Practice effects of a breathing technique on pilots' cognitive and stress associated heart rate variability during flight operations.

Commercial pilots endure multiple stressors in their daily and occupational lives which are detrimental to psychological well-being and cognitive functioning. The Quick coherence technique (QCT) is an effective intervention tool to improve stress resilience and psychophysiological balance based on a five-minute paced breathing exercise with heart rate variability (HRV) biofeedback. The current research reports on the application of QCT training within an international airline to improve commercial pilots' psychological health and support cognitive functions. Forty-four commercial pilots volunteered in a one-month training programme to practise self-regulated QCT in day-to-day life and flight operations. Pilots' stress index, HRV time-domain and frequency-domain parameters were collected to examine the influence of QCT practice on the stress resilience process. The results demonstrated that the QCT improved psychophysiological indicators associated with stress resilience and cognitive functions, in both day-to-day life and flight operation settings. HRV fluctuations, as measured through changes in RMSSD and LF/HF, revealed that the resilience processes were primarily controlled by the sympathetic nervous system activities that are important in promoting pilots' energy mobilization and cognitive functions, thus QCT has huge potential in facilitating flight performance and aviation safety. These findings provide scientific evidence for implementing QCT as an effective mental support programme and controlled rest strategy to improve pilots' psychological health, stress management, and operational performance.

When "more for others, less for self" leads to co-benefits: A tri-MRI dyad-hyperscanning study.

Unselfishness is admired, especially when collaborations between groups of various scales are urgently needed. However, its neural mechanisms remain elusive. In a tri-MRI dyad-hyperscanning experiment involving 26 groups, each containing 4 participants as two rotating pairs in a coordination game, we sought to achieve reciprocity, or "winning in turn by the two interacting players," as the precursor to unselfishness. Due to its critical role in social processing, the right temporal-parietal junction (rTPJ) was the seed for both time domain (connectivity) and frequency domain (i.e., coherence) analyses. For the former, negative connectivity between the rTPJ and the mentalizing network areas (e.g., the right inferior parietal lobule, rIPL) was identified, and such connectivity was further negatively correlated with the individual's final gain, supporting our task design that "rewarded" the reciprocal participants. For the latter, cerebral coherences of the rTPJs emerged between the interacting pairs (i.e., within-group interacting pairs), and the coupling between the rTPJ and the right superior temporal gyrus (rSTG) between the players who were not interacting with each other (i.e., within-group noninteracting pairs). These coherences reinforce the hypotheses that the rTPJ-rTPJ coupling tracks the collaboration processes and the rTPJ-rSTG coupling for the emergence of decontextualized shared meaning. Our results underpin two social roles (inferring others' behavior and interpreting social outcomes) subserved by the rTPJ-related network and highlight its interaction with other-self/other-concerning brain areas in reaching co-benefits among unselfish players.

Mapping between cognitive theories and psycho-physiological models of attention system performance.

Declines in the capacity to sustain attention to repetitive, monotonous tasks is a phenomenon known as vigilance decrement (Endsley M, Kiris E. The out-of-the-loop performance problem and level of control in automation. 1995. Hum Factors. 37:32-64). This review compares cognitive theories with psycho-physiological models of vigilance decrement, and a gap is identified in mapping between the 2. That is, theories of vigilance decrement refer to "cognitive" resources; by contrast, psychophysiological models of the cerebral systems associated with attention explain performance functions according to neurochemical resources. A map does not currently exist in the literature that bridges the gap between cognitive theories of vigilance decrement and psychophysiological models of the human attention system. The link between "cognitive resource" theories of vigilance decrement and the psychophysiological models of attention performance is a gap in the literature that this review fills. This comprehensive review provides an expanded psychophysiological understanding of vigilance decrement that could help inform the management of declines in sustained attention capacity in operational settings. In addition, elucidating the link between cognitive theories of vigilance decrement and psychophysiological models of the human attention system might be used to treat and better understand pathologies such as attention-deficit hyperactivity disorder.

Machine learning-enabled detection of attention-deficit/hyperactivity disorder with multimodal physiological data: a case-control study.

