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1. A Micro-Level Analysis of Physiological Responses to COVID-19: Continuous Monitoring of Pregnant Women in California

   https://doi.org/10.3389/fpubh.2022.808763  

   Jimah, Tamara ; Kehoe, Priscilla ; Borg, Holly ; Pimentel, Pamela ; Rahmani, Amir ; Dutt, Nikil ; Guo, Yuqing ( April 2022 , Frontiers in Public Health)

   Continuous monitoring of perinatal women in a descriptive case study allowed us the opportunity to examine the time during which the COVID-19 infection led to physiological changes in two low-income pregnant women. An important component of this study was the use of a wearable sensor device, the Oura ring, to monitor and record vital physiological parameters during sleep. Two women in their second and third trimesters, respectively, were selected based on a positive COVID-19 diagnosis. Both women were tested using the polymerase chain reaction method to confirm the presence of the virus during which time we were able to collect these physiological data. In both cases, we observed 3–6 days of peak physiological changes in resting heart rate (HR), heart rate variability (HRV), and respiratory rate (RR), as well as sleep surrounding the onset of COVID-19 symptoms. The pregnant woman in her third trimester showed a significant increase in resting HR ( p = 0.006) and RR ( p = 0.048), and a significant decrease in HRV ( p = 0.027) and deep sleep duration ( p = 0.029). She reported experiencing moderate COVID-19 symptoms and did not require hospitalization. At 38 weeks of gestation, she had a normal deliverymore »and gave birth to a healthy infant. The participant in her second trimester showed similar physiological changes during the 3-day peak period. Importantly, these changes appeared to return to the pre-peak levels. Common symptoms reported by both cases included loss of smell and nasal congestion, with one losing her sense of taste. Results suggest the potential to use the changes in cardiorespiratory responses and sleep for real-time monitoring of health and well-being during pregnancy.« less
2. Pregnant women’s daily patterns of well-being before and during the COVID-19 pandemic in Finland: Longitudinal monitoring through smartwatch technology

   https://doi.org/10.1371/journal.pone.0246494  

   Niela-Vilén, Hannakaisa ; Auxier, Jennifer ; Ekholm, Eeva ; Sarhaddi, Fatemeh ; Asgari Mehrabadi, Milad ; Mahmoudzadeh, Aysan ; Azimi, Iman ; Liljeberg, Pasi ; Rahmani, Amir M. ; Axelin, Anna ( February 2021 , PLOS ONE)

   Ryckman, Kelli K (Ed.)

   Background Technology enables the continuous monitoring of personal health parameter data during pregnancy regardless of the disruption of normal daily life patterns. Our research group has established a project investigating the usefulness of an Internet of Things–based system and smartwatch technology for monitoring women during pregnancy to explore variations in stress, physical activity and sleep. The aim of this study was to examine daily patterns of well-being in pregnant women before and during the national stay-at-home restrictions related to the COVID-19 pandemic in Finland. Methods A longitudinal cohort study design was used to monitor pregnant women in their everyday settings. Two cohorts of pregnant women were recruited. In the first wave in January-December 2019, pregnant women with histories of preterm births (gestational weeks 22–36) or late miscarriages (gestational weeks 12–21); and in the second wave between October 2019 and March 2020, pregnant women with histories of full-term births (gestational weeks 37–42) and no pregnancy losses were recruited. The final sample size for this study was 38 pregnant women. The participants continuously used the Samsung Gear Sport smartwatch and their heart rate variability, and physical activity and sleep data were collected. Subjective stress, activity and sleep reports were collected using amore »smartphone application developed for this study. Data between February 12 to April 8, 2020 were included to cover four-week periods before and during the national stay-at-home restrictions. Hierarchical linear mixed models were exploited to analyze the trends in the outcome variables. Results The pandemic-related restrictions were associated with changes in heart rate variability: the standard deviation of all normal inter-beat intervals (p = 0.034), low-frequency power (p = 0.040) and the low-frequency/high-frequency ratio (p = 0.013) increased compared with the weeks before the restrictions. Women’s subjectively evaluated stress levels also increased significantly. Physical activity decreased when the restrictions were set and as pregnancy proceeded. The total sleep time also decreased as pregnancy proceeded, but pandemic-related restrictions were not associated with sleep. Daily rhythms changed in that the participants overall started to sleep later and woke up later. Conclusions The findings showed that Finnish pregnant women coped well with the pandemic-related restrictions and lockdown environment in terms of stress, physical activity and sleep.« less
3. Sleep Tracking of a Commercially Available Smart Ring and Smartwatch Against Medical-Grade Actigraphy in Everyday Settings: Instrument Validation Study

   https://doi.org/10.2196/20465  

   Asgari Mehrabadi, Milad ; Azimi, Iman ; Sarhaddi, Fatemeh ; Axelin, Anna ; Niela-Vilén, Hannakaisa ; Myllyntausta, Saana ; Stenholm, Sari ; Dutt, Nikil ; Liljeberg, Pasi ; Rahmani, Amir M ( January 2020 , JMIR mHealth and uHealth)

