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Many adults worldwide do not meet current physical activity (PA) guidelines. Mental fatigue decreases the likelihood of choosing to engage in PA. Message framing may enhance PA motivation when fatigued. We examined the effects of mental fatigue and message framing on PA motivation with additional focus on the messaging "congruency effect." Three hundred and twenty undergraduates completed measures of dispositional motivational orientation and were exposed to either gain-framed or loss-framed messages before completing an effort discounting questionnaire. Results showed lower motivation to engage in PA of higher intensities and longer durations. Direct effects of message framing on PA motivation were not significant. Interaction effects revealed that participants receiving messages congruent with their dominant motivational orientation showed increased motivation for light-intensity PA and decreased motivation for vigorous-intensity PA as mental fatigue increased. Findings suggest that providing messages congruent with one's dominant motivational orientation may increase motivation for engaging in light-intensity PA when fatigued.

Purpose: Listening effort is a broad construct, and there is no consensus on how to subdivide listening effort into dimensions. This project focuses on the subjective experience of effortful listening and tests if cognitive workload, mental fatigue, and mood are interrelated dimensions., Method: Two online studies tested young adults ( n = 74 and n = 195) and measured subjective workload, fatigue (subscales of fatigue and energy), and mood (subscales of positive and negative mood) before and after a challenging listening task. In the listening effort task, participants responded to intermittent 1-kHz target tones in continuous white noise for approximately 12 min., Results: Correlations and principal component analysis showed that fatigue and mood were distinct but interrelated constructs that weakly correlated with workload. Effortful listening provoked increased fatigue and decreased energy and positive mood yet did not influence negative mood or workload., Conclusions: The findings suggest that self-reported listening effort has multiple dimensions that can have different responses to the same effortful listening episode. The results can help guide evidence-based development of clinical listening effort tests and may reveal mechanisms for how listening effort relates to quality of life in those with hearing impairment., Supplemental Material: https://doi.org/10.23641/asha.26418976.