BACKGROUND: Attention-Deficit/Hyperactivity Disorder (ADHD) is a multifaceted neurodevelopmental psychiatric condition that typically emerges during childhood but often persists into adulthood, significantly impacting individuals' functioning, relationships, productivity, and overall quality of life. However, the current diagnostic process exhibits limitations that can significantly affect its overall effectiveness. Notably, its face-to-face and time-consuming nature, coupled with the reliance on subjective recall of historical information and clinician subjectivity, stand out as key challenges. To address these limitations, objective measures such as neuropsychological evaluations, imaging techniques and physiological monitoring of the Autonomic Nervous System functioning, have been explored. METHODS: The main aim of this study was to investigate whether physiological data (i.e., Electrodermal Activity, Heart Rate Variability, and Skin Temperature) can serve as meaningful indicators of ADHD, evaluating its utility in distinguishing adult ADHD patients. This observational, case-control study included a total of 76 adult participants (32 ADHD patients and 44 healthy controls) who underwent a series of Stroop tests, while their physiological data was passively collected using a multi-sensor wearable device. Univariate feature analysis was employed to identify the tests that triggered significant signal responses, while the Informative k-Nearest Neighbors (KNN) algorithm was used to filter out less informative data points. Finally, a machine-learning decision pipeline incorporating various classification algorithms, including Logistic Regression, KNN, Random Forests, and Support Vector Machines (SVM), was utilized for ADHD patient detection. RESULTS: Results indicate that the SVM-based model yielded the optimal performance, achieving 81.6% accuracy, maintaining a balance between the experimental and control groups, with sensitivity and specificity of 81.4% and 81.9%, respectively. Additionally, integration of data from all physiological signals yielded the best results, suggesting that each modality captures unique aspects of ADHD. CONCLUSIONS: This study underscores the potential of physiological signals as valuable diagnostic indicators of adult ADHD. For the first time, to the best of our knowledge, our findings demonstrate that multimodal physiological data collected via wearable devices can complement traditional diagnostic approaches. Further research is warranted to explore the clinical applications and long-term implications of utilizing physiological markers in ADHD diagnosis and management.

Functional connectivity characteristics of the brain network involved in prickle perception of single fiber stimulation.

BACKGROUND: The complex network connections, information transmission and organization play key roles in brain cognition on sensory stimulation. Previous studies showed that several brain regions of somatosensory, motor, emotional, cognitive, etc. are linked to fabric-evoked prickle. But the functional connectivity characteristics of the brain network involved in prickle perception is still unclear. MATERIALS AND METHODS: In the present study, resting state fMRI (functional magnetic resonance imaging) with functional connectivity analysis was adopted to build the initial brain functional network, and task fMRI with psychophysiological interaction analysis was employed to investigate modulation features of prickling task to functional connections in the brain network. RESULTS: The results showed that, in resting state, six groups or sub-networks can be identified in the prickle network, and when the subjects performed the prickling task, functional connectivity strength between some seed regions (e.g., somatosensory regions and precuneus, emotional regions and the prefrontal cortex, etc.) in the network increased. CONCLUSION: Combining resting-state fMRI with task fMRI is a feasible and promising method to study functional connectivity characteristics of the brain network involved in prickle perception. It is inferred that the "itch" ingredient of prickle sensation was transmitted from somatosensory cortices to precuneus, and emotional attribute (e.g., pain) from somatosensory cortices to the prefrontal cortex and at last to emotional regions.

Physiological Effects of Psychological Interventions Among Persons with Financial Stress: A Systematic Review, Meta-analysis, and Introduction to Psychophysiological Economics.

