i.e., progressively attenuates with stimulus repetition. The skin conductance responses (SCRs) are known to represent a reliable measure of OR at the peripheral level. Yet, it is still a matter of debate which of the P3 subcomponents is the most likely to represent the central counterpart of the OR. The aim of the present work was to study habituation, recovery, and dishabituation phenomena intrinsic to a two-stimulus auditory oddball paradigm, one of the most-used paradigms both in research and clinic, by simultaneously recording SCRs and P3 in twenty healthy volunteers. Our findings show that the target stimulus was capable of triggering a more marked OR, as indexed by both SCRs and P3, compared to the standard stimulus, that could be due to its affective saliency and relevance for task completion; the application of temporal principal components analysis (PCA) to the P3 complex allowed us to identify several subcomponents including both early and late P3a (eP3a; lP3a), P3b, novelty P3 (nP3), and both a positive and a negative Slow Wave (+SW; -SW). Particularly, lP3a and P3b subcomponents showed a similar behavior to that observed for SCRs , suggesting them as central counterparts of OR. Finally, the P3 evoked by the first standard stimulus after the target showed a significant dishabituation phenomenon which could represent a sign of the local stimulus change. However, it did not reach a sufficient level to trigger an SCR/OR since it did not represent a salient event in the context of the task.

Zooming into the Complex Dynamics of Electrodermal Activity Recorded during Emotional Stimuli: A Multiscale Approach.

Physiological phenomena exhibit complex behaviours arising at multiple time scales. To investigate them, techniques derived from chaos theory were applied to physiological signals, providing promising results in distinguishing between healthy and pathological states. Fractal-like properties of electrodermal activity (EDA), a well-validated tool for monitoring the autonomic nervous system state, have been reported in previous literature. This study proposes the multiscale complexity index of electrodermal activity (MComEDA) to discern different autonomic responses based on EDA signals. This method builds upon our previously proposed algorithm, ComEDA, and it is empowered with a coarse-graining procedure to provide a view at multiple time scales of the EDA response. We tested MComEDA's performance on the EDA signals of two publicly available datasets, i.e., the Continuously Annotated Signals of Emotion (CASE) dataset and the Affect, Personality and Mood Research on Individuals and Groups (AMIGOS) dataset, both containing physiological data recorded from healthy participants during the view of ultra-short emotional video clips. Our results highlighted that the values of MComEDA were significantly different (p-value < 0.05 after Wilcoxon signed rank test with Bonferroni's correction) when comparing high- and low-arousal stimuli. Furthermore, MComEDA outperformed the single-scale approach in discriminating among different valence levels of high-arousal stimuli, e.g., showing significantly different values for scary and amusing stimuli (p-value = 0.024). These findings suggest that a multiscale approach to the nonlinear analysis of EDA signals can improve the information gathered on task-specific autonomic response, even when ultra-short time series are considered.

Combining electrodermal activity analysis and dynamic causal modeling to investigate the visual-odor multimodal integration during face perception.

Objective. This study presents a novel methodological approach for incorporating information related to the peripheral sympathetic response into the investigation of neural dynamics. Particularly, we explore how hedonic contextual olfactory stimuli influence the processing of neutral faces in terms of sympathetic response, event-related potentials and effective connectivity analysis. The objective is to investigate how the emotional valence of odors influences the cortical connectivity underlying face processing and the role of face-induced sympathetic arousal in this visual-olfactory multimodal integration.Approach. To this aim, we combine electrodermal activity (EDA) analysis and dynamic causal modeling to examine changes in cortico-cortical interactions.Results. The results reveal that stimuli arising sympathetic EDA responses are associated with a more negative N170 amplitude, which may be a marker of heightened arousal in response to faces. Hedonic odors, on the other hand, lead to a more negative N1 component and a reduced the vertex positive potential when they are unpleasant or pleasant. Concerning connectivity, unpleasant odors strengthen the forward connection from the inferior temporal gyrus (ITG) to the middle temporal gyrus, which is involved in processing changeable facial features. Conversely, the occurrence of sympathetic responses after a stimulus is correlated with an inhibition of this same connection and an enhancement of the backward connection from ITG to the fusiform face gyrus.Significance. These findings suggest that unpleasant odors may enhance the interpretation of emotional expressions and mental states, while faces capable of eliciting sympathetic arousal prioritize identity processing.

Maternal singing sustains preterm hospitalized newborns' autonomic nervous system maturation: an RCT.