Acute mental fatigue, characterized by a transient decline in cognitive efficiency during or following prolonged cognitive tasks, can be managed through adaptive effort deployment. In response to mental fatigue, individuals can employ two main behavioral patterns: engaging a compensatory effort to limit performance decrements, or disengaging effort, leading to performance deterioration. This study investigated the behavioral pattern used by participants in mental fatigue conditions. Fifty participants underwent a sequential-task protocol with counterbalanced sessions who took place in two separate sessions: a 30-min incongruent Stroop task (fatiguing session) or a 30-min documentary viewing task (control session), followed by a time-to-exhaustion (TTE) handgrip task at 13 % of maximal voluntary contraction. Psychophysiological measures included the preejection period, heart rate variability, blood pressure, and respiration. Behavioral results showed deteriorated TTE handgrip performance after the Stroop task compared to after the documentary viewing task. During the Stroop task participants were more conservative and prioritized accuracy over speed. Self-reported fatigue was greater after the Stroop task. Psychophysiological data revealed a gradual decrease in sympathetic activity over time in both tasks, with the Stroop task showing a more pronounced decrease. Taken together, these findings suggest a disengagement of effort for a large proportion of participants (49 %) that could be partly attributed to a habituation to the demands of the Stroop task. This study illustrates the interplay of behavioral patterns of effort investment in the context of mental fatigue and underscores the role of disengagement as a dominant response to this phenomenon among healthy participants., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Mental fatigue has been highly cited as having a negative impact on endurance performance. Few, however, have investigated whether different types of mental fatigue, namely active and passive fatigue, might affect endurance performance differently. This study used a repeated-measures design where 11 participants completed a 3 km run after three 32-min conditions: an actively fatiguing task (Task-load Dual-back; TloadDback); a passively fatiguing task (Mackworth Clock); and a control task (Documentary). Subjective ratings and performance on a second task (Flanker task) were taken before and after the 32-min tasks, while ratings of perceived effort, motivation and workload were taken during the 3 km run. Results showed that both fatigue conditions were mentally fatiguing, with the TloadDback rated as more demanding and the Mackworth Clock more boring and less motivating. Performance on subsequent tasks showed different effects: the TloadDback condition had the slowest responses on the post-test Flanker task, while the Mackworth Clock condition had the slowest completion time on the 3 km run, though this difference in completion times was non-significant. These results suggest that different cognitive tasks lead to different types of mental fatigue, which can lead to different outcomes on subsequent cognitive tasks but non-significant differences on subsequent physical tasks. This study highlights that to understand the influence of mental fatigue on physical performance, it is important to understand the cognitive tasks used and how different cognitive and physical tasks interact. Future work should examine whether performance outcomes in other areas commonly affected by mental fatigue, like technical and tactical sporting skills, are affected differently by active and passive fatigue., Competing Interests: Declaration of competing interest This work was supported by an Australian Government Research Training Program (RTP) Scholarship. There are no relationships to disclose. There are no patents to disclose. There are no additional activities to disclose., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Globally, the COVID-19 pandemic has presented serious mental health challenges for healthcare professionals. This study investigated the mental health, mental fatigue, quality of life, and stigma of social discrimination among healthcare workers in the United Arab Emirates (UAE) during the COVID-19 pandemic. A correlational, cross-sectional, multi-centric design was employed to collect data from 1383 healthcare workers across various healthcare settings. Participants were recruited using combined cluster and purposive sampling techniques. Standardized questionnaires, including the COVID-19 Pandemic Mental Health Questionnaire (CoPaQ), the Mental Fatigue Scale (MFS), the Social Discrimination Scale-Stigma Subscale (SDS), and the WHO Quality of Life Questionnaire-Brief (WHOQOL-BREF), were administered to assess the study variables. The results indicated significant mental health impacts, with high average scores for post-traumatic stress disorder (PTSD) (9.37 ± 6.74) and positive coping by inner strengths (17.63 ± 5.72). Mental fatigue was prevalent (8.15 ± 8.62), and stigma of social discrimination scored notably (23.83 ± 7.46). Quality of life was the highest in the social domain (65.38 ± 24.58). Significant correlations were observed between mental health subscales, mental fatigue, and quality of life domains. These findings highlight the critical need for targeted mental health support programs, improved social support networks, and personalized interventions to mitigate the mental health challenges faced by healthcare workers. Healthcare organizations can guarantee a resilient workforce that can handle future health crises by giving mental health resources and support systems top priority., Competing Interests: The authors declare no conflicts of interest.

We conducted two studies to evaluate the construct validity, short term test-retest reliability, and sensitivity to mental fatigue of the Stroop task when used with older adults. In Study 1, 40 participants visited our lab on two separate days. On the first visit, they took five screening scales, and we measured their height and body mass. On the second visit, they completed the Stroop task twice with a 30-minute interval between assessments. In Study 2, 15 different participants took a 30-minute Flanker/Reverse Flanker task during the interval between the two administrations of the Stroop tasks and they gave subjective ratings of their mental fatigue on the Visual Analogue Scale (VAS) prior to taking either of the Stroop tasks. In Study 1, participants showed a ceiling effect on the Stroop accuracy measure, there was strong concurrent validity for the Stroop with significant score differences between the Stroop's congruent and incongruent conditions ( p < .001), and there was excellent response time reliability (ICC = 0.926) on day two when participants took the Stroop twice within a 30-minute inter-test interval. However, there were significant test-retest performance differences with respect to cognitive inhibition ( p < .001). In Study 2, mental fatigue from the Flanker/Reverse Flanker test resulted in a significantly worse second Stroop performance ( p = .045). We concluded that the Stroop task demonstrated strong concurrent validity and response time reliability among older adults, but it showed sensitivity to mental fatigue, and repeated administrations within the short 30-minute test-retest interval revealed that the most important Stroop measure (cognitive inhibition) was unreliable. We discuss the implications of these findings., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: The Mindfulness-Based Stress Reduction (MBSR) program has shown promising results for people suffering from mental fatigue after an acquired brain injury. The aim was to evaluate the feasibility of a MBSR program performed as an online self-study course for this group of people., Methods: Sixty participants who had suffered an acquired brain injury with lasting mental fatigue were randomized to an online MBSR course or to a waitlist control group. They answered self-report questionnaires before start and after the course., Results: Sixteen completed the MBSR program. With the repeated ANOVA no significant difference between groups was found, although there was a significant change in time (the repetition factor). The post-hoc paired t-test indicated a significant reduction and a large-to-median effect size in mental fatigue ( p  = 0.003, d = 0.896), depression ( p  = 0.038, d = 0.569) and anxiety ( p  = 0.030, d = 0.598) for the MBSR group. No significant changes were found for the control group., Conclusion: An online self-study MBSR program for people suffering from mental fatigue after an acquired brain injury can be a feasible option for those suffering from less severe mental fatigue and emotional symptoms, while others may require a program adapted to their needs.