It is known that economic problems can cause psychological stress, and that psychological stress causes physiological changes often linked to disease. Here we report a systematic review and meta-analysis of studies on physiological effects of psychological treatment for individuals with economic problems. Of 5071 papers in our initial PsycInfo search, we identified 16 papers on physiological effects for psychological treatment of the economically stressed. We found 11 controlled studies, among which we found a small to moderate significant effect size, Hedges' g = 0.319, p < 0.001. The largest effect sizes were found for heart rate variability and measures of inflammation, and the smallest for measures involving cortisol. The studies were all on chronically poor populations, thus restricting generalization to other financially stressed populations such as students, athletes in training, and those stressed by relative deprivation compared with neighbors or other reference groups. None of the studies examined effects of these psychophysiological changes on disease susceptibility, and none included elements of financial planning. The nascent field of financial psychophysiology calls for more research in these areas. Even so, results suggest that financially stressed people can benefit physiologically from psychological stress management methods.

Utilising raw psycho-physiological data and functional data analysis for estimating mental workload in human drivers.

Recent studies have focused on accurately estimating mental workload using machine learning algorithms and extracting features from physiological measures. However, feature extraction leads to the loss of valuable information and often results in binary classifications that lack specificity in the identification of optimum mental workload. This study investigates the feasibility of using raw physiological data (EEG, facial EMG, ECG, EDA, pupillometry) combined with Functional Data Analysis (FDA) to estimate the mental workload of human drivers. A driving scenario with five tasks was employed, and subjective ratings were collected. Results demonstrate that the FDA applied nine different combinations of raw physiological signals achieving a maximum 90% accuracy, outperforming extracted features by 73%. This study shows that the mental workload of human drivers can be accurately estimated without utilising burdensome feature extraction. The approach proposed in this study offers promise for mental workload assessment in real-world applications.

This study aimed to estimate the mental workload of human drivers using physiological signals and Functional Data Analysis (FDA). By comparing models using raw data and extracted features, the results show that the FDA with raw data achieved a high accuracy of 90%, outperforming the model with extracted features (73%).

Dimensionality and optimal combination of autonomic fear-conditioning measures in humans.

Fear conditioning, also termed threat conditioning, is a commonly used learning model with clinical relevance. Quantification of threat conditioning in humans often relies on conditioned autonomic responses such as skin conductance responses (SCR), pupil size responses (PSR), heart period responses (HPR), or respiration amplitude responses (RAR), which are usually analyzed separately. Here, we investigate whether inter-individual variability in differential conditioned responses, averaged across acquisition, exhibits a multi-dimensional structure, and the extent to which their linear combination could enhance the precision of inference on whether threat conditioning has occurred. In a mega-analytic approach, we re-analyze nine data sets including 256 individuals, acquired by the group of the last author, using standard routines in the framework of psychophysiological modeling (PsPM). Our analysis revealed systematic differences in effect size between measures across datasets, but no evidence for a multidimensional structure across various combinations of measures. We derive the statistically optimal weights for combining the four measures and subsets thereof, and we provide out-of-sample performance metrics for these weights, accompanied by bias-corrected confidence intervals. We show that to achieve the same statistical power, combining measures allows for a relevant reduction in sample size, which in a common scenario amounts to roughly 24%. To summarize, we demonstrate a one-dimensional structure of threat conditioning measures, systematic differences in effect size between measures, and provide weights for their optimal linear combination in terms of maximal retrodictive validity.

Comparative Analysis of Psychophysiological Responses in Fibromyalgia Patients: Evaluating Neuromodulation Alone, Neuromodulation Combined with Virtual Reality, and Exercise Interventions.

