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The drivers' distraction plays a crucial role in road safety as it is one of the main impacting causes of road accidents. The phenomenon of distraction encompasses both psychological and environmental factors and, therefore, addressing the complex interplay contributing to human distraction in automotive is crucial for developing technologies and interventions for improving road safety. In scientific literature, different works were proposed for the distraction characterization in automotive, but there is still the lack of a univocal measure to assess the degree of distraction, nor a gold-standard tool that allows to "detect" eventual events, road traffic, and additional driving tasks that might contribute to the drivers' distraction. Therefore, the present study aimed at developing an EEG-based "Distraction index" obtained by the combination of the driver's mental workload and attention neurometrics and investigating and validating its reliability by analyzing together subjective and behavioral measures. A total of 25 licensed drivers were involved in this study, where they had to drive in two different scenarios, i.e., City and Highway, while different secondary tasks were alternatively proposed in addition to the main one to modulate the driver's attentional demand. The statistical analysis demonstrated the reliability of the proposed EEG-based distraction index in identifying the drivers' distraction when driving along different roads and traffic conditions (all p < 0.001). More importantly, the proposed index was demonstrated to be reliable in identifying which are the most impacting additional driving tasks on the drivers' distraction (all p < 0.01).

Tixagevimab-cilgavimab is effective for the treatment of early COVID-19 in outpatients with risk factors for progression to severe illness, as well as for primary prevention and post-exposure prophylaxis. We aimed to retrospectively evaluate the hospital stay (expressed in days), prognosis, and negativity rate for COVID-19 in patients after treatment with tixagevimab-cilgavimab. We enrolled 42 patients who were nasal swab-positive for SARS-CoV-2 (antigenic and molecular)-both vaccinated and not vaccinated for COVID-19-hospitalized at the first division of the Cotugno Hospital in Naples who had received a single intramuscular dose of tixagevimab-cilgavimab (300 mg/300 mg). All patient candidates for tixagevimab-cilgavimab had immunocompromised immune systems either due to chronic degenerative disorders (Group A: 27 patients) or oncohematological diseases (Group B: 15 patients). Patients enrolled in group A came under our observation after 10 days of clinical symptoms and 5 days after testing positivite for COVID-19, unlike the other patients enrolled in the study. The mean stay in hospital for the patients in Group A was 21 ± 5 days vs. 25 ± 5 days in Group B. Twenty patients tested negative after a median hospitalization stay of 16 days (IQR: 18-15.25); of them, five (25%) patients belonged to group B. Therefore, patients with active hematological malignancy had a lower negativization rate when treated 10 days after the onset of clinical symptoms and five days after their first COVID-19 positive nasal swab.

When assessing trainees' progresses during a driving training program, instructors can only rely on the evaluation of a trainee's explicit behavior and their performance, without having any insight about the training effects at a cognitive level. However, being able to drive does not imply knowing how to drive safely in a complex scenario such as the road traffic. Indeed, the latter point involves mental aspects, such as the ability to manage and allocate one's mental effort appropriately, which are difficult to assess objectively. In this scenario, this study investigates the validity of deploying an electroencephalographic neurometric of mental effort, obtained through a wearable electroencephalographic device, to improve the assessment of the trainee. The study engaged 22 young people, without or with limited driving experience. They were asked to drive along five different but similar urban routes, while their brain activity was recorded through electroencephalography. Moreover, driving performance, subjective and reaction times measures were collected for a multimodal analysis. In terms of subjective and performance measures, no driving improvement could be detected either through the driver's subjective measures or through their driving performance. On the other side, through the electroencephalographic neurometric of mental effort, it was possible to catch their improvement in terms of mental performance, with a decrease in experienced mental demand after three repetitions of the driving training tasks. These results were confirmed by the analysis of reaction times, that significantly improved from the third repetition as well. Therefore, being able to measure when a task is less mentally demanding, and so more automatic, allows to deduce the degree of users training, becoming capable of handling additional tasks and reacting to unexpected events.