Mental fatigue is a commonplace human experience which is the focus of a growing body of research. Whilst researchers in numerous disciplines have attempted to uncover the origins, nature, and effects of mental fatigue, the literature is marked by many contradictory findings. We identified two major methodological problems for mental fatigue research. First, researchers rarely use objective measures of mental fatigue. Instead, they rely heavily on subjective reports as evidence that mental fatigue has been induced in participants. We aimed to develop a task which led to not only a subjective increase in mental fatigue, but a corresponding performance decrement in the mentally fatiguing task as an objective measure. Secondly, current mental fatigue paradigms have low ecological validity - in most prior studies participants have been fatigued with a single repetitive task such as the n-back or Stroop. To move towards a more ecologically valid paradigm, our participants undertook a battery of diverse cognitive tasks designed to challenge different aspects of executive function. The AX-CPT, n-back, mental rotation, and visual search tasks were chosen to challenge response inhibition, working memory, spatial reasoning, and attention. We report results from 45 participants aged 19 to 63 years who completed a two-hour battery comprising four different cognitive tasks. Subjective fatigue ratings and task performance were measured at the beginning and end of the battery. Our novel method resulted in an increase in subjective ratings of fatigue (p < 0.001) and a reduction in task performance (p = 0.008). Future research into mental fatigue may benefit from using this task battery., (© 2023. The Author(s).)

Cognitive fatigue (CF) can lead to an increase in the latency of simple reaction time, although the processes involved in this delay are unknown. One potential explanation is that a longer time may be required for sensory processing of relevant stimuli. To investigate this possibility, the current study used a visual inspection time task to measure perceptual processing speed before and after a CF (math and memory) or non-fatiguing (documentary film) intervention. Subjective fatigue and simple reaction time significantly increased following the CF, but not the non-fatiguing intervention, confirming that CF was induced. Conversely, there was no effect of CF on inspection time task performance. It was therefore concluded that the speed of perceptual processing is not significantly impacted by CF, and thus is unlikely to underlie CF-related reaction time increases. Instead, increases in simple reaction time latency in CF may be due to delays in response preparation or initiation., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

The deleterious effects of mental fatigue (MF) on athletes have been carefully studied in various sports, such as soccer, badminton, and swimming. Even though many researchers have sought ways to ameliorate the negative impact of MF, there is still a lack of studies that review the interventions used to counteract MF among athletes. This review aims to report the current evidence exploring the effects of interventions on MF and sport-specific performance, including sport-specific motor performance and perceptual-cognitive skills. Web of Science, Scopus, PubMed, and SPORTDicus (EBSCOhost) were combed through to find relevant publications. Additionally, the references and Google Scholar were searched for any grey literature. For the current review, we included only randomized controlled trials that involved athletes, a primary task to induce MF, interventions to counter MF with comparable protocols, and the outcomes of sport-specific motor performance and perceptual-cognitive skill. The selection criteria resulted in the inclusion of 10 articles. The manipulations of autonomous self-control exertion, person-fit, nature exposure, mindfulness, and transactional direct current stimulation showed that positive interventions counteract MF and improve sport-specific performance in different domains, including strength, speed, skill, stamina, and perceptual-cognitive skills. The selected interventions could significantly counteract MF and improve subsequent sport-specific performance. Moreover, self-regulation and attention resources showed the importance of the potential mechanisms behind the relevant interventions., (© 2024. The Author(s).)