   Background Assessment of sleep quality is essential to address poor sleep quality and understand changes. Owing to the advances in the Internet of Things and wearable technologies, sleep monitoring under free-living conditions has become feasible and practicable. Smart rings and smartwatches can be employed to perform mid- or long-term home-based sleep monitoring. However, the validity of such wearables should be investigated in terms of sleep parameters. Sleep validation studies are mostly limited to short-term laboratory tests; there is a need for a study to assess the sleep attributes of wearables in everyday settings, where users engage in their daily routines. Objective This study aims to evaluate the sleep parameters of the Oura ring along with the Samsung Gear Sport watch in comparison with a medically approved actigraphy device in a midterm everyday setting, where users engage in their daily routines. Methods We conducted home-based sleep monitoring in which the sleep parameters of 45 healthy individuals (23 women and 22 men) were tracked for 7 days. Total sleep time (TST), sleep efficiency (SE), and wake after sleep onset (WASO) of the ring and watch were assessed using paired t tests, Bland-Altman plots, and Pearson correlation. The parameters were also investigated considering themore »gender of the participants as a dependent variable. Results We found significant correlations between the ring’s and actigraphy’s TST (r=0.86; P<.001), WASO (r=0.41; P<.001), and SE (r=0.47; P<.001). Comparing the watch with actigraphy showed a significant correlation in TST (r=0.59; P<.001). The mean differences in TST, WASO, and SE of the ring and actigraphy were within satisfactory ranges, although there were significant differences between the parameters (P<.001); TST and SE mean differences were also within satisfactory ranges for the watch, and the WASO was slightly higher than the range (31.27, SD 35.15). However, the mean differences of the parameters between the watch and actigraphy were considerably higher than those of the ring. The watch also showed a significant difference in TST (P<.001) between female and male groups. Conclusions In a sample population of healthy adults, the sleep parameters of both the Oura ring and Samsung watch have acceptable mean differences and indicate significant correlations with actigraphy, but the ring outperforms the watch in terms of the nonstaging sleep parameters.« less
4. Micro-expressions in Animated Agents

   https://doi.org/10.54941/ahfe1001081  

   Hou, Tianyu ; Adamo, Nicoletta ; Villani, Nicholas ( January 2022 , AHFE International)

