Association of response time and intermittent hypoxemia in extremely preterm infants.

AIM: To determine the relationship between medical staff's response time (RT) to oxygen saturation (SpO2 ) below 80% and the associated time from tactile intervention until SpO2 normalisation (CT). METHODS: Time-lapse video and continuous SpO2 were recorded for six consecutive 24 h periods. Regression analyses of RT and SpO2 in association with postmenstrual age (PMA), weight, infant sex and frequency of intermittent hypoxemia (IH). RESULTS: Five hundred and twelve hypoxemia episodes received tactile intervention in 20 extremely preterm infants (gestational age ≤28 weeks, birthweight <1500 g). Median RT was 20.5 s (IQR 16.63-25.50). RT increased with increased IH frequency (p = 0.023) independently of PMA and weight. SpO2 decreased by 3.7% with every 10 s RT (p = 0.039). Time until SpO2 normalisation was strongly associated with RT (ß = 0.58, p = 0.042). The association was amplified by lower PMA (p = 0.043). Female preterm infants experienced longer RT than males (p = 0.027). Because the total length of an IH is the sum of RT and CT, preterm infants with low PMA can reach a critical hypoxemia duration of >60 s, even with short RT. CONCLUSION: The RT is a critical factor that affects the overall time of IH treatments and the depth of desaturation. The consequences of a prolonged RT are worse for more immature preterm infants.

Cognitive and emotional regulation processes of spontaneous facial self-touch are activated in the first milliseconds of touch: Replication of previous EEG findings and further insights.

Spontaneously touching one's own face (sFST) is an everyday behavior that occurs in people of all ages, worldwide. It is-as opposed to actively touching the own face-performed without directing one's attention to the action, and it serves neither instrumental (scratching, nose picking) nor communicative purposes. These sFST have been discussed in the context of self-regulation, emotional homeostasis, working memory processes, and attention focus. Even though self-touch research dates back decades, neuroimaging studies of this spontaneous behavior are basically nonexistent. To date, there is only one electroencephalography study that analyzed spectral power changes before and after sFST in 14 participants. The present study replicates the previous study on a larger sample. Sixty participants completed a delayed memory task of complex haptic relief stimuli while distracting sounds were played. During the retention interval 44 of the participants exhibited spontaneous face touch. Spectral power analyses corroborated the results of the replicated study. Decreased power shortly before sFST and increased power right after sFST indicated an involvement of regulation of attentional, emotional, and working memory processes. Additional analyses of spectral power changes during the skin contact phase of sFST revealed that significant neurophysiological changes do not occur while skin contact is in progress but at the beginning of sFST (movement toward face and initial skin contact). The present findings clearly illustrate the complexity of sFST and that the specific trigger mechanisms and functions of this spontaneous behavior need to be further investigated in controlled, experimental studies.

Refraining from spontaneous face touch is linked to personality traits, reduced memory performance and EEG changes.

Spontaneous touches of one's face (sFST) were suggested to serve cognitive-emotional regulation processes. During the pandemic, refraining from face-touching was recommended, yet, accompanying effects and the influence of personal attributes remain unclear. Ninety participants (45 female, 45 male) filled out a questionnaire concerning personality, anxiety screening and ADHD screening. Subsequently, they performed a delayed verbal memory recall task four times. After two times, sixty participants were instructed to refrain from face-touching (experimental group). Thirty participants did not receive behavioral instructions (control group). To identify face-touches and conduct further analysis, Video, EMG, and EEG data were recorded. Two samples were formed, depending on the adherence to completely refrain from face-touching (adherent, non-adherent sample) and compared to each other and the control group. EEG analyses uncovered that refraining from face-touching is accompanied by increased beta-power at sensorimotor sites and, exclusively in the non-adherent sample, at frontal sites. Decreased memory performance was found exclusively in subsamples, who non-adherently touched their face while retaining words. In terms of questionnaire results, lower Conscientiousness and higher ADHD screening scores were revealed by the non-adherent compared to the adherent sample. No differences were found among the subsamples. The presented results indicate that refraining from face-touching is related to personal attributes, accompanied by neurophysiological shifts and for a portion of humans by lower memory performance, supporting the notion that sFST serve processes beyond sensorimotor.

Spontaneity matters! Network alterations before and after spontaneous and active facial self-touches: An EEG functional connectivity study.