Objective: To investigate the effects of sustained mental activity on perceptions of mental fatigue, cognitive performance, and autonomic response in patients with clinical burnout as compared to a healthy control group., Methods: Patients with clinical burnout (n = 30) and healthy control participants (n = 30) completed a 3-hour test session, in which they were administered a set of cognitive tests before and after an effortful cognitive task with concurrent sound exposure. Perceptions of mental fatigue and task demands (mental effort and concentration difficulties) were assessed repeatedly over the course of the test session. Heart rate variability was recorded to index autonomic response., Results: In comparison with controls, perceived mental fatigue increased earlier in the session for the clinical burnout group and did not recover following a short rest period. Throughout the session, patients rated the tasks as more demanding and showed less improvement on measures of attention and processing speed, inhibition and working memory. While autonomic responses were initially comparable, there was a unique decrease in high-frequency heart rate variability in the clinical burnout group after extended testing and exposure., Conclusion: Patients with clinical burnout are affected differently than healthy controls by sustained mental activity, as reflected by ratings of perceived mental fatigue, aspects of cognitive performance and autonomic response. Further investigation into the role of autonomic regulation in relation to cognitive symptoms in clinical burnout is warranted., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

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.

Mental fatigue (MF) is likely to occur in the industrial working population. However, the link between MF and industrial work performance has not been investigated, nor how this interacts with a passive lower back exoskeleton used during industrial work. Therefore, to elucidate its potential effect(s), this study investigated the accuracy of work performance and movement duration through a dual task paradigm and compared results between mentally fatigued volunteers and controls, with and without the exoskeleton. No main effects of MF and the exoskeleton were found. However, when mentally fatigued and wearing the exoskeleton, movement duration significantly increased compared to the baseline condition (β MF:Exo  = 0.17, p = .02, ω 2  = .03), suggesting an important interaction between the exoskeleton and one's psychobiological state. Importantly, presented data indicate a negative effect on production efficiency through increased performance time. Further research into the cognitive aspects of industrial work performance and human-exoskeleton interaction is therefore warranted., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Mental fatigue has attracted much attention from researchers as it plays a key role in performance efficiency and safety situations. Functional connectivity analysis using graph theory is an effective method for revealing changes in cognition resources influenced by mental fatigue. Previous studies have revealed that functional networks are dynamically reorganized. Therefore, it is critical to explore dynamic timescales of networks related to specific cognitive abilities. In this study, we used an open EEG dataset of twenty-one subjects recorded in a 60-minutes sustained attention task. After preprocessing, we constructed connectivity matrices using the weighted phase lag index (wPLI) in the theta band and characterized them with dynamic graph measures, namely characteristic path length (CPL) and clustering coefficient (CC). The results show that the frontal-parietal brain networks in theta band are involved in a sustaining attention task. When averaging from temporal and spatial activations, CPL and CC decreased with time-on-task. Our results indicate that mental fatigue results in deteriorations in sustaining attention, and graph theory analysis can provide support for mental fatigue analysis.Clinical Relevance- Identification of the effects of long term sustained attention on dynamic brain networks may be potential for mechanism study and detection of mental states and attentional deficits caused by mental diseases.

