The challenges of emotion recognition methods based on electroencephalogram signals: a literature review

Electroencephalogram (EEG) signals in recognizing emotions have several advantages. Still, the success of this study, however, is strongly influenced by: i) the distribution of the data used, ii) consider of differences in participant characteristics, and iii) consider the characteristics of the EEG signals. In response to these issues, this study will examine three important points that affect the success of emotion recognition packaged in several research questions: i) What factors need to be considered to generate and distribute EEG data?, ii) How can EEG signals be generated with consideration of differences in participant characteristics?, and iii) How do EEG signals with characteristics exist among its features for emotion recognition? The results, therefore, indicate some important challenges to be studied further in EEG signals-based emotion recognition research. These include i) determine robust methods for imbalanced EEG signals data, ii) determine the appropriate smoothing method to eliminate disturbances on the baseline signals, iii) determine the best baseline reduction methods to reduce the differences in the characteristics of the participants on the EEG signals, iv) determine the robust architecture of the capsule network method to overcome the loss of knowledge information and apply it in more diverse data set.

A ten-year review of indications and outcomes of obstetric admissions to an intensive care unit in a low-resource country

Introduction Obstetric intensive care unit admission (ICU) suggests severe morbidity. However, there is no available data on the subject in Ghana. This retrospective review was conducted to determine the indications for obstetric ICU admission, their outcomes and factors influencing these outcomes to aid continuous quality improvement in obstetric care. Methods This was a retrospective review conducted in a tertiary hospital in Ghana. Data on participant characteristics including age and whether participant was intubated were collected from patient records for all obstetric ICU admissions from 1st January 2010 to 31st December 2019. Descriptive statistics were presented as frequencies, proportions and charts. Hazard ratios were generated for relations between obstetric ICU admission outcome and participant characteristics. A p-value <0.05 was deemed statistically significant. Results There were 443 obstetric ICU admissions over the review period making up 25.7% of all ICU admissions. The commonest indications for obstetric ICU admissions were hypertensive disorders of pregnancy (70.4%, n = 312/443), hemorrhage (14.4%, n = 64/443) and sepsis (9.3%, n = 41/443). The case fatality rates for hypertension, hemorrhage, and sepsis were 17.6%, 37.5%, and 63.4% respectively. The obstetric ICU mortality rate was 26% (115/443) over the review period. Age ≥25 years and a need for mechanical ventilation carried increased mortality risks following ICU admission while surgery in the index pregnancy was associated with a reduced risk of death. Conclusion Hypertension, haemorrhage and sepsis are the leading indications for obstetric ICU admissions. Thus, preeclampsia screening and prevention, as well as intensifying antenatal education on the danger signs of pregnancy can minimize obstetric complications. The establishment of an obstetric HDU in CCTH and the strengthening of communication between specialists and the healthcare providers in the lower facilities, are also essential for improved pregnancy outcomes. Further studies are needed to better appreciate the wider issues underlying obstetric ICU admission outcomes. Plain language summary This was a review of the reasons for admitting severely-ill pregnant women and women who had delivered within the past 42 days to the intensive care unit (ICU), the admission outcomes and risk factors associated with ICU mortality in a tertiary hospital in a low-resource country. High blood pressure and its complications, bleeding and severe infections were observed as the three most significant reasons for ICU admissions in decreasing order of significance. Pre-existing medical conditions and those arising as a result of, or aggravated by pregnancy; obstructed labour and post-operative monitoring were the other reasons for ICU admission over the study period. Overall, 26% of the admitted patients died at the ICU and maternal age of at least 25 years and the need for intubation were identified as risk factors for ICU deaths. Attention must be paid to high blood pressure during pregnancy.

Cognitive and Linguistic Benefits of Aerobic Exercise: A State-of-the-Art Systematic Review of the Stroke Literature

This systematic review aimed to determine how aerobic exercise affects cognition after stroke, with particular focus on aphasia and language improvement. Methodological quality was assessed with the PEDro+ scale with half of the 27 included studies rated as high quality. Data extraction focused on cognitive effects of aerobic exercise post-stroke, intervention characteristics, outcome measures, and participant characteristics. Whereas attention, memory, and executive functioning measures were common across the included studies, no study included a language-specific, performance-based measure. Seventeen studies reported positive cognitive effects, most frequently in the domains of attention, memory and executive functioning. Variability in outcome measures, intervention characteristics, and participant characteristics made it difficult to identify similarities among studies reporting positive cognitive effects of exercise or among those studies reporting null outcomes. Only three studies provided specific information about the number of individuals with aphasia included or excluded, who comprise approximately one-third of the stroke population. The review identified patent gaps in our understanding of how aerobic exercise may affect not only the cognitive domain of language post-stroke but also the broader cognitive functioning of individuals with post-stroke aphasia. Methodological limitations of the reviewed studies also warrant further examination of the direct impact of aerobic exercise on cognition post-stroke with careful attention to the selection and reporting of population, intervention, and outcomes.