The current industrial environment relies heavily on maritime transportation. Despite the continuous technological advances for the development of innovative safety software and hardware systems, there is a consistent gap in the scientific literature regarding the objective evaluation of the performance of maritime operators. The human factor is profoundly affected by changes in human performance or psychological state. The difficulty lies in the fact that the technology, tools, and protocols for investigating human performance are not fully mature or suitable for experimental investigation. The present research aims to integrate these two concepts by (i) objectively characterizing the psychological state of mariners, i.e., mental workload, stress, and attention, through their electroencephalographic (EEG) signal analysis, and (ii) validating an innovative safety framework countermeasure, defined as Human Risk-Informed Design (HURID), through the aforementioned neurophysiological approach. The proposed study involved 26 mariners within a high-fidelity bridge simulator while encountering collision risk in congested waters with and without the HURID. Subjective, behavioral, and neurophysiological data, i.e., EEG, were collected throughout the experimental activities. The results showed that the participants experienced a statistically significant higher mental workload and stress while performing the maritime activities without the HURID, while their attention level was statistically lower compared to the condition in which they performed the experiments with the HURID (all p < 0.05). Therefore, the presented study confirmed the effectiveness of the HURID during maritime operations in critical scenarios and led the way to extend the neurophysiological evaluation of the HFs of maritime operators during the performance of critical and/or standard shipboard tasks.

It has been demonstrated that odors could affect humans at the psychophysiological level. Significant research has been done on odor perception and physiological mechanisms; however, this research was mainly performed in highly controlled conditions in order to highlight the perceptive phenomena and the correlated physiological responses in the time frame of milliseconds. The present study explored how human physiological activity evolves in response to different odor conditions during an ecological olfactory experience on a broader time scale (from 1 to 90 s). Two odors, vanilla and menthol, together with a control condition (blank) were employed as stimuli. Electroencephalographic (EEG) activity in four frequency bands of interest, theta, alpha, low beta, and high beta, and the electrodermal activity (EDA) of the skin conductance level and response (SCL and SCR) were investigated at five time points taken during: (i) the first ten seconds of exposure (short-term analysis) and (ii) throughout the entire exposure to each odor (90 s, long-term analysis). The results revealed significant interactions between the odor conditions and the time periods in the short-term analysis for the overall frontal activity in the theta ( p = 0.03), alpha ( p = 0.005), and low beta ( p = 0.0067) bands, the frontal midline activity in the alpha ( p = 0.015) and low beta ( p = 0.02) bands, and the SCR component ( p = 0.024). For the long-term effects, instead, only one EEG parameter, frontal alpha asymmetry, was significantly sensitive to the considered dimensions ( p = 0.037). In conclusion, the present research determined the physiological response to different odor conditions, also demonstrating the sensitivity of the employed parameters in characterizing the dynamic of such response during the time. As an exploratory study, this work points out the relevance of considering the effects of continuous exposure instead of short stimulation when evaluating the human olfactory experience, providing insights for future studies in the field.

The capability of measuring specific neurophysiological and autonomic parameters plays a crucial role in the objective evaluation of a human's mental and emotional states. These human aspects are commonly known in the scientific literature to be involved in a wide range of processes, such as stress and arousal. These aspects represent a relevant factor especially in real and operational environments. Neurophysiological autonomic parameters, such as Electrodermal Activity (EDA) and Photoplethysmographic data (PPG), have been usually investigated through research-graded devices, therefore resulting in a high degree of invasiveness, which could negatively interfere with the monitored user's activity. For such a reason, in the last decade, recent consumer-grade wearable devices, usually designed for fitness-tracking purposes, are receiving increasing attention from the scientific community, and are characterized by a higher comfort, ease of use and, therefore, by a higher compatibility with daily-life environments. The present preliminary study was aimed at assessing the reliability of a consumer wearable device, i.e., the Fitbit Sense, with respect to a research-graded wearable, i.e., the Empatica E4 wristband, and a laboratory device, i.e., the Shimmer GSR3+. EDA and PPG data were collected among 12 participants while they performed multiple resting conditions. The results demonstrated that the EDA- and PPG-derived features computed through the wearable and research devices were positively and significantly correlated, while the reliability of the consumer device was significantly lower.