Many forestry roles have changed from being manual tasks with a high physical workload to being a machine operator task with a high mental workload. Automation can support a decrease in mental fatigue by removing tasks that are repetitive and monotonous for the operators. Cable yarding presents an ideal opportunity for early adoption of automation technology; specifically the carriage movement along a defined corridor. A Valentini V-850 cable yarder was used in an Italian harvesting setting, in order to gauge the ergonomic benefit of carriage control automation. The study showed that automating yarder carriage movements improved the ergonomic situation of the workers directly involved in the related primary tasks. However, the caveat is that improving one work task may negatively affect the other work tasks, and therefore introducing automation to a worksite must be done after considering all impacts on the whole system. Practitioner summary: Automation decreased the winch operator's mental workload while improving overall productivity. At the same time, the mental and physiological workload of the operator tasked with bucking were slightly increased. Ideally, winch automation should be coupled with bucking mechanisation to balance the intervention and boost both operator well-being and productivity.

The antioxidant properties of polyphenols, which are found in most plants, have been shown to be useful for maintaining health, including enhancing brain function and alleviating stress. We aimed to investigate the effect of a single intake of taxifolin-containing foods on cognitive task performance and whole blood gene expression in healthy young adults. This study was a randomized, placebo-controlled, double-blind, crossover trial in which healthy young adults were administered a single dose of either a placebo or food containing taxifolin. Cognitive tests (serial 3s, serial 7s, and rapid visual information processing) to examine brain activity and visual analog scale questionnaires to analyze mental fatigue were applied. The set of tests was repeated four times. The findings showed that taxifolin intake improved calculation abilities and reduced mental fatigue. An analysis of whole blood gene expression before and after the test revealed that the expression of foreign substance removal-related genes increased following the ingestion of taxifolin and that most differentially expressed genes were enriched in granulocytes. Taxifolin intake was shown to affect the brain activity of healthy young adults and demonstrated an antifatigue effect, thereby reducing subjective fatigue. A single intake of taxifolin may enhance the removal of foreign substances by strengthening the innate immune system and suppressing the occurrence of injury.

Aim: Mental fatigue (MF) has been defined as a psychobiological state commonly caused by prolonged periods of demanding cognitive activity. However, the differences between women and men in their reaction times (RTs) to visual stimuli due to mental fatigue remain largely unknown. We compare the differences in RT and heart rate after an acute intervention of mental fatigue between male and female athletes., Materials and Methods: For this aim, 64 participants (age 31.7 ± 6.2 y) performed a routine of 15 min of the Stroop test (PsyTool), with 600 tasks and five different colors. Their heart rate (HR) was registered before, during, and one, three, and five minutes after the Stroop test. Meanwhile, the RT was evaluated before and after the Stroop test. A general linear mixed model (GLMM) and a Bonferroni post hoc test were used to compare the HR between the conditions and an ANOVA two-way analysis was used to compare the values pre-/post-Stroop test. (α = 0.05)., Results: The GLMM for HR showed an effect on the time ( p < 0.001) and the time × group interaction ( p = 0.004). The RT was significantly increased pre- to post-Stroop test ( p < 0.05); however, there was no difference between the pre- and post-HR measurements ( p = 1.000) and the measurements one ( p = 0.559), three ( p = 1.000) and five ( p = 1.000) min after the Stroop test., Conclusion: The present findings suggest that the parasympathetic branch of the autonomous nervous system which functions as a relaxation system tends to be activated under increasing mental fatigue, with a decreased performance (RT) similarly in men and women. Therefore, athletes could use MF induced during training to improve the time delay related to motor tasks.