BACKGROUND AND OBJECTIVES: Fibromyalgia, a chronic condition, manifests as widespread musculoskeletal pain, fatigue, sleep disturbances, autonomic and cognitive dysfunction, hypersensitivity to stimuli, and various somatic and psychiatric symptoms. This study, a controlled and randomized experiment, aimed to evaluate and compare the immediate effects of different treatments on fibromyalgia patients. MATERIALS AND METHODS: The treatments included the EXOPULSE Mollii suit, a combination of the EXOPULSE Mollii suit with a virtual reality (VR) protocol, and a physical exercise regimen. A cohort of 89 female fibromyalgia patients was randomly assigned to one of four groups: Control (n = 20), Suit only (n = 22), Suit combined with VR (n = 21), and Exercise (n = 26). RESULTS: This study found notable differences across the groups in several key parameters. In the Control group, significant changes were observed in Forced Expiratory Volume (FEV 1/FEV 6), the Numeric Rating Scale (NRS) for pain, Pressure Pain Threshold (PPT) at the epicondyle, cortical arousal levels, the 10 m up-and-go test, and in all measured variables related to temperature and muscle oxygenation. For the group using the suit alone, there were significant differences noted in the NRS, the chair stand test, palm temperature, and all muscle oxygenation parameters. The Suit + VR group showed significant changes in the NRS, PPT at the knee, handgrip strength test, the 10 m up-and-go test, one-leg balance test with the right leg, muscle oxygen saturation (SmO2), deoxygenated hemoglobin (HHb), and oxygenated hemoglobin (O2Hb). Finally, the Exercise group exhibited significant differences in FEV 1/FEV 6, chest perimeter difference, NRS, PPT at both the epicondyle and knee, cortical arousal, the chair stand test, the 10-m up-and-go test, and in SmO2, HHb, and O2Hb levels. CONCLUSIONS: combining neuromodulation with VR and targeted exercise regimens can effectively alleviate fibromyalgia symptoms, offering promising avenues for non-pharmacological management.

Lifespan differences in visual short-term memory load-modulated functional connectivity.

Working memory is critical to higher-order executive processes and declines throughout the adult lifespan. However, our understanding of the neural mechanisms underlying this decline is limited. Recent work suggests that functional connectivity between frontal control and posterior visual regions may be critical, but examinations of age differences therein have been limited to a small set of brain regions and extreme group designs (i.e., comparing young and older adults). In this study, we build on previous research by using a lifespan cohort and a whole-brain approach to investigate working memory load-modulated functional connectivity in relation to age and performance. The article reports on analysis of the Cambridge center for Ageing and Neuroscience (Cam-CAN) data. Participants from a population-based lifespan cohort (N = 101, age 23-86) performed a visual short-term memory task during functional magnetic resonance imaging. Visual short-term memory was measured with a delayed recall task for visual motion with three different loads. Whole-brain load-modulated functional connectivity was estimated using psychophysiological interactions in a hundred regions of interest, sorted into seven networks (Schaefer et al., 2018, Yeo et al., 2011). Results showed that load-modulated functional connectivity was strongest within the dorsal attention and visual networks during encoding and maintenance. With increasing age, load-modulated functional connectivity strength decreased throughout the cortex. Whole-brain analyses for the relation between connectivity and behavior were non-significant. Our results give additional support to the sensory recruitment model of working memory. We also demonstrate the widespread negative impact of age on the modulation of functional connectivity by working memory load. Older adults might already be close to ceiling in terms of their neural resources at the lowest load and therefore less able to further increase connectivity with increasing task demands.

Cognitive inflexibility is linked to abnormal frontoparietal-related activation and connectivity in obsessive-compulsive disorder.

Although it was acknowledged that patients with obsessive-compulsive disorder (OCD) would exhibit cognitive inflexibility, the underlying neural mechanism has not been fully clarified. Therefore, this study aimed to investigate the neural substrates involved in cognitive inflexibility among individuals with OCD. A total of 42 patients with OCD and 48 healthy controls (HCs) completed clinical assessment and functional magnetic resonance imaging (fMRI) data collection during cued task switching. Behavioral performances and fMRI activation were compared between the OCD group and the HC group. Psychophysiological interactions (PPIs) analyses were applied to explore functional connectivity related to task switching. Pearson correlation was used to investigate the relationships among behavioral performance, fMRI activity, and obsessive-compulsive symptoms in OCD. The OCD group had a greater switch cost than HCs (χ2 = 5.89, p < .05). A significant difference in reaction time was found during switch (χ2 = 17.72, p < .001) and repeat (χ2 = 16.60, p = .018) between the two groups, while there was no significant difference in group accuracy. Comparison of group differences showed that the OCD group had increased activation in the right superior parietal cortex (rSPL) during task switching, and exhibited increased connectivity of frontoparietal network/default mode network (FPN-DMN; i.e., middle frontal gyrus [MFG]/inferior parietal cortex-precuneus, MFG-middle/posterior cingulate gyrus) and within the FPN (inferior parietal cortex-postcentral gyrus). In the OCD group, the compulsion score was positively correlated with accuracy during switch (r = .405, p = .008, FDRq <.05), and negatively correlated with activation of rSPL (r = -.328, p = .034, FDRq >.05). Patients with OCD had impaired cognitive flexibility and cautious response strategy. The neural mechanism of cognitive inflexibility in OCD may involve increased activation in the rSPL, as well as hyperconnectivity within the FPN and between the FPN and DMN.