Nowadays, fostered by technological progress and contextual circumstances such as the economic crisis and pandemic restrictions, remote education is experiencing growing deployment. However, this growth has generated widespread doubts about the actual effectiveness of remote/online learning compared to face-to-face education. The present study was aimed at comparing face-to-face and remote education through a multimodal neurophysiological approach. It involved forty students at a driving school, in a real classroom, experiencing both modalities. Wearable devices to measure brain, ocular, heart and sweating activities were employed in order to analyse the students' neurophysiological signals to obtain insights into the cognitive dimension. In particular, four parameters were considered: the Eye Blink Rate, the Heart Rate and its Variability and the Skin Conductance Level. In addition, the students filled out a questionnaire at the end to obtain an explicit measure of their learning performance. Data analysis showed higher cognitive activity, in terms of attention and mental engagement, in the in-presence setting compared to the remote modality. On the other hand, students in the remote class felt more stressed, particularly during the first part of the lesson. The analysis of questionnaires demonstrated worse performance for the remote group, thus suggesting a common "disengaging" behaviour when attending remote courses, thus undermining their effectiveness. In conclusion, neuroscientific tools could help to obtain insights into mental concerns, often "blind", such as decreasing attention and increasing stress, as well as their dynamics during the lesson itself, thus allowing the definition of proper countermeasures to emerging issues when introducing new practices into daily life.

In recent years, technological advances and the introduction of social streaming platforms (e.g., Twitch) have contributed to an increase in the popularity of esports, a highly profitable industry with millions of active users. In this context, there is little evidence, if any, on how users perceive in-game advertising (IGA) and other key elements of the game viewing experience (e.g., facecam and chat) in terms of visual attention. The present eye-tracking study aimed at investigating those aspects, and introducing an eye-tracking research protocol specifically designed to accurately measure the visual attention associated with key elements of the game viewing experience. Results showed that (1) the ads available in the game view (IGAs) are capable altogether to attract 3.49% of the users' visual attention; (2) the chat section draws 10.68% of the users' visual attention and more than the streamer's face, known as a powerful attentional driver; (3) the animated ad format elicits higher visual attention (1.46%) than the static format (1.12%); and (4) in some circumstances, the visual attention elicited by the ads is higher in the "Goal" scenes (0.69%) in comparison to "No-Goal" scenes (0.51%). Relevant managerial implications and future directions for the esports industry are reported and discussed., Competing Interests: The authors declare no conflict of interest.

Driver's stress affects decision-making and the probability of risk occurrence, and it is therefore a key factor in road safety. This suggests the need for continuous stress monitoring. This work aims at validating a stress neurophysiological measure-a Neurometric-for out-of-the-lab use obtained from lightweight EEG relying on two wet sensors, in real-time, and without calibration. The Neurometric was tested during a multitasking experiment and validated with a realistic driving simulator. Twenty subjects participated in the experiment, and the resulting stress Neurometric was compared with the Random Forest (RF) model, calibrated by using EEG features and both intra-subject and cross-task approaches. The Neurometric was also compared with a measure based on skin conductance level (SCL), representing one of the physiological parameters investigated in the literature mostly correlated with stress variations. We found that during both multitasking and realistic driving experiments, the Neurometric was able to discriminate between low and high levels of stress with an average Area Under Curve (AUC) value higher than 0.9. Furthermore, the stress Neurometric showed higher AUC and stability than both the SCL measure and the RF calibrated with a cross-task approach. In conclusion, the Neurometric proposed in this work proved to be suitable for out-of-the-lab monitoring of stress levels.

The sample size is a crucial concern in scientific research and even more in behavioural neurosciences, where besides the best practice it is not always possible to reach large experimental samples. In this study we investigated how the outcomes of research change in response to sample size reduction. Three indices computed during a task involving the observations of four videos were considered in the analysis, two related to the brain electroencephalographic (EEG) activity and one to autonomic physiological measures, i.e., heart rate and skin conductance. The modifications of these indices were investigated considering five subgroups of sample size (32, 28, 24, 20, 16), each subgroup consisting of 630 different combinations made by bootstrapping n (n = sample size) out of 36 subjects, with respect to the total population (i.e., 36 subjects). The correlation analysis, the mean squared error (MSE), and the standard deviation (STD) of the indexes were studied at the participant reduction and three factors of influence were considered in the analysis: the type of index, the task, and its duration (time length). The findings showed a significant decrease of the correlation associated to the participant reduction as well as a significant increase of MSE and STD ( p < 0.05). A threshold of subjects for which the outcomes remained significant and comparable was pointed out. The effects were to some extents sensitive to all the investigated variables, but the main effect was due to the task length. Therefore, the minimum threshold of subjects for which the outcomes were comparable increased at the reduction of the spot duration.