Mental fatigue is usually accompanied by drops in task performance and reduced willingness for further exertion. A value-based theoretical account may help to explain such negative effects. In this view, mental fatigue influences perceived costs and rewards of exerting effort. However, no formal mathematical framework has yet been proposed to model and quantitatively estimate the effects of mental fatigue on subjective evaluations of effort expenditure, under possibly imperfect self-perceptions of internal fatigue states. We proposed a mathematical framework to model human cognitive effort allocations, assuming mental fatigue states are partially observable with semi-Markov dynamics. We modeled effort allocation decisions as a means to the goal of maximizing cumulative subjective values over a given time horizon. We developed an estimation method to identify subjective values and the hidden dynamics of mental fatigue, which can in future work be applied to self-reports, psychophysiological indices, and behavioral outcomes associated with fatigue. The modeling and estimation method was tested using a simulated n -back task under a free-choice paradigm, with model parameters fine-tuned from past studies. The proposed approach was able to recapitulate task performance and task engagement patterns observed under mental fatigue. This work advances a reward/cost trade-off account for explaining the exertion of mental effort and suggests new avenues for both theoretically and empirically relevant understandings of how cognitive operations are affected by mental fatigue. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Ketone supplementation has been proposed to enhance cognition during exercise. To assess whether any benefits are due to reduced cognitive fatigue during the latter portions of typical sport game action, we induced cognitive fatigue, provided a ketone monoester supplement (KME) vs. a non-caloric placebo (PLAC), and assessed cognitive performance during a simulated soccer match (SSM). In a double-blind, balanced, crossover design, nine recreationally active men (174.3 ± 4.2 cm, 76.6 ± 7.4 kg, 30 ± 3 y, 14.2 ± 5.5 % body fat, V˙O2 max = 55 ± 5 mL·kg BM−1·min−1; mean ± SD) completed a 45-min SSM (3 blocks of intermittent, variable intensity exercise) consuming either KME (25 g) or PLAC, after a 40-min mental fatiguing task. Cognitive function (Stroop and Choice Reaction Task [CRT]) and blood metabolites were measured throughout the match. KME reduced concentrations of both blood glucose (block 2: 4.6 vs. 5.2 mM, p = 0.02; block 3: 4.7 vs. 5.3 mM, p = 0.01) and blood lactate (block 1: 4.7 vs. 5.4 mM, p = 0.05; block 2: 4.9 vs. 5.9 mM, p = 0.01) during the SSM vs. PLAC, perhaps indicating a CHO sparing effect. Both treatments resulted in impaired CRT performance during the SSM relative to baseline, but KME displayed a reduced (p < 0.05) performance decrease compared to PLAC (1.3 vs. 3.4% reduction in correct answers, p = 0.02). No other differences in cognitive function were seen. These data suggest that KME supplementation attenuated decrements in CRT during repeated, high intensity, intermittent exercise. More study is warranted to assess fully the potential cognitive/physical benefits of KME for athletes.

The purpose of this study was to investigate the relationship between mental fatigue induced by a demanding cognitive task and impaired physical performance in endurance due to a higher perception of effort. A total of 12 healthy adults and volunteers, who had previously practiced endurance activities for 4 to 8 h per week, performed a one-hour cognitive task involving either the process of response inhibition (Stroop task) or not (visualization of a documentary as control task), then 20 min of pedaling on a cycle ergometer at a constant perception of effort while cardio-respiratory and neuromuscular functions were measured. The Stroop task induces subjective feelings of mental fatigue (vigor: 3.92 ± 2.61; subjective workload: 58.61 ± 14.57) compared to the control task (vigor: 5.67 ± 3.26; p = 0.04; subjective workload: 32.5 ± 10.1; p = 0.005). This fatigue did not act on the produced perceived effort, self-imposed, and did not affect the cardio-respiratory or neuromuscular functions during the subsequent physical task whose type was medium-term endurance. Regardless of the mental condition, the intensity of physical effort is better controlled when the participants in physical activity control their perception of effort. Mental fatigue does not affect subsequent physical performance but estimated perceived exertion, which increases with the intensity and duration of the exercise.