BACKGROUND: Premature birth is known to affect the newborn's autonomic nervous system (ANS) maturation, with potential short and long-term impact on their neurobehavioral development. The purpose of the study was to investigate the effects of maternal directed singing and speaking on the preterm infants' autonomic nervous system (ANS) maturation as measured by the heart rate variability (HRV) parameters. METHODS: In this multi-center randomized clinical trial, 30 stable preterm infants (m = 29,6 weeks of gestational age), without any abnormalities were randomized into an intervention (16) or a control group (14). HRV was measured weekly, for a total of 80 recordings during hospitalization, as well as before and after each session of singing or speaking. RESULTS: The intervention group showed a significant increase of the percentage value of HRV power in the high frequency range when compared to the control group (p = 0.044). More specifically, the maternal singing significantly increased the high frequency power and decreased the low/high frequency power ratio (p = 0.037). CONCLUSIONS: The preterm infant's vagal activity significantly increased in the intervention group, potentially enhancing their ANS maturation. The effect is specifically evidenced in the singing condition. IMPACT: Maternal singing affects the autonomic nervous system maturation of preterm hospitalized newborns in the NICU. No previous studies investigated how early vocal parental intervention can affect preterm infants developement, throught their autonomic nervous system maturation. Early Vocal Contact as an early intervention involving parents has a positive impact on preterm infant's development and it can be easily implemented in the care of preterm infants. TRIAL REGISTRATION: NCT04759573, retrospectively registered, 17 February 2021.

Predictors of the Use of a Mental Health-Focused eHealth System in Patients With Breast and Prostate Cancer: Bayesian Structural Equation Modeling Analysis of a Prospective Study.

BACKGROUND: eHealth systems have been increasingly used to manage depressive symptoms in patients with somatic illnesses. However, understanding the factors that drive their use, particularly among patients with breast and prostate cancer, remains a critical area of research. OBJECTIVE: This study aimed to determine the factors influencing use of the NEVERMIND eHealth system among patients with breast and prostate cancer over 12 weeks, with a focus on the Technology Acceptance Model. METHODS: Data from the NEVERMIND trial, which included 129 patients with breast and prostate cancer, were retrieved. At baseline, participants completed questionnaires detailing demographic data and measuring depressive and stress symptoms using the Beck Depression Inventory-II and the Depression, Anxiety, and Stress Scale-21, respectively. Over a 12-week period, patients engaged with the NEVERMIND system, with follow-up questionnaires administered at 4 weeks and after 12 weeks assessing the system's perceived ease of use and usefulness. Use log data were collected at the 2- and 12-week marks. The relationships among sex, education, baseline depressive and stress symptoms, perceived ease of use, perceived usefulness (PU), and system use at various stages were examined using Bayesian structural equation modeling in a path analysis, a technique that differs from traditional frequentist methods. RESULTS: The path analysis was conducted among 100 patients with breast and prostate cancer, with 66% (n=66) being female and 81% (n=81) having a college education. Patients reported good mental health scores, with low levels of depression and stress at baseline. System use was approximately 6 days in the initial 2 weeks and 45 days over the 12-week study period. The results revealed that PU was the strongest predictor of system use at 12 weeks (ßuse at 12 weeks is predicted by PU at 12 weeks=.384), whereas system use at 2 weeks moderately predicted system use at 12 weeks (ßuse at 12 weeks is predicted by use at 2 weeks=.239). Notably, there were uncertain associations between baseline variables (education, sex, and mental health symptoms) and system use at 2 weeks, indicating a need for better predictors for early system use. CONCLUSIONS: This study underscores the importance of PU and early engagement in patient engagement with eHealth systems such as NEVERMIND. This suggests that, in general eHealth implementations, caregivers should educate patients about the benefits and functionalities of such systems, thus enhancing their understanding of potential health impacts. Concentrating resources on promoting early engagement is also essential given its influence on sustained use. Further research is necessary to clarify the remaining uncertainties, enabling us to refine our strategies and maximize the benefits of eHealth systems in health care settings.

Neuronal correlates of eyeblinks are an expression of primary consciousness phenomena.