In several fields, the need for a joint analysis of brain activity and eye activity to investigate the association between brain mechanisms and manifest behavior has been felt. In this work, two levels of attentional demand, elicited through a conjunction search task, have been modelled in terms of eye blinks, brain activity, and brain network features. Moreover, the association between endogenous neural mechanisms underlying attentional demand and eye blinks, without imposing a time-locked structure to the analysis, has been investigated. The analysis revealed statistically significant spatial and spectral modulations of the recorded brain activity according to the different levels of attentional demand, and a significant reduction in the number of eye blinks when a higher amount of attentional investment was required. Besides, the integration of information coming from high-density electroencephalography (EEG), brain source localization, and connectivity estimation allowed us to merge spectral and causal information between brain areas, characterizing a comprehensive model of neurophysiological processes behind attentional demand. The analysis of the association between eye and brain-related parameters revealed a statistically significant high correlation (R > 0.7) of eye blink rate with anterofrontal brain activity at 8 Hz, centroparietal brain activity at 12 Hz, and a significant moderate correlation with the participation of right Intra Parietal Sulcus in alpha band (R = -0.62). Due to these findings, this work suggests the possibility of using eye blinks measured from one sensor placed on the forehead as an unobtrusive measure correlating with neural mechanisms underpinning attentional demand.

Fatigued driving is one of the main causes of traffic accidents. The electroencephalogram (EEG)-based mental state analysis method is an effective and objective way of detecting fatigue. However, as EEG shows significant differences across subjects, effectively "transfering" the EEG analysis model of the existing subjects to the EEG signals of other subjects is still a challenge. Domain-Adversarial Neural Network (DANN) has excellent performance in transfer learning, especially in the fields of document analysis and image recognition, but has not been applied directly in EEG-based cross-subject fatigue detection. In this paper, we present a DANN-based model, Generative-DANN (GDANN), which combines Generative Adversarial Networks (GAN) to enhance the ability by addressing the issue of different distribution of EEG across subjects. The comparative results show that in the analysis of cross-subject tasks, GDANN has a higher average accuracy of 91.63% in fatigue detection across subjects than those of traditional classification models, which is expected to have much broader application prospects in practical brain-computer interaction (BCI).

The capability of monitoring user's performance represents a crucial aspect to improve safety and efficiency of several human-related activities. Human errors are indeed among the major causes of work-related accidents. Assessing human factors (HFs) could prevent these accidents through specific neurophysiological signals' evaluation but laboratory sensors require highly-specialized operators and imply a certain grade of invasiveness which could negatively interfere with the worker's activity. On the contrary, consumer wearables are characterized by their ease of use and their comfortability, other than being cheaper compared to laboratory technologies. Therefore, wearable sensors could represent an ideal substitute for laboratory technologies for a real-time assessment of human performances in ecological settings. The present study aimed at assessing the reliability and capability of consumer wearable devices (i.e., Empatica E4 and Muse 2) in discriminating specific mental states compared to laboratory equipment. The electrooculographic (EOG), electrodermal activity (EDA) and photoplethysmographic (PPG) signals were acquired from a group of 17 volunteers who took part to the experimental protocol in which different working scenarios were simulated to induce different levels of mental workload, stress, and emotional state. The results demonstrated that the parameters computed by the consumer wearable and laboratory sensors were positively and significantly correlated and exhibited the same evidences in terms of mental states discrimination.