BACKGROUND: Despite humans frequently performing spontaneous facial self-touches (sFST), the function of this behavior remains speculative. sFST have been discussed in the context of self-regulation, emotional homeostasis, working memory processes, and attention focus. First evidence indicates that sFST and active facial self-touches (aFST) are neurobiologically different phenomena. The aim of the present analysis was to examine EEG-based connectivity in the course of sFST and aFST to test the hypotheses that sFST affect brain network interactions relevant for other than sensorimotor processes. METHODS: To trigger spontaneous FST a previously successful setting was used: 60 healthy participants manually explored two haptic stimuli and held the shapes of the stimuli in memory for a 14 min retention interval. Afterwards the shapes were drawn on a sheet of paper. During the retention interval, artifact-free EEG-data of 97 sFST by 32 participants were recorded. At the end of the experiment, the participants performed aFST with both hands successively. For the EEG-data, connectivity was computed and compared between the phases before and after sFST and aFST and between the respective before-and the after-phases. RESULTS: For the before-after comparison, brainwide distributed significant connectivity differences (p < .00079) were observed for sFST, but not for aFST. Additionally, comparing the before- and after-phases of sFST and aFST, respectively, revealed increased similarity between the after-phases than between the before-phases. CONCLUSION: The results support the assumption that sFST and aFST are neurobiologically different phenomena. Furthermore, the aligned network properties of the after-phases compared to the before-phases indicate that sFST serve self-regulatory functions that aFST do not serve.

Incidence of Intermittent Hypoxemia Increases during Clinical Care and Parental Touch in Extremely Preterm Infants.

OBJECTIVES: An increased frequency of intermittent hypoxemia (IH) is associated with a higher risk for poor developmental outcomes, disability, or death in extremely preterm infants. The objective of the prFesent study is to quantify the effect of hands-on medical and parental interventions on the incidence of IH in extremely preterm infants. METHODS: An observational design with intraindividual comparisons was used. Blood oxygen saturation levels (SpO2) and time-lapse video were recorded. Frequency, duration, and time to occurrence of IH (SpO2 <80% for ≥10 s) were compared between nursing and medical care (NMC), health care by parents, skin-to-skin contact (SSC), touch in incubator, physiotherapy, and rest. Each infant was observed for six consecutive 24-h periods. Inclusion criteria were as follows: gestational age ≤28 weeks, birth weight <1500 g, postnatal age 0-6 weeks, gavage feeding, no severe illnesses or invasive procedures, no mechanical ventilation. RESULTS: The highest proportion of time with IH occurred during NMC (2.49%) and incubator touch (1.32%), the lowest during SSC (0.74%) and health care by parents (0.67%). IH frequency per hour was highest during NMC (2.95, IQR 1.19-4.01) and lowest during SSC (0.88, IQR 0.37-2.32, p < 0.001). While an increase in IH during NMC was expected, the high incidence during incubator touch was surprising. Parental touch in the incubator is intended to be soothing, not stressful. CONCLUSIONS: Future studies need to clarify how preterm infants process touch, which attributes of touch are fundamental trigger mechanisms of IH, and which handling strategies are most effective in lowering the incidence of IH during hands-on medical care.

The suppression of spontaneous face touch and resulting consequences on memory performance of high and low self-touching individuals.

Spontaneous touching of one's own face (sFST) is an everyday behavior that occurs primarily in cognitively and emotionally demanding situations, regardless of a persons' age or gender. Recently, sFST have sparked scientific interest since they are associated with self-inoculation and transmission of respiratory diseases. Several studies addressed the need to reduce sFST behaviors without discussing the underlying functions of this spontaneous behavior. In addition, the question of why this behavior occurs very frequently in some individuals (high self-touching individuals, HT) but less frequently in others (low self-touching individuals, LT) has not yet been addressed. For the first time, we distinguished between HT and LT and investigated the behavioral consequences of sFST suppression in these two groups. For this purpose, we examined performance outcomes of 49 participants depending on sFST behaviors during a haptic working memory task. In addition, we assessed personality traits of HT and LT using the Freiburg Personality Inventory (FPI-R). The results of our study reveal that suppressing sFST in HT is negatively related to memory performance outcomes. Moreover, HT show tendencies to differ from LT in certain personality traits. Our results highlight the relevance of distinguishing between HT and LT in future studies of sFST.

Stop touching your face! A systematic review of triggers, characteristics, regulatory functions and neuro-physiology of facial self touch.