The blinking rate far exceeds that required for moistening the cornea and changes depending on whether a person is resting or engaged in cognitive tasks. During ecological cognitive tasks (such as speaking, reading, and watching videos), blinks occur at breakpoints of attention suggesting a role in information segmentation, but the close relationship between cognition dynamics and blink timing still escapes a full understanding. The aim of the present study is to seek (1) if there is a temporal relationship between blink events and the consecutive steps of cognitive processing, and (2) if blink timing and the intensity of blink-related EEG responses are affected by task-relevance of stimuli. Our results show that, in a classical visual oddball task, (i) the occurrence of blinks is influenced by stimuli, irrespective of their relevance, (ii) blinks following relevant stimuli are only apparently delayed due to the need of finalizing a behavioural response, and (iii) stimulus relevance does not affect the intensity of the blink-related EEG response. This evidence reinforce the idea that blinks are not emitted until the last step of the processing sequence has been completed and suggests that blink-related EEG responses are generated by primary consciousness phenomena which are considered by their nature non-modulable (all-or-nothing) phenomena.

Autonomic Regulation of Facial Temperature during Stress: A Cross-Mapping Analysis.

Skin temperature reflects the Autonomic Nervous System (ANS)'s response to emotions and mental states and can be remotely measured using InfraRed Thermography. Understanding the physiological mechanisms that affect facial temperature is essential to improve the precision of emotional inference from thermal imaging. To achieve this aim, we recorded thermal images from 30 volunteers, at rest and under acute stress induced by the Stroop test, together with two autonomic correlates, i.e., heart rate variability and electrodermal activity, the former serving as a measure of cardiovascular dynamics, and the latter of the activity of the sweat glands. We used a Cross Mapping (CM) approach to quantify the nonlinear coupling of the temperature from four facial regions with the ANS correlates. CM reveals that facial temperature has a statistically significant correlation with the two autonomic time series, under both conditions, which was not evident in the linear domain. In particular, compared to the other regions, the nose shows a significantly higher link to the electrodermal activity in both conditions, and to the heart rate variability under stress. Moreover, the cardiovascular activity seems to be primarily responsible for the well-known decrease in nose temperature, and its coupling with the thermal signals significantly varies with gender.

Contactless Cardiovascular Assessment by Imaging Photoplethysmography: A Comparison with Wearable Monitoring.

Despite the notable recent developments in the field of remote photoplethysmography (rPPG), extracting a reliable pulse rate variability (PRV) signal still remains a challenge. In this study, eight image-based photoplethysmography (iPPG) extraction methods (GRD, AGRD, PCA, ICA, LE, SPE, CHROM, and POS) were compared in terms of pulse rate (PR) and PRV features. The algorithms were made robust for motion and illumination artifacts by using ad hoc pre- and postprocessing steps. Then, they were systematically tested on the public dataset UBFC-RPPG, containing data from 42 subjects sitting in front of a webcam (30 fps) while playing a time-sensitive mathematical game. The performances of the algorithms were evaluated by statistically comparing iPPG-based and finger-PPG-based PR and PRV features in terms of Spearman's correlation coefficient, normalized root mean square error (NRMSE), and Bland-Altman analysis. The study revealed POS and CHROM techniques to be the most robust for PR estimation and the assessment of overall autonomic nervous system (ANS) dynamics by using PRV features in time and frequency domains. Furthermore, we demonstrated that a reliable characterization of the vagal tone is made possible by computing the Poincaré map of PRV series derived from the POS and CHROM methods. This study supports the use of iPPG systems as promising tools to obtain clinically useful and specific information about ANS dynamics.

EEG cortical activity and connectivity correlates of early sympathetic response during cold pressor test.

Previous studies have identified several brain regions involved in the sympathetic response and its integration with pain, cognition, emotions and memory processes. However, little is known about how such regions dynamically interact during a sympathetic activation task. In this study, we analyzed EEG activity and effective connectivity during a cold pressor test (CPT). A source localization analysis identified a network of common active sources including the right precuneus (r-PCu), right and left precentral gyri (r-PCG, l-PCG), left premotor cortex (l-PMC) and left anterior cingulate cortex (l-ACC). We comprehensively analyzed the network dynamics by estimating power variation and causal interactions among the network regions through the direct directed transfer function (dDTF). A connectivity pattern dominated by interactions in [Formula: see text] (8-12) Hz band was observed in the resting state, with r-PCu acting as the main hub of information flow. After the CPT onset, we observed an abrupt suppression of such [Formula: see text]-band interactions, followed by a partial recovery towards the end of the task. On the other hand, an increase of [Formula: see text]-band (1-4) Hz interactions characterized the first part of CPT task. These results provide novel information on the brain dynamics induced by sympathetic stimuli. Our findings suggest that the observed suppression of [Formula: see text] and rise of [Formula: see text] dynamical interactions could reflect non-pain-specific arousal and attention-related response linked to stimulus' salience.