The mediating role of default mode network during meaning-making aroused by mental simulation between stressful events and stress-related growth: a task fMRI study.

BACKGROUND: Stressful events and meaning-making toward them play an important role in adolescents' life and growth. However, ignoring positive stressful events leads to negativity bias; further, the neural mechanisms of meaning-making are unclear. We aimed to verify the mediating role of meaning-making in stressful events and stress-related growth and the function of the default mode network (DMN) during meaning-making in this functional magnetic resonance imaging (fMRI) study. METHODS: Participants comprised 59 university students. Stressful life events, meaning-making, and stress-related growth were assessed at baseline, followed by fMRI scanning during a meaning-making task aroused by mental simulation. General linear modeling and psychophysiological interaction (PPI) analyses were used to explore the activation and functional connectivity of DMN during meaning-making. RESULTS: Mental simulation triggered meaning-making, and DMN activity decreased during meaning-making. Activation of the DMN was negatively correlated with coping flexibility, an indicator of stress-related growth. PPI analysis showed that meaning-making was accompanied by diminished connectivity in the DMN. DMN activation during meaning-making can mediate the relationship between positive stressful events and coping flexibility. CONCLUSIONS: Decreased DMN activity and diminished functional connectivity in the DMN occurred during meaning-making. Activation of the DMN during meaning-making could mediate the relationship between positive stressful events and stress-related growth, which provides a cognitive neural basis for the mediating role of meaning-making in the relationship between stressful events and indicators of stress-related growth. IMPLICATIONS: This study supports the idea that prosperity makes heroes, expands the meaning-making model, and suggests the inclusion of enhancing personal resources and meaning-making in education. This study was the first to validate the activation pattern and functional connectivity of the DMN during meaning-making aroused by mental simulation using an fMRI task-state examination, which can enhance our sense of meaning and provide knowledge that can be used in clinical psychology interventions. TRIAL REGISTRATION: The study protocol was pre-registered in Open Science Framework (see osf.io/ahm6e for details).

Dynamic hippocampal functional connectivity responses to varying working memory loads following total sleep deprivation.

Sleep loss with work overload can impact human cognitive performance. However, the brain's response to an increased working memory load following total sleep deprivation (TSD) remains unclear. In the present study, we focussed on the dynamic response of the hippocampus to increased working memory load before and after total sleep deprivation of 36 h. A total of 16 male participants completed a verbal working memory task under functional magnetic resonance imaging. After whole-brain activation analysis and region of interest analysis of the hippocampus, the generalised form of context-dependent psychophysiological interactions (gPPI) was used to analyse the hippocampal functional connectivity with the whole brain. The results revealed that as the working memory load increased within a small range, from 0-back to 1-back task, the left hippocampal functional connectivity decreased with the left supplementary motor area, left pars opercularis, left rolandic operculum, right superior frontal gyrus, bilateral precentral gyrus, and left middle cingulate cortex following total sleep deprivation compared with that observed in resting wakefulness. When the working memory load further increased from 1-back to 2-back task, the connectivity increased between the left hippocampus and the left superior parietal lobule as well as between the left hippocampus and right lingual gyrus after total sleep deprivation compared with that observed in resting wakefulness. Moreover, the left hippocampus gPPI effect on the left middle cingulate cortex and left superior parietal lobule could predict the behavioural test accuracy in 1-back and 2-back task, respectively, following total sleep deprivation. These findings indicated that increased working memory load after total sleep deprivation disrupts working memory processes. The brain reacts to these disruptions in a dynamic and flexible manner, involving not only brain activation but also hippocampus-related functional network connections.