Experts have highlighted the importance of coaches knowing the level of mental fatigue (MF) induced by different tasks. This study aimed to compare the mentally fatiguing nature of cognitive, physical, and combined tasks and, additionally, assess the effect of different moderating variables on MF. Twenty-three physically active (16 males: Mage = 24 years; seven females: Mage = 22.57 years) participants performed three experimental sessions: (a) physically fatiguing: 30 min of cycloergometer work (at 65%-75% of maximum heart rate), (b) mentally fatiguing: 30 min of an incongruent Stroop task, and (c) mixed fatiguing: 30 min of combining the physically and mentally fatiguing protocols. Subjective MF (visual analog scale), reaction time (psychomotor vigilance task), and cognitive performance (Stroop) were measured throughout the different protocols. Results showed significant increments in subjective MF after all tasks, with the mental and mixed protocols showing significantly higher increases. Only the mentally fatiguing protocol caused significant impairments in reaction time. No significant effects of sex, years of experience, or degree of mental toughness were observed. These results suggest that the use of all these tasks, and especially the mentally fatiguing exercises, should be avoided immediately prior to competitions due to the negative consequences of MF on performance. Moreover, this effect seems to be independent of the sex, years of experience, or mental toughness of athletes.

Purpose: We performed a mediation analysis to investigate how mental fatigue mediates the relationship between cognitive functions and the return to productive activity following TBI., Methods: One hundred and one people (≥20 years) with first-time TBI more than 3 months who completed a series of cognitive tasks followed by Chinese versions of the Mental Fatigue Scale and Community Integration Questionnaire-Revised. Mediation analysis was used to test our hypotheses., Results: Recognition memory and information processing speed were the only cognitive functions correlated with mental fatigue (B = -0.56 and -0.37, P = .04 and < 0.001) and the return to productive activity (B = 0.69 and 0.19, both P < .001) after controlling for confounders. Mental fatigue partially mediated the associations of recognition memory and information processing speed with the return to productive activity (B = 0.15 and 0.08, P = .001 and < 0.001, proportion of mediation = 22% and 46%) after the adjustment of confounders., Conclusions: The findings suggest that mental fatigue can partially mediate the relationship between cognitive deficits and return to productive activity. Mental fatigue can be considered a crucial, treatable mediator of the adverse effects of cognitive impairment upon return to productive activity following TBI.

Because of the undesired fatigue-related consequences, accumulating efforts have been made to find an effective intervention to alleviate the suboptimal cognitive function caused by mental fatigue. Nonetheless, limitations of intervention and evaluation methods may hinder the revealing of underlying neural mechanisms of fatigue recovery. Through the newly-developed dynamic functional connectivity (FC) analysis framework, this study aims to investigate the effects of two types of mid-task interventions (i.e., rest-break and moderate-intensity exercise-break) on the dynamic reorganization of FC during the execution of psychomotor vigilance test (PVT). Using a sliding window approach, temporal brain networks within each frequency band (i.e., δ , θ , α , & β ) were estimated before and immediately after the intervention, and towards the end of the task to investigate the immediate and delayed effects respectively during post-break task reengagement. Behaviourally, similar beneficial effects of exercise- and rest-break on performance were observed, manifested by the immediate improvements after both interventions and a long-lasting influence towards the end of tasks. Moreover, temporal brain networks assessment showed significant immediate decreases of fluctuability, which was followed by an increase of fluctuability towards the end of intervention tasks. Furthermore, the temporal nodal measure revealed the channels with significant differences across tasks were mainly resided in the fronto-parietal areas that exhibited interesting frequency-dependent distribution. The observations of immediate and delayed dynamic FC reorganizations extend previous fatigue-related intervention and static FC studies, and provide new insight into the dynamic characteristics of FC during post-break task reengagement.