Spontaneous face touching (sFST) is an ubiquitous behavior that occurs in people of all ages and all sexes, up to 800 times a day. Despite their high frequency, they have rarely been considered as an independent phenomenon. Recently, sFST have sparked scientific interest since they contribute to self-infection with pathogens. This raises questions about trigger mechanisms and functions of sFST and whether they can be prevented. This systematic comprehensive review compiles relevant evidence on these issues. Facial self-touches seem to increase in frequency and duration in socially, emotionally as well as cognitively challenging situations. They have been associated with attention focus, working memory processes and emotion regulating functions as well as the development and maintenance of a sense of self and body. The dominance of face touch over other body parts is discussed in light of the proximity of hand-face cortical representations and the peculiarities of facial innervations. The results show that underlying psychological and neuro-physiological mechanisms of sFST are still poorly understood and that various basic questions remain unanswered.

Light or Deep Pressure: Medical Staff Members Differ Extensively in Their Tactile Stimulation During Preterm Apnea.

Background: Even though tactile stimulation is common practice to terminate preterm apnea, the style and intensity of these interventions is not specified during theoretical or practical training and has never been clinically evaluated. Objective: The present study was designed to analyze the various modes of tactile stimulation used to terminate preterm apnea and measure the pressure intensity and frequency of these stimulations. Methods: A model with the size and weight of an actual preterm infant was equipped with sensor technology to measure stimulation pressure and frequency of tactile stimulation. Additionally a camera system was used to record hand positions and stimulation modes. Seventy medical staff members took part in the experiment. Results: We found extreme between subjects differences in stimulation pressure that could not be explained by professional experience but, to a degree, depended on apnea intensity. Pressures ranged from 11.11 to 226.87 mbar during low intensity apnea and from 9.89 to 428.15 mbar during high intensity apnea. The majority of participants used rhythmic stimulation movements with a mean frequency of ~1 Hz. Different modes (rubbing, squeezing, tickling, and tapping) and finger positions were used. Conclusion: Medical staff members intuitively adjust their tactile stimulation pressure depending on the premature infants' apnea intensity. However, mean pressure values varied greatly between subjects, with similar pressure ranges for low and high intensity apnea. The question remains which pressure intensities are necessary or sufficient for the task. It is reasonable to assume that some stimulation types may be more effective in rapidly terminating an apneic event.

Self-touch: Contact durations and point of touch of spontaneous facial self-touches differ depending on cognitive and emotional load.

Every human being spontaneously touches its eyes, cheeks, chin and mouth manifold every day. These spontaneous facial self-touches (sFST) are elicited with little or no awareness and are distinct from gestures and instrumental acts. Self-touch frequency has been shown to be influenced by negative affect and attention distraction and may be involved in regulating emotion and working memory functions. Yet, even though self-touch research dates back several decades fundamental aspects, like the temporal progression of sFST or the effects of executing hand and touched face area, have not yet been analyzed. For the first time, the present study measured sFST temporal aspects to the millisecond using accelerometers and EMG. Spontaneous self-touch was triggered in sixty participants who completed a delayed memory task of complex haptic relief stimuli while listening to distracting aversive sounds. We found that while both hands were used equally often and with the same overall movement times and contact durations, significant effects occurred for face area in both frequency and contact durations. Ergo the point of touch seems to have some relevance of its own, independently of which hand is used to perform it. The results show that not only frequency but also the point of touch and contact durations are influenced by cognitive and emotional demands. We argue that investigating the fundamental characteristics of sFST will further the understanding of cognitive focusing and attentional mechanisms.

Temporal Modulations of Contact Force during Haptic Surface Exploration.

Individuals constantly modulate their exploratory movements and adapt their internal hypotheses to incoming sensory information to achieve a thorough and realistic percept. Perception depends on the exploratory movements as well as influencing them. While this seems to be common sense, scientifically we know very little about the temporal dynamics during haptic exploration. To address this, we investigated the exploratory force modulations of two groups of healthy young adults during the exploration of grated surfaces with differing detection difficulty during successive (n = 20) and random stimulus presentation (n = 20). Results showed that exploratory force depended on stimulus properties and increased with increasing detection difficulty. Both experiments yielded the same direction of results with slightly smaller effects in the random stimulus presentation group. Across exploration time average fingertip force also increased. The biggest increase occurred systematically at the beginning (within the first 40 percent) of exploration time per stimulus indicating that most critical information is received during the initial contact phase and is directly transformed into the exploration procedure and force application. Furthermore, video-analyses and comparisons to our high temporal resolution data revealed strong dynamic changes in pressure application during test stimulus exploration with differences in the force dynamics and exploration strategies of simple and difficult stimuli.