On the Reliability of Wearable Technology: A Tutorial on Measuring Heart Rate and Heart Rate Variability in the Wild

The effect of social anxiety on social attention in naturalistic situations

BACKGROUND AND OBJECTIVES

This multimodal two-phase study investigated the impact of trait social anxiety on exploration, social attention, and autonomic responses in a naturalistic setting. We expected higher avoidance of potentially crowded spaces, reduced visual attention on other people, and heightened physiological arousal in social situations for participants with higher social anxiety levels.

DESIGN AND METHODS

Eighty-seven participants, pre-screened for high variance in trait social anxiety, first completed a half-hour walk on a freely chosen route and subsequently had a staged social interaction with a confederate consisting of a non-interactive waiting phase and a short conversation.

RESULTS

While social anxiety did not modulate the choice of route during the walk phase, socially anxious participants avoided gazing at other individuals in non-interactive situations, i.e., during the walk and the waiting phase. In contrast, during actual interaction, they showed increased visual attention towards the confederate's face. Across all experimental phases, highly socially anxious individuals showed elevated heart rates, but this effect was independent of the social context.

CONCLUSIONS

This study showed that social anxiety affects social exploration behavior not in a way of general avoidance, but rather in nuanced adaptations depending on the concrete situation, likelihood of interaction and associated socio-evaluative threat.

Frustration and its impact on search and rescue canines

Despite advances in modern technology, dogs remain the primary detection tool in search and rescue (SAR) missions, locating missing persons across diverse and dynamic environments, including wilderness, avalanche zones, water, and disaster areas. Their exceptional olfactory abilities, combined with their capacity to process complex discrimination tasks and adapt to varied environmental stimuli, make them uniquely suited for this work. However, SAR operations can be both physically and psychologically demanding, requiring sustained focus, endurance, and consistent performance under stressful conditions. Frustration, a form of psychological stress, arises when a dog encounters blocked access to a goal or when an expectation is violated, triggering physiological and behavioral changes that may impact performance. This study investigated the physiological and behavioral responses of SAR dogs to two distinct stress conditions: psychological stress induced by frustration and physiological stress induced by moderate exercise. We measured heart rate variability as an indicator of autonomic nervous system response to stress and analyzed search task performance to assess how frustration and exercise affected the dogs' latency and accuracy in executing their trained final response to the target odor. Our results revealed significant decreases in heart rate variability following frustration and increased latency in the search task, suggesting that frustration had a more pronounced impact on the dogs' physiological state and performance compared to exercise. By examining the effects of psychological and physiological stress, this study contributes to a deeper understanding of how different stressors influence SAR dog performance and welfare. These findings provide valuable insights for optimizing training methodologies and operational preparedness, ensuring both the effectiveness and well-being of SAR dogs in the field.

The ethical dimension of personal health monitoring in the armed forces: a scoping review

BACKGROUND

Personal Health Monitoring (PHM) has the potential to enhance soldier health outcomes. To promote morally responsible development, implementation, and use of PHM in the armed forces, it is important to be aware of the inherent ethical dimension of PHM. In order to improve the understanding of the ethical dimension, a scoping review of the existing academic literature on the ethical dimension of PHM was conducted.

METHODS

Four bibliographical databases (Ovid/Medline, Embase.com, Clarivate Analytics/Web of Science Core Collection, and Elsevier/SCOPUS) were searched for relevant literature from their inception to June 1, 2023. Studies were included if they sufficiently addressed the ethical dimension of PHM and were related to or claimed relevance for the military. After selection and extraction, the data was analysed using a qualitative thematic approach.

RESULTS

A total of 9,071 references were screened. After eligibility screening, 19 articles were included for this review. The review identifies and describes three categories reflecting the ethical dimension of PHM in the military: (1) utilitarian considerations, (2) value-based considerations, and (3) regulatory responsibilities. The four main values that have been identified as being of concern are those of privacy, security, trust, and autonomy.

CONCLUSIONS

This review demonstrates that PHM in the armed forces is primarily approached from a utilitarian perspective, with a focus on its benefits, without explicit critical deliberation on PHM's potential moral downsides. Also, the review highlights a significant research gap with a specific lack of empirical studies focussing specifically on the ethical dimension of PHM. Awareness of the inherent ethical dimension of PHM in the military, including value conflicts and how to balance them, can help to contribute to a morally responsible development, implementation, and use of PHM in the armed forces.