Physiologically-Informed Gaussian Processes for Interpretable Modelling of Psycho-Physiological States.

The widespread popularity of Machine Learning (ML) models in healthcare solutions has increased the demand for their interpretability and accountability. In this paper, we propose the Physiologically-Informed Gaussian Process (PhGP) classification model, an interpretable machine learning model founded on the Bayesian nature of Gaussian Processes (GPs). Specifically, we inject problem-specific domain knowledge of inherent physiological mechanisms underlying the psycho-physiological states as a prior distribution over the GP latent space. Thus, to estimate the hyper-parameters in PhGP, we rely on the information from raw physiological signals as well as the designed prior function encoding the physiologically-inspired modelling assumptions. Alongside this new model, we present novel interpretability metrics that highlight the most informative input regions that contribute to the GP prediction. We evaluate the ability of PhGP to provide an accurate and interpretable classification on three different datasets, including electrodermal activity (EDA) signals collected during emotional, painful, and stressful tasks. Our results demonstrate that, for all three tasks, recognition performance is improved by using the PhGP model compared to competitive methods. Moreover, PhGP is able to provide physiological sound interpretations over its predictions.

ComEDA: A new tool for stress assessment based on electrodermal activity.

Non-specific sympathetic arousal responses to different stressful elicitations can be easily recognized from the analysis of physiological signals. However, neural patterns of sympathetic arousal during physical and mental fatigue are clearly not unitary. In the context of physiological monitoring through wearable and non-invasive devices, electrodermal activity (EDA) is the most effective and widely used marker of sympathetic activation. This study presents ComEDA, a novel approach for the characterization of complex dynamics of EDA. ComEDA overcomes the methodological limitations related to the application of nonlinear analysis to EDA dynamics, is not parameter-sensitive and is suitable for the analysis of ultra-short time series. We validated the proposed algorithm using synthetic series of white noise and 1/f noise, varying the number of samples from 50 to 5000. By applying our approach, we were able to discriminate a statistically significant increase of complexity in the 1/f noise with respect to white noise, obtaining p-values in the range [4.35 × 10-6, 0.03] after the Mann-Whitney test. Then, we tested ComEDA on both EDA signal and its tonic and phasic components, acquired from healthy subjects during four experimental protocols: two inducing a sympathetic activation through physical efforts and two based on mentally stressful tasks. Results are encouraging and promising, outperforming state of the art metrics such as the Sample Entropy. ComEDA shows good performance not only in discriminating between stressful tasks and resting state (p-value < 0.01 after the Wilcoxon non-parametric statistical test applied to EDA signals of all the four datasets), but also in differentiating different trends of complexity of EDA dynamics when induced by physical and mental stressors. These findings suggest future applications to automatically detect and selectively identify threats due to overwhelming stress impacting both physical and mental health or in the field of telemedicine to monitor autonomic diseases correlated to atypical sympathetic activation. The Matlab code implementing the ComEDA algorithm is available online.

Modeling subjective fear using skin conductance: a preliminary study in virtual reality.

Reliably measuring fear perception could help evaluate the effectiveness of treatments for pathological conditions such as specific phobias or post-traumatic stress syndrome (e.g., exposure therapy). In this study, we developed a novel vir-tual reality (VR) scenario to induce fear and evaluate the related physiological response by the analysis of skin conductance (SC) signal. Eighteen subjects voluntarily experienced the fear VR scenario while their SC was recorded. After the experiment, each participant was asked to score the perceived subjective fear using a Likert scale from 1 to 10. We used the cvxEDA algorithm to process the collected SC signals and extract several features able to estimate the autonomic response to the fearful stimuli. Finally, the extracted features were linearly combined to model the subjective fear perception scores by means of LASSO linear regression. The sparsification imposed by the LASSO procedure to mitigate the overfitting risk identified an optimal linear model including only the standard deviation of the tonic SC component as a regressor (p = 0.007; R2 = 0.3337). The significant contribution of this feature to the model suggests that subjects experiencing more intense subjective fear have a more variable and unstable sympathetic tone.

Human body odors of happiness and fear modulate the late positive potential component during neutral face processing: a preliminary ERP study on healthy subjects.