   The overall goal of our research is to develop a system of intelligent multimodal affective pedagogical agents that are effective for different types of learners (Adamo et al., 2021). While most of the research on pedagogical agents tends to focus on the cognitive aspects of online learning and instruction, this project explores the less-studied role of affective (or emotional) factors. We aim to design believable animated agents that can convey realistic, natural emotions through speech, facial expressions, and body gestures and that can react to the students’ detected emotional states with emotional intelligence. Within the context of this goal, the specific objective of the work reported in the paper was to examine the extent to which the agents’ facial micro-expressions affect students’ perception of the agents’ emotions and their naturalness. Micro-expressions are very brief facial expressions that occur when a person either deliberately or unconsciously conceals an emotion being felt (Ekman &Friesen, 1969). Our assumption is that if the animated agents display facial micro expressions in addition to macro expressions, they will convey higher expressive richness and naturalness to the viewer, as “the agents can possess two emotional streams, one based on interaction with the viewer and the other basedmore »on their own internal state, or situation” (Queiroz et al. 2014, p.2).The work reported in the paper involved two studies with human subjects. The objectives of the first study were to examine whether people can recognize micro-expressions (in isolation) in animated agents, and whether there are differences in recognition based on the agent’s visual style (e.g., stylized versus realistic). The objectives of the second study were to investigate whether people can recognize the animated agents’ micro-expressions when integrated with macro-expressions, the extent to which the presence of micro + macro-expressions affect the perceived expressivity and naturalness of the animated agents, the extent to which exaggerating the micro expressions, e.g. increasing the amplitude of the animated facial displacements affects emotion recognition and perceived agent naturalness and emotional expressivity, and whether there are differences based on the agent’s design characteristics. In the first study, 15 participants watched eight micro-expression animations representing four different emotions (happy, sad, fear, surprised). Four animations featured a stylized agent and four a realistic agent. For each animation, subjects were asked to identify the agent’s emotion conveyed by the micro-expression. In the second study, 234 participants watched three sets of eight animation clips (24 clips in total, 12 clips per agent). Four animations for each agent featured the character performing macro-expressions only, four animations for each agent featured the character performing macro- + micro-expressions without exaggeration, and four animations for each agent featured the agent performing macro + micro-expressions with exaggeration. Participants were asked to recognize the true emotion of the agent and rate the emotional expressivity ad naturalness of the agent in each clip using a 5-point Likert scale. We have collected all the data and completed the statistical analysis. Findings and discussion, implications for research and practice, and suggestions for future work will be reported in the full paper. ReferencesAdamo N., Benes, B., Mayer, R., Lei, X., Meyer, Z., &Lawson, A. (2021). Multimodal Affective Pedagogical Agents for Different Types of Learners. In: Russo D., Ahram T., Karwowski W., Di Bucchianico G., Taiar R. (eds) Intelligent Human Systems Integration 2021. IHSI 2021. Advances in Intelligent Systems and Computing, 1322. Springer, Cham. https://doi.org/10.1007/978-3-030-68017-6_33Ekman, P., &Friesen, W. V. (1969, February). Nonverbal leakage and clues to deception. Psychiatry, 32(1), 88–106. https://doi.org/10.1080/00332747.1969.11023575 Queiroz, R. B., Musse, S. R., &Badler, N. I. (2014). Investigating Macroexpressions and Microexpressions in Computer Graphics Animated Faces. Presence, 23(2), 191-208. http://dx.doi.org/10.1162/

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5. Effect of Sleep and Biobehavioral Patterns on Multidimensional Cognitive Performance: Longitudinal, In-the-Wild Study

   https://doi.org/10.2196/23936  

   Kalanadhabhatta, Manasa ; Rahman, Tauhidur ; Ganesan, Deepak ( January 2021 , Journal of Medical Internet Research)

   Background With nearly 20% of the US adult population using fitness trackers, there is an increasing focus on how physiological data from these devices can provide actionable insights about workplace performance. However, in-the-wild studies that understand how these metrics correlate with cognitive performance measures across a diverse population are lacking, and claims made by device manufacturers are vague. While there has been extensive research leading to a variety of theories on how physiological measures affect cognitive performance, virtually all such studies have been conducted in highly controlled settings and their validity in the real world is poorly understood. Objective We seek to bridge this gap by evaluating prevailing theories on the effects of a variety of sleep, activity, and heart rate parameters on cognitive performance against data collected in real-world settings. Methods We used a Fitbit Charge 3 and a smartphone app to collect different physiological and neurobehavioral task data, respectively, as part of our 6-week-long in-the-wild study. We collected data from 24 participants across multiple population groups (shift workers, regular workers, and graduate students) on different performance measures (vigilant attention and cognitive throughput). Simultaneously, we used a fitness tracker to unobtrusively obtain physiological measures that could influence these performancemore »measures, including over 900 nights of sleep and over 1 million minutes of heart rate and physical activity metrics. We performed a repeated measures correlation (rrm) analysis to investigate which sleep and physiological markers show association with each performance measure. We also report how our findings relate to existing theories and previous observations from controlled studies. Results Daytime alertness was found to be significantly correlated with total sleep duration on the previous night (rrm=0.17, P<.001) as well as the duration of rapid eye movement (rrm=0.12, P<.001) and light sleep (rrm=0.15, P<.001). Cognitive throughput, by contrast, was not found to be significantly correlated with sleep duration but with sleep timing—a circadian phase shift toward a later sleep time corresponded with lower cognitive throughput on the following day (rrm=–0.13, P<.001). Both measures show circadian variations, but only alertness showed a decline (rrm=–0.1, P<.001) as a result of homeostatic pressure. Both heart rate and physical activity correlate positively with alertness as well as cognitive throughput. Conclusions Our findings reveal that there are significant differences in terms of which sleep-related physiological metrics influence each of the 2 performance measures. This makes the case for more targeted in-the-wild studies investigating how physiological measures from self-tracking data influence, or can be used to predict, specific aspects of cognitive performance.« less