Current telemedicine and remote healthcare applications foresee different interactions between the doctor and the patient relying on the use of commercial and medical wearable sensors and internet-based video conferencing platforms. Nevertheless, the existing applications necessarily require a contact between the patient and sensors for an objective evaluation of the patient's state. The proposed study explored an innovative video-based solution for monitoring neurophysiological parameters of potential patients and assessing their mental state. In particular, we investigated the possibility to estimate the heart rate (HR) and eye blinks rate (EBR) of participants while performing laboratory tasks by mean of facial-video analysis. The objectives of the study were focused on: (i) assessing the effectiveness of the proposed technique in estimating the HR and EBR by comparing them with laboratory sensor-based measures and (ii) assessing the capability of the video-based technique in discriminating between the participant's resting state ( Nominal condition ) and their active state ( Non-nominal condition ). The results demonstrated that the HR and EBR estimated through the facial-video technique or the laboratory equipment did not statistically differ ( p > 0.1), and that these neurophysiological parameters allowed to discriminate between the Nominal and Non-nominal states ( p < 0.02).

Scents have the ability to affect peoples' mental states and task performance with to different extents. It has been widely demonstrated that the lemon scent, included in most all-purpose cleaners, elicits stimulation and activation, while the lavender scent elicits relaxation and sedative effects. The present study aimed at investigating and fostering a novel approach to evaluate users' experience with respect to scents' effects through the joint employment of Virtual Reality and users' neurophysiological monitoring, in particular Electroencephalography. In particular, this study, involving 42 participants, aimed to compare the effects of lemon and lavender scents on the deployment of cognitive resources during a daily life experience consisting in a train journey carried out in virtual reality. Our findings showed a significant higher request of cognitive resources during the processing of an informative message for subjects exposed to the lavender scent with respect to the lemon exposure. No differences were found between lemon and lavender conditions on the self-reported items of pleasantness and involvement; as this study demonstrated, the employment of the lavender scent preserves the quality of the customer experience to the same extent as the more widely used lemon scent.

Analysis of physiological signals, electroencephalography more specifically, is considered a very promising technique to obtain objective measures for mental workload evaluation, however, it requires a complex apparatus to record, and thus, with poor usability in monitoring in-vehicle drivers' mental workload. This study proposes a methodology of constructing a novel mutual information-based feature set from the fusion of electroencephalography and vehicular signals acquired through a real driving experiment and deployed in evaluating drivers' mental workload. Mutual information of electroencephalography and vehicular signals were used as the prime factor for the fusion of features. In order to assess the reliability of the developed feature set mental workload score prediction, classification and event classification tasks were performed using different machine learning models. Moreover, features extracted from electroencephalography were used to compare the performance. In the prediction of mental workload score, expert-defined scores were used as the target values. For classification tasks, true labels were set from contextual information of the experiment. An extensive evaluation of every prediction tasks was carried out using different validation methods. In predicting the mental workload score from the proposed feature set lowest mean absolute error was 0.09 and for classifying mental workload highest accuracy was 94%. According to the outcome of the study, it can be stated that the novel mutual information based features developed through the proposed approach can be employed to classify and monitor in-vehicle drivers' mental workload.

The need for automatic detection and classification of high-frequency oscillations (HFOs) as biomarkers of the epileptogenic tissue is strongly felt in the clinical field. In this context, the employment of artificial intelligence methods could be the missing piece to achieve this goal. This work proposed a double-step procedure based on machine learning algorithms and tested it on an intracranial electroencephalogram (iEEG) dataset available online. The first step aimed to define the optimal length for signal segmentation, allowing for an optimal discrimination of segments with HFO relative to those without. In this case, binary classifiers have been tested on a set of energy features. The second step aimed to classify these segments into ripples, fast ripples and fast ripples occurring during ripples. Results suggest that LDA applied to 10 ms segmentation could provide the highest sensitivity (0.874) and 0.776 specificity for the discrimination of HFOs from no-HFO segments. Regarding the three-class classification, non-linear methods provided the highest values (around 90%) in terms of specificity and sensitivity, significantly different to the other three employed algorithms. Therefore, this machine-learning-based procedure could help clinicians to automatically reduce the quantity of irrelevant data.