Human body odors (HBOs) are powerful stimuli that can affect emotional, cognitive and behavioral processes. However, the characterization of the physiological response to HBOs is still to be fully investigated. Here, we analyzed the self-assessed emotion perception and the EEG event-related potentials (ERP) on 17 healthy young women during a simultaneous visual-olfactory stimulation. Particularly, we evaluated the effect of happiness and fear HBO on the amplitude of ERP waveforms elicited by neutral face processing. In addition, we evaluated the subjective valence and arousal perception of the presented neutral faces by means of the self-assessment-manikin test. We observed a significant increase in the amplitude of the late positive potential (LPP) for central left sites (i.e., C3) during the administration of HBOs with respect to clean air. On the other hand, we did not observe any significant change in the subjective valence and arousal scores as well as for the early components of the ERP (i.e., P100, N170, Vertex-Positive-Potential). Our preliminary results suggest that fear and happiness HBO can induce a protracted increase in the LPP, and possibly reflect an automatic and sustained engagement with emotionally significant content.

The NEVERMIND e-health system in the treatment of depressive symptoms among patients with severe somatic conditions: A multicentre, pragmatic randomised controlled trial.

Background: This study assessed the effectiveness of the NEVERMIND e-health system, consisting of a smart shirt and a mobile application with lifestyle behavioural advice, mindfulness-based therapy, and cognitive behavioural therapy, in reducing depressive symptoms among patients diagnosed with severe somatic conditions. Our hypothesis was that the system would significantly decrease the level of depressive symptoms in the intervention group compared to the control group. Methods: This pragmatic, randomised controlled trial included 425 patients diagnosed with myocardial infarction, breast cancer, prostate cancer, kidney failure, or lower limb amputation. Participants were recruited from hospitals in Turin and Pisa (Italy), and Lisbon (Portugal), and were randomly assigned to either the NEVERMIND intervention or to the control group. Clinical interviews and structured questionnaires were administered at baseline, 12 weeks, and 24 weeks. The primary outcome was depressive symptoms at 12 weeks measured by the Beck Depression Inventory II (BDI-II). Intention-to-treat analyses included 425 participants, while the per-protocol analyses included 333 participants. This trial is registered in the German Clinical Trials Register, DRKS00013391. Findings: Patients were recruited between Dec 4, 2017, and Dec 31, 2019, with 213 assigned to the intervention and 212 to the control group. The sample had a mean age of 59·41 years (SD=10·70), with 44·24% women. Those who used the NEVERMIND system had statistically significant lower depressive symptoms at the 12-week follow-up (mean difference=-3·03, p<0·001; 95% CI -4·45 to -1·62) compared with controls, with a clinically relevant effect size (Cohen's d=0·39). Interpretation: The results of this study show that the NEVERMIND system is superior to standard care in reducing and preventing depressive symptoms among patients with the studied somatic conditions. Funding: The NEVERMIND project received funding from the European Union's Horizon 2020 Research and Innovation Programme under grant agreement No. 689691.

Sociodemographic Characteristics Associated With an eHealth System Designed to Reduce Depressive Symptoms Among Patients With Breast or Prostate Cancer: Prospective Study.

BACKGROUND: eHealth interventions have become a topic of interest in the field of mental health owing to their increased coordination and integration of different elements of care, in treating and preventing mental ill health in patients with somatic illnesses. However, poor usability, learnability, and user engagement might affect the effectiveness of an eHealth intervention. Identifying different sociodemographic characteristics that might be associated with higher perceived usability can help improve the usability of eHealth interventions. OBJECTIVE: This study aimed to identify the sociodemographic characteristics that might be associated with the perceived usability of the NEVERMIND (Neurobehavioural Predictive and Personalised Modelling of Depressive Symptoms During Primary Somatic Diseases) eHealth system, comprising a mobile app and a sensorized shirt, in reducing comorbid depressive symptoms in patients with breast or prostate cancer. METHODS: The study included a total of 129 patients diagnosed with breast (n=80, 62%) or prostate (n=49, 38%) cancer, who received a fully automated mobile app and sensorized shirt (NEVERMIND system). Sociodemographic data on age, sex, marital status, education level, and employment status were collected at baseline. Usability outcomes included the System Usability Scale (SUS), a subjective measure that covers different aspects of system usability; the user version of the Mobile App Rating Scale (uMARS), a user experience questionnaire; and a usage index, an indicator calculated from the number of days patients used the NEVERMIND system during the study period. RESULTS: The analysis was based on 108 patients (n=68, 63%, patients with breast cancer and n=40, 37%, patients with prostate cancer) who used the NEVERMIND system for an average of 12 weeks and completed the study. The overall mean SUS score at 12 weeks was 73.4 (SD 12.5), which indicates that the NEVERMIND system has good usability, with no statistical differences among different sociodemographic characteristics. The global uMARS score was 3.8 (SD 0.3), and women rated the app higher than men (ß=.16; P=.03, 95% CI 0.02-0.3), after adjusting for other covariates. No other sociodemographic characteristics were associated with higher uMARS scores. There was a statistical difference in the use of the NEVERMIND system between women and men. Women had significantly lower use (ß=-0.13; P=.04, 95% CI -0.25 to -0.01), after adjusting for other covariates. CONCLUSIONS: The findings suggest that the NEVERMIND system has good usability according to the SUS and uMARS scores. There was a higher favorability of mobile apps among women than among men. However, men had significantly higher use of the NEVERMIND system. Despite the small sample size and low variability, there is an indication that the NEVERMIND system does not suffer from the digital divide, where certain sociodemographic characteristics are more associated with higher usability. TRIAL REGISTRATION: German Clinical Trials Register RKS00013391; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00013391.