Participant Characteristics Predicting Communication Outcomes in AAC Implementation for Individuals with ASD and IDD: A Systematic Review and Meta-analysis

This meta-analysis examined social communication outcomes in augmentative and alternative communication (AAC) interventions, or those that involved aided (e.g., speech generating devices, picture point systems) or unaided AAC (e.g., gestures, manual sign language) as a component of intervention, and the extent to which communication outcomes were predicted by participant characteristics. Variables of interest included chronological age, communication mode used prior to intervention, number of words produced and imitation skills of participants prior to intervention. Investigators identified 117 primary studies that implemented AAC interventions with school-aged individuals (up to 22 years) with autism spectrum disorder and/or intellectual disability associated with complex communication needs and assessed social-communication outcomes. All included studies involved single-case experimental designs and met basic study design quality standards. We synthesized findings across studies using two complementary effect size indices, Tau(AB) and the log response ratio, and multi-level meta-analysis with robust variance estimation. With Tau(AB), the overall average effect across 338 participants was 0.72, 95% CI [0.67, 0.76], with a high degree of heterogeneity across studies. With the log response ratio, the overall average effect corresponded to a 538% increase from baseline levels of responding, 95% CI [388%, 733%], with a high degree of heterogeneity across studies and contrasts. Moderator analyses detected few differences in effectiveness when comparing across diagnoses, ages, the number and type of communication modes the participants used prior to intervention, the number of words used by the participants prior to intervention, and imitation use prior to intervention.

Attenuation of Antibody Titers from 3 to 6 Months after the Second Dose of the BNT162b2 Vaccine Depends on Sex, with Age and Smoking Risk Factors for Lower Antibody Titers at 6 Months

Objective: We aimed to determine antibody titers at six months and their percentage change from three to six months after the second dose of the BNT162b2 coronavirus disease 2019 (COVID-19) mRNA vaccine (Pfizer/BioNTech) and to explore clinical variables associated with titers in Japan. Methods: We enrolled 365 healthcare workers (250 women, 115 men) whose three-month antibody titers were analyzed in our previous study and whose blood samples were collected 183 ± 15 days after the second dose. Participant characteristics, collected previously, were used. The relationships of these factors with antibody titers at six months and percentage changes in antibody titers from three to six months were analyzed. Results: Median age was 44 years. Median antibody titer at six months was 539 U/mL. Older participants had significantly lower antibody titers (20s, 752 U/mL; 60s–70s, 365 U/mL). In age-adjusted analysis, smoking was the only factor associated with lower antibody titers. Median percentage change in antibody titers from three to six months was −29.4%. The only factor significantly associated with the percentage change in Ab titers was not age or smoking, but sex (women, −31.6%; men, −25.1%). Conclusion: The most important factors associated with lower antibody titers at six months were age and smoking, as at three months, probably reflecting their effect on peak antibody titers. However, the only factor significantly associated with the attenuation in Ab titers from three to six months was sex, which reduced the sex difference seen during the first three months. Antibody titers may be affected by different factors at different time points.