Measures of nutrition status and health for weight-inclusive patient care: A narrative review

In healthcare, weight is often equated to and used as a marker for health. In examining nutrition and health status, there are many more effective markers independent of weight. In this article, we review practical and emerging clinical applications of technologies and tools used to collect non-weight-related data in nutrition assessment, monitoring, and evaluation in the outpatient setting. The aim is to provide clinicians with new ideas about various types of data to evaluate and track in nutrition care.

A Comprehensive Review on Advancements in Wearable Technologies: Revolutionizing Cardiovascular Medicine

Wearable technologies have emerged as powerful tools in healthcare, offering continuous monitoring and personalized insights outside traditional clinical settings. These devices have garnered significant attention in cardiovascular medicine for their potential to transform patient care and improve outcomes. This comprehensive review provides an overview of wearable technologies' evolution, advancements, and applications in cardiovascular medicine. We examine the miniaturization of sensors, integration of artificial intelligence (AI), and proliferation of remote patient monitoring solutions. Key findings include the role of wearables in the early detection of cardiovascular conditions, personalized health tracking, and remote patient management. Challenges such as data privacy concerns and regulatory hurdles are also addressed. The adoption of wearable technologies holds promise for shifting healthcare from reactive to proactive, enabling precision diagnostics, treatment optimization, and preventive strategies. Collaboration among healthcare stakeholders is essential to harnessing the full potential of wearables in cardiovascular medicine and ushering in a new era of personalized, proactive healthcare.

Night time heart rate predicts next-day pain in fibromyalgia and primary back pain

Introduction

Primary chronic pain is pain that persists for over 3 months without associated measurable tissue damage. One of the most consistent findings in primary chronic pain is its association with autonomic hyperactivation. Yet whether the autonomic hyperactivation causes the pain or results from it is still unclear. It is also unclear to what extent autonomic hyperactivation is related to experienced pain intensity in different subtypes or primary chronic pain.

Objectives

Our first aim was to test lagged relationships between the markers of autonomic activation (heart rate) and pain intensity to determine its directionality. The main question here was whether autonomic biomarkers predict pain intensity or whether pain intensity predicts autonomic biomarkers. The second aim was to test whether this relationship is different between people with primary back pain and people with fibromyalgia.

Methods

Sixty-six patients with chronic pain were observed over an average of 81 days. Sleep heart rate and heart rate variability were measured with a wearable sensor, and pain intensity was assessed from daily subjective reports.

Results

The results showed a predictive relationship between sleep heart rate and next-day pain intensity (P < 0.05), but not between daily pain intensity and next night heart rate. There was no interaction with the type of chronic pain.

Conclusions

These findings suggest that autonomic hyperactivation, whether stress-driven or arising from other causes, precedes increases in primary chronic pain. Moreover, the present results suggest that autonomic hyperactivation is a common mechanism underlying the pain experience in fibromyalgia and chronic back pain.

The Future of Stress Management: Integration of Smartwatches and HRV Technology

In the modern world, stress has become a pervasive concern that affects individuals' physical and mental well-being. To address this issue, many wearable devices have emerged as potential tools for stress detection and management by measuring heart rate, heart rate variability (HRV), and various metrics related to it. This literature review aims to provide a comprehensive analysis of existing research on HRV tracking and biofeedback using smartwatches pairing with reliable 3rd party mobile apps like Elite HRV, Welltory, and HRV4Training specifically designed for stress detection and management. We apply various algorithms and methodologies employed for HRV analysis and stress detection including time-domain, frequency-domain, and non-linear analysis techniques. Prominent smartwatches, such as Apple Watch, Garmin, Fitbit, Polar, and Samsung Galaxy Watch, are evaluated based on their HRV measurement accuracy, data quality, sensor technology, and integration with stress management features. We describe the efficacy of smartwatches in providing real-time stress feedback, personalized stress management interventions, and promoting overall well-being. To assist researchers, doctors, and developers with using smartwatch technology to address stress and promote holistic well-being, we discuss the data's advantages and limitations, future developments, and the significance of user-centered design and personalized interventions.