Towards a Contactless Stress Classification Using Thermal Imaging.

Thermal cameras capture the infrared radiation emitted from a body in a contactless manner and can provide an indirect estimation of the autonomic nervous system (ANS) dynamics through the regulation of the skin temperature. This study investigates the contribution given by thermal imaging for an effective automatic stress detection with the perspective of a contactless stress recognition system. To this aim, we recorded both ANS correlates (cardiac, electrodermal, and respiratory activity) and thermal images from 25 volunteers under acute stress induced by the Stroop test. We conducted a statistical analysis on the features extracted from each signal, and we implemented subject-independent classifications based on the support vector machine model with an embedded recursive feature elimination algorithm. Particularly, we trained three classifiers using different feature sets: the full set of features, only those derived from the peripheral autonomic correlates, and only those derived from the thermal images. Classification accuracy and feature selection results confirmed the relevant contribution provided by the thermal features in the acute stress detection task. Indeed, a combination of ANS correlates and thermal features achieved 97.37% of accuracy. Moreover, using only thermal features we could still successfully detect stress with an accuracy of 86.84% in a contact-free manner.

Maternal Singing but Not Speech Enhances Vagal Activity in Preterm Infants during Hospitalization: Preliminary Results.

BACKGROUND: Early parental interventions in the Neonatal Intensive Care Units (NICUs) have beneficial effects on preterm infants' short and long-term outcomes. The aim of this study was to investigate the effects of Early Vocal Contact (EVC)-singing and speaking-on preterm infants' vagal activity and autonomic nervous system (ANS) maturation. METHODS: In this multi-center randomized clinical trial, twenty-four stable preterm infants, born at 25-32 weeks gestational age, were randomized to either the EVC group or control group, where mothers did not interact with the babies but observed their behavior. Heart Rate Variability (HRV) was acquired before intervention (pre-condition), during vocal contact, and after it (post condition). RESULTS: No significant effect of the vocal contact, singing and speaking, was found in HRV when the intervention group was compared to the control group. However, a significant difference between the singing and the pre and post conditions, respectively, preceding and following the singing intervention, was found in the Low and High Frequency power nu, and in the low/high frequency features (p = 0.037). By contrast, no significant effect of the speaking was found. CONCLUSIONS: Maternal singing, but not speaking, enhances preterm infants' vagal activity in the short-term, thus improving the ANS stability. Future analyses will investigate the effect of enhanced vagal activity on short and long-term developmental outcomes of preterm infants in the NICU.

Reliability of Pulse Rate Variability in Elderly Men and Women: an Application of Cross-Mapping Approach.

Photoplethysmography (PPG) is a completely noninvasive, optical method of assessing blood flow dynamics in peripheral vasculature. Wearable devices for PPG recording are becoming increasingly popular, due to their cost-effectiveness and ease of use. For these reasons, many recent scientific studies have proposed the use of pulse rate variability (PRV) extracted from PPG as a surrogate for heart rate variability (HRV), in monitoring autonomic activity and cardiovascular health.In this work, we used a cross-mapping approach, a methodology based on chaos theory, to compare PRV and HRV dynamics, and investigate their agreement according to age and gender of healthy subjects. We used ECG and PPG data acquired from 57 subjects (41 young and 16 elderly) during resting state in the supine position. Signals were gathered from the publicly available VORTAL dataset. Our results showed a statistically significant decrease of PRV reliability as an HRV surrogate in old participants, which was confirmed as significant when only men subjects were analyzed (p-value<0.01).Our findings, although preliminary, suggest greater caution in the use of PPG devices for monitoring cardiovascular health, especially in elderly men.