New Findings: What is the topic of this review? It provides an overview of the recent papers linking brain neurotransmission with exercise-induced and/or mental fatigue. What advances does it highlight? The noradrenergic neurotransmitter system hastens central fatigue during prolonged exercise, a finding that coincides with a faster rate of increase in the rating of perceived exertion. 2) Mental fatigue affects several neurotransmitter systems, with presumably an important role for dopamine and adenosine, in multiple brain regions such as the prefrontal cortex and the anterior cingulate cortex., Abstract: In sports and exercise science, fatigue is an elusive concept that has important implications in performance during exercise. It has been described in many ways (tiredness, exhaustion, lethargy or weariness) and describes a physical and/or mental state of being tired and lack of energy. Exercise-induced fatigue can be defined as an acute impairment of exercise performance, and a distinction has been made between peripheral and central fatigue. Mental fatigue can be defined as a psychobiological state caused by prolonged exertion that has the potential to reduce cognitive performance and exercise performance. Recent studies have given clear indications that brain catecholamines are involved in the onset of fatigue during endurance exercise. Evidence is provided indicating that the noradrenergic neurotransmitter system hastens central fatigue, a finding that coincides with a faster rate of increase in the rating of perceived exertion. Brain neurotransmission is also suggested to play an important role in mental fatigue. Several neurotransmitter systems might be implicated (with the most important role for dopamine and adenosine) in multiple brain regions, such as the prefrontal cortex and the anterior cingulate cortex, and the summation of these alterations might explain the impairment in endurance performance in a mentally fatigued state. Obviously, we have to keep in mind that fatigue is a very complex construct and that, besides brain neurochemistry, several other factors play a role in its onset., (© 2020 The Authors. Experimental Physiology © 2020 The Physiological Society.)

Background: Mental fatigue is a psychobiological state induced by a prolonged duration of demanding cognitive tasks. The effects of mental fatigue on physical performance have been well investigated in the literature. However, the effect of mental fatigue on skilled performance in sports remains unclear., Objective: This study aimed to report a comprehensive systematic review investigating the carryover effects of mental fatigue on skilled performance among athletes., Methods: A thorough search was conducted on PubMed, Web of Science, EBSCOhost (CENTRAL, SPORTDicus), and Scopus to select relevant literature, as well as on Google Scholar and sources of reference for grey literature. The selected literatures are centred on a mental fatigue protocol in which cognitive tasks are performed prior to athletic tasks. Only studies that used an experimental design to test two conditions, namely mental fatigue and non-mental fatigue, were selected., Results: Eleven articles were chosen based on the selection criteria. Mental fatigue affects skilled performance in three sports: soccer, basketball, and table tennis. A decline in skilled performance (decreased accuracy, increased performing time etc) is relevant to impaired executive functions. Seven studies focus on offensive skills, whereas only two studies are associated with defensive skills., Conclusion: Mental fatigue has a negative effect on various sports skills of high-level athletes, including their technical and decision-making skills; however, the impact is greater on offensive skills than that of defensive skills in terms of the role of athletes. Impaired executive functions may be responsible for the negative effects of mental fatigue on skilled performance., Competing Interests: The authors have declared that no competing interests exist.

Working memory (WM) is one of the most investigated cognitive functions albeit the extent to which individual characteristics impact on performance is still unclear, especially when older adults are involved. The present study considers repeated practice of a visual N -Back task with three difficulty levels (1-, 2-, and 3-Back) in healthy young and older individuals. Our results reveal that, for both age groups, the expected mental fatigue was countered by a learning effect, in terms of accuracies and reaction times, which turned out to benefit females more than males, for all three N -Back levels. We conclude that future WM studies, in particular when relying on repeated N -Back sessions, should account for learning effects in relation to mental fatigue and gender, in both young and older adults., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2021 Valentina Pergher et al.)

Objective: The aims of this study were to describe nurses' self-perceptions of fatigue and to examine nurses' acceptance of specific fatigue countermeasures., Background: The work of nurses places them at a high risk of fatigue. Evidence suggests 75% to 80% of nurses in the United States experience high levels of fatigue., Methods: This descriptive, cross-sectional correlational study surveyed 279 nurses., Results: Results suggest that almost half of nurses (46%) are not able to accurately self-assess fatigue. Nurses expressed acceptance of several workplace fatigue reduction strategies., Conclusions: It may be unrealistic to expect nurses to self-assess fatigue levels and make decisions about their ability to safely provide patient care. Reliable methods for assessing fatigue in the workplace are needed. Several strategies exist that may be used to alleviate fatigue, and many were acceptable to nurses. Nurse leaders are well positioned to implement changes that impact the occurrence of nurse fatigue and thereby the quality of patient care., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Background and Aims: Capsule endoscopy (CE) interpretation requires the