Vigilance degradation usually causes significant performance decrement. It is also considered the major factor causing the out-of-the-loop phenomenon (OOTL) occurrence. OOTL is strongly related to a high level of automation in operative contexts such as the Air Traffic Management (ATM), and it could lead to a negative impact on the Air Traffic Controllers' (ATCOs) engagement. As a consequence, being able to monitor the ATCOs' vigilance would be very important to prevent risky situations. In this context, the present study aimed to characterise and assess the vigilance level by using electroencephalographic (EEG) measures. The first study, involving 13 participants in laboratory settings allowed to find out the neurophysiological features mostly related to vigilance decrements. Those results were also confirmed under realistic ATM settings recruiting 10 professional ATCOs. The results demonstrated that (i) there was a significant performance decrement related to vigilance reduction; (ii) there were no substantial differences between the identified neurophysiological features in controlled and ecological settings, and the EEG-channel configuration defined in laboratory was able to discriminate and classify vigilance changes in ATCOs' vigilance with high accuracy (up to 84%); (iii) the derived two EEG-channel configuration was able to assess vigilance variations reporting only slight accuracy reduction., Competing Interests: The authors declare no conflict of interest.

One century after the first recording of human electroencephalographic (EEG) signals, EEG has become one of the most used neuroimaging techniques. The medical devices industry is now able to produce small and reliable EEG systems, enabling a wide variety of applications also with no-clinical aims, providing a powerful tool to neuroscientific research. However, these systems still suffer from a critical limitation, consisting in the use of wet electrodes, that are uncomfortable and require expertise to install and time from the user. In this context, dozens of different concepts of EEG dry electrodes have been recently developed, and there is the common opinion that they are reaching traditional wet electrodes quality standards. However, although many papers have tried to validate them in terms of signal quality and usability, a comprehensive comparison of different dry electrode types from multiple points of view is still missing. The present work proposes a comparison of three different dry electrode types, selected among the main solutions at present, against wet electrodes, taking into account several aspects, both in terms of signal quality and usability. In particular, the three types consisted in gold-coated single pin, multiple pins and solid-gel electrodes. The results confirmed the great standards achieved by dry electrode industry, since it was possible to obtain results comparable to wet electrodes in terms of signals spectra and mental states classification, but at the same time drastically reducing the time of montage and enhancing the comfort. In particular, multiple-pins and solid-gel electrodes overcome gold-coated single-pin-based ones in terms of comfort.

Human tissues own conductive properties, and the electrical activity produced by human organs can propagate throughout the body due to neuro transmitters and electrolytes. Therefore, it might be reasonable to hypothesize correlations and similarities between electrical activities among different parts of the body. Since no works have been found in this direction, the proposed study aimed at overcoming this lack of evidence and seeking analogies between the brain activity and the electrical activity of non-cerebral locations, such as the neck and wrists, to determine if i) cerebral parameters can be estimated from non-cerebral sites, and if ii) non-cerebral sensors can replace cerebral sensors for the evaluation of the users under specific experimental conditions, such as eyes open or closed. In fact, the use of cerebral sensors requires high-qualified personnel, and reliable recording systems, which are still expensive. Therefore, the possibility to use cheaper and easy-to-use equipment to estimate cerebral parameters will allow making some brain-based applications less invasive and expensive, and easier to employ. The results demonstrated the occurrence of significant correlations and analogies between cerebral and non-cerebral electrical activity. Furthermore, the same discrimination and classification accuracy were found in using the cerebral or non-cerebral sites for the user's status assessment.

Subjects' interaction is the core of most human activities. This is the reason why a lack of coordination is often the cause of missing goals, more than individual failure. While there are different subjective and objective measures to assess the level of mental effort required by subjects while facing a situation that is getting harder, that is, mental workload, to define an objective measure based on how and if team members are interacting is not so straightforward. In this study, behavioral, subjective and synchronized electroencephalographic data were collected from couples involved in a cooperative task to describe the relationship between task difficulty and team coordination, in the sense of interaction aimed at cooperatively performing the assignment. Multiple-brain connectivity analysis provided information about the whole interacting system. The results showed that averaged local properties of a brain network were affected by task difficulty. In particular, strength changed significantly with task difficulty and clustering coefficients strongly correlated with the workload itself. In particular, a higher workload corresponded to lower clustering values over the central and parietal brain areas. Such results has been interpreted as less efficient organization of the network when the subjects' activities, due to high workload tendencies, were less coordinated., Competing Interests: The authors declare no conflict of interest. The founding sponsors had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results