The effect of episodic future thinking on delay discounting

<p>Delay discounting refers to the fact that rewards lose their value if they are delayed. Excessive delay discounting is associated with various health-related problems such as over-eating and substance abuse. One phenomenon shown to reduce delay discounting is Episodic Future Thinking (EFT; imagining personal future events). Across multiple experiments and a meta-analysis, the current thesis examined the reliability of the effect of EFT on delay discounting and also sought to clarify the components of EFT that are necessary to reduce delay discounting. Experiment 1 replicated the EFT effect using a common titrating-amount procedure, and the meta-analysis based on 40 independent studies confirmed that EFT has a reliable, medium-sized effect on delay discounting. The meta-analysis also assessed the robustness of the EFT effect across various methodological features and participant characteristics. A multiple meta-regression revealed that the between-study variability in the size of the EFT effect was accounted for by study design and type of discounting measure. Within-subjects design studies had significantly smaller effect sizes than between-subjects design studies. Studies that used k as a discounting rate measure had significantly smaller effect sizes than studies that used area under the discounting curve or other atheoretical discounting measures. The size of the EFT effect was robust across different participant characteristics and ages, suggesting that EFT may be utilized as an effective intervention for a variety of age groups and impulsive behaviors. Experiments 2A, 2B and 2C assessed the suitability of an alternative and briefer delay discounting procedure (in which participants simply report their indifference points) for subsequent EFT experiments. The report indifference points procedure produced a high percentage of invalid data, a finding that was replicated across all three experiments. We therefore continued to use the well-established titrating-amount procedure in subsequent studies. Experiment 3A found that episodic past thinking (imagining personal past events) and semantic future thinking (estimating what a person could buy with the larger, delayed amount) had no effect on discounting, indicating that both episodic thinking and future thinking are necessary components of the EFT effect. Experiment 3A results also indicated that financial relevance alone is not sufficient to reducing discounting. Experiment 3B found that the future events also need to be personally relevant to reduce discounting, and that participants perceived EFT to reduce their discounting by primarily making the larger, delayed reward more valuable. We also showed that demand characteristics, where participants change their behavior to conform to the researcher’s expectations, are an unlikely explanation for the EFT effects found in Experiments 3A and 3B. Further research is warranted to form a better understanding of the mechanism(s) through which EFT reduces delay discounting.</p>

The effect of episodic future thinking on delay discounting

<p>Delay discounting refers to the fact that rewards lose their value if they are delayed. Excessive delay discounting is associated with various health-related problems such as over-eating and substance abuse. One phenomenon shown to reduce delay discounting is Episodic Future Thinking (EFT; imagining personal future events). Across multiple experiments and a meta-analysis, the current thesis examined the reliability of the effect of EFT on delay discounting and also sought to clarify the components of EFT that are necessary to reduce delay discounting. Experiment 1 replicated the EFT effect using a common titrating-amount procedure, and the meta-analysis based on 40 independent studies confirmed that EFT has a reliable, medium-sized effect on delay discounting. The meta-analysis also assessed the robustness of the EFT effect across various methodological features and participant characteristics. A multiple meta-regression revealed that the between-study variability in the size of the EFT effect was accounted for by study design and type of discounting measure. Within-subjects design studies had significantly smaller effect sizes than between-subjects design studies. Studies that used k as a discounting rate measure had significantly smaller effect sizes than studies that used area under the discounting curve or other atheoretical discounting measures. The size of the EFT effect was robust across different participant characteristics and ages, suggesting that EFT may be utilized as an effective intervention for a variety of age groups and impulsive behaviors. Experiments 2A, 2B and 2C assessed the suitability of an alternative and briefer delay discounting procedure (in which participants simply report their indifference points) for subsequent EFT experiments. The report indifference points procedure produced a high percentage of invalid data, a finding that was replicated across all three experiments. We therefore continued to use the well-established titrating-amount procedure in subsequent studies. Experiment 3A found that episodic past thinking (imagining personal past events) and semantic future thinking (estimating what a person could buy with the larger, delayed amount) had no effect on discounting, indicating that both episodic thinking and future thinking are necessary components of the EFT effect. Experiment 3A results also indicated that financial relevance alone is not sufficient to reducing discounting. Experiment 3B found that the future events also need to be personally relevant to reduce discounting, and that participants perceived EFT to reduce their discounting by primarily making the larger, delayed reward more valuable. We also showed that demand characteristics, where participants change their behavior to conform to the researcher’s expectations, are an unlikely explanation for the EFT effects found in Experiments 3A and 3B. Further research is warranted to form a better understanding of the mechanism(s) through which EFT reduces delay discounting.</p>

Finding a Composite Measure for Data From Wrist Actigraphy in Bipolar Disorder

Actigraphy can objectively measure sleep in studies on Bipolar Disorder (BD) where subjective sleep ratings might be influenced by affect. Actigraphy data are complex necessitating data reduction approaches. We created a composite score of actigraphy sleep metrics (total sleep time [TST], wake after sleep onset [WASO], and percent sleep [PS]) in BD. We computed z-scores of sleep measures for n=51 BD vs. n=80 healthy subjects and averaged scores. We examined associations with participant characteristics and used LASSO to identify metrics best explaining composite variability. Higher composite scores (better sleep) were seen in employed vs. unemployed (t=2.40, df=34, p=0.02), and correlated with higher medication load (r=0.41, p=0.004), lower mania symptomatology (r=-0.33, p=0.04) and lower interleukin (IL)-6 levels (r=-0.32, p=0.02). TST best explained variability in medication load and PS best explained employment, mania symptoms and IL-6. Given observed specificity of associations, selecting theory-driven sleep metrics may be more appropriate than a composite.