Psychophysiological Responses of College Students to Audio-Visual Forest Trail Landscapes.

Forest trails provide urban residents with contact with nature that improves health and well-being. Vision and hearing are important forms of environmental perception, and visual and auditory stimuli should not be overlooked in forest trail landscapes. This study focused on the health benefits of the audio-visual perception of forest trail landscapes. Forest density (FD) and forest sounds (FS) in forest trail landscapes were examined as visual and auditory variables, respectively. FD was divided into three levels: high (Hd), medium (Md), and low density (Ld). FS were divided into four levels: quiet natural and anthropogenic sounds (QnQa), quiet natural and loud anthropogenic sounds (QnLa), loud natural and quiet anthropogenic sounds (LnQa), and loud natural and loud anthropogenic sounds (LnLa). The levels of these two variables were combined to create 12 conditions. A total of 360 college students were randomly assigned to 12 groups (mapping onto the 12 conditions; N=30 per group). All subjects performed the same 5-min high-pressure task indoors, followed by a 5-min recovery period of experiencing a simulated forest trail landscape (viewing pictures and listening to sounds). Brain waves, blood pressure, blood oxygen saturation (SpO2, measured with a finger monitor), the pulse rate, and mood indicators were collected to analyse the physiological and psychological responses to the audio-visual forest trail landscapes. The results indicated that higher FD and lower FS improved health benefits. The interaction between FD and FS revealed a pattern of combinations that facilitated stress reduction and positive mood recovery. These results are of theoretical value in that they indicate important audio-visual characteristics of forest trail landscapes. In terms of practical applications, these findings support the construction of urban forest trails to provide health benefits.

Whole-brain connectivity during encoding: age-related differences and associations with cognitive and brain structural decline.

There is a limited understanding of age differences in functional connectivity during memory encoding. In the present study, a sample of cognitively healthy adult participants (n = 488, 18-81 years), a subsample of whom had longitudinal cognitive and brain structural data spanning on average 8 years back, underwent functional magnetic resonance imaging while performing an associative memory encoding task. We investigated (1) age-related differences in whole-brain connectivity during memory encoding; (2) whether encoding connectivity patterns overlapped with the activity signatures of specific cognitive processes, and (3) whether connectivity associated with memory encoding related to longitudinal brain structural and cognitive changes. Age was associated with lower intranetwork connectivity among cortical networks and higher internetwork connectivity between networks supporting higher level cognitive functions and unimodal and attentional areas during encoding. Task-connectivity between mediotemporal and posterior parietal regions-which overlapped with areas involved in mental imagery-was related to better memory performance only in older age. The connectivity patterns supporting memory performance in older age reflected preservation of thickness of the medial temporal cortex. The results are more in accordance with a maintenance rather than a compensation account.

An explorative single-arm clinical study to assess craving in patients with alcohol use disorder using Virtual Reality exposure (CRAVE)-study protocol.

BACKGROUND: Alcohol use disorder (AUD) belongs to the most burdensome clinical disorders worldwide. Current treatment approaches yield unsatisfactory long-term effects with relapse rates up to 85%. Craving for alcohol is a major predictor for relapse and can be intentionally induced via cue exposure in real life as well as in Virtual Reality (VR). The induction and habituation of craving via conditioned cues as well as extinction learning is used in Cue Exposure Therapy (CET), a long-known but rarely used strategy in Cognitive Behavioral Therapy (CBT) of AUD. VR scenarios with alcohol related cues offer several advantages over real life scenarios and are within the focus of current efforts to develop new treatment options. As a first step, we aim to analyze if the VR scenarios elicit a transient change in craving levels and if this is measurable via subjective and psychophysiological parameters. METHODS: A single-arm clinical study will be conducted including n = 60 patients with AUD. Data on severity of AUD and craving, comorbidities, demographics, side effects and the feeling of presence in VR will be assessed. Patients will use a head-mounted display (HMD) to immerse themselves into three different scenarios (neutral vs. two target situations: a living room and a bar) while heart rate, heart rate variability, pupillometry and electrodermal activity will be measured continuously. Subjective craving levels will be assessed before, during and after the VR session. DISCUSSION: Results of this study will yield insight into the induction of alcohol craving in VR cue exposure paradigms and its measurement via subjective and psychophysiological parameters. This might be an important step in the development of innovative therapeutic approaches in the treatment of patients with AUD. TRIAL REGISTRATION: This study was approved by the Charité-Universitätsmedizin Berlin Institutional Review Board (EA1/190/22, 23.05.2023). It was registered on ClinicalTrials.gov (NCT05861843).

Psychophysiological coherence training to moderate air traffic controllers' fatigue on rotating roster.

The nature of the current rotating roster, providing 24-h air traffic services over five irregular shifts, leads to accumulated fatigue which impairs air traffic controllers' cognitive function and task performance. It is imperative to develop an effective fatigue risk management system to improve aviation safety based upon scientific approaches. Two empirical studies were conducted to address this issue. Study 1 investigated the mixed effect of circadian rhythm disorders and resource depletion on controllers' accumulated fatigue. Then, study 2 proposed a potential biofeedback solution of quick coherence technique which can mitigate air traffic controllers' (ATCOs') fatigue while on controller working position and improve ATCOs' mental/physical health. The current two-studies demonstrated a scientific approach to fatigue analysis and fatigue risk mitigation in the air traffic services domain. This research offers insights into the fluctuation of ATCO fatigue levels and the influence of a numbers of factors related to circadian rhythm and resource depletion impact on fatigue levels on study 1; and provides psychophysiological coherence training to increase ATCOs' fatigue resilience to mitigate negative impacts of fatigue on study 2. Based on these two studies, the authors recommended that an extra short break for air traffic controllers to permit practicing the quick coherence breathing technique for 5 min at the sixth working hour could substantially recharge cognitive resources and increase fatigue resilience. Application: Present studies highlight an effective fatigue intervention based on objective biofeedback to moderate controllers' accumulated fatigue as a result of rotating shift work. Accordingly, air navigation services providers and regulators can develop fatigue risk management systems based on scientific approaches to improve aviation safety and air traffic controller's wellbeing.

Time Since Last Drink is Positively Associated with Heart Rate Variability in Outpatients with Alcohol Use Disorder: Further Evidence of Psychophysiological Recovery in Early Alcohol Use Disorder Recovery.

Heart rate variability (HRV) is a biomarker of psychological and physiological health with greater variability reflecting greater psychophysiological regulatory capacity. The damaging effects of chronic, heavy alcohol use on HRV have been well explored, with greater alcohol use associated with lower resting HRV. In this study we sought to replicate and extend our previous finding that HRV improves as individuals with alcohol use disorder (AUD) reduce or stop drinking and engage in treatment. With a sample of treatment engaged adults in the first year of a current AUD recovery attempt (N = 42), we used general linear models to explore associations between indices of HRV (dependent variables) and time since last alcoholic drink at study baseline assessed using timeline follow-back (independent variable), with checks for effects of age, medication, and baseline AUD severity. As predicted, HRV increased as a function of time since last drink, however, contrary to hypotheses, HR did not decrease. Effect sizes were largest for HRV indices fully under parasympathetic control, and these significant associations remained after controlling for age, medications, and AUD severity. Because HRV is an indicant of psychophysiological health, as well as self-regulatory capacity that may portend subsequent relapse risk, assessing HRV in individuals entering AUD treatment could provide important information about patient risk. At-risk patients may do well with additional support and may especially benefit from interventions like Heart Rate Variability Biofeedback that exercise the psychophysiological systems regulating brain/cardiovascular communication.

Quick coherence technique facilitating commercial pilots' psychophysiological resilience to the impact of COVID-19.

This study investigates the effect of quick coherence technique (QCT) on commercial pilots' resilience to the unprecedented impact of a pandemic. Eighteen commercial pilots voluntarily participated in a 2-day training course on QCT followed by 2 months of self-regulated QCT practicing during controlled rest in the flight deck and day-to day life. There are subjective and objective assessments to evaluate the effects of QCT on commercial pilots' psychophysiological resilience. Results demonstrated that QCT training can significantly increase pilots' psychophysiological resilience thereby improving their mental/physical health, cognitive functions, emotional stability and wellness on both subjective (PSS & AWSA) and objective measures (coherence scores). Moreover, pilots who continued practicing self-regulated QCT gained the maximum benefits. Current research has identified great potential to enhance pilots' mental/physical health via QCT training. Operators can develop peer support programs for pilots to increase resilience and maintain mental and physical health using the QCT technique. Practitioner summary: QCT breathing has been proven to increase commercial pilots' resilience by moderating psychophysiological coherence, strengthening mental/physical capacity and sustaining positive emotions to deal with the challenges both on the flight deck and in everyday life.HIGHLIGHTSPilots have suffered from the impact of the Covid-19 pandemic across many factors including social, economic, mental, physical, emotional, and operational issuesBiofeedback training can increase commercial pilots' resilience by moderating psychophysiological coherence, strengthening mental and physical capacitySelf-regulated practicing QCT to form a habitual behaviour is required to sustain the maximum benefits either in the flight or day-to-day lifeQCT is an effective intervention for aviation authorities and airline operators to develop peer support programs to increase pilots' fatigue resilience.

The Relationship Between Health-Related Quality of Life and Lower-Extremity Visuomotor Reaction Time in Young Adult Women Following Ankle Sprain.

CONTEXT: Many individuals who sustain a lateral ankle sprain (LAS) fail to return to prior activity due to residual symptoms; and report elevated levels of injury-related fear, decreased function, and decreased health-related quality of life (HRQOL). Additionally, individuals with history of LAS exhibit deficits in neurocognitive functional measures like visuomotor reaction time (VMRT), which contributes to worse patient-reported outcome scores. The aim of this study was to examine the relationship between HRQOL and lower-extremity (LE) VMRT in individuals with LAS history. DESIGN: Cross-sectional. METHODS: Young adult female volunteers with history of LAS (n = 22; age = 24 [3.5] y; height = 163.1 [9.8] cm; mass = 65.1 [11.5] kg; and time since last LAS = 67.8 [50.5] mo) completed HRQOL outcomes including the following: (1) Tampa Scale of Kinesiophobia-11, (2) Fear-Avoidance Beliefs Questionnaire, (3) Penn State Worry Questionnaire, (4) modified Disablement in the Physically Active Scale, and (5) Foot and Ankle Disability Index (FADI). Additionally, participants completed a LE-VMRT task by responding to a visual stimulus using their foot to deactivate light sensors. Participants completed trials bilaterally. Separate Spearman rho correlations were performed to assess the relationship between patient-reported outcomes assessing constructs of HRQOL and LE-VRMT bilaterally. Significance was set at P < .05. RESULTS: There was a strong, significant negative correlation between FADI-Activities of Daily Living (ρ = -.68; P = .002) and FADI-Sport (ρ = -.76; P = .001) scores and injured limb LE-VMRT; moderate, significant negative correlations between the uninjured limb LE-VMRT and FADI-Activities of Daily Living (ρ = -.60; P = .01) and FADI-Sport (ρ = -.60; P = .01) scores; and moderate, significant positive correlations between the injured limb LE-VMRT and modified Disablement in the Physically Active Scale-Physical Summary Component (ρ = .52; P = .01) and modified Disablement in the Physically Active Scale-Total (ρ = .54; P = .02) scores. All other correlations were not statistically significant. CONCLUSIONS: Young adult women with history of LAS demonstrated an association between self-reported constructs of HRQOL and LE-VMRT. As LE-VMRT is a modifiable injury risk factor, future studies should examine the effectiveness of interventions designed to improve LE-VMRT and the impact on self-reported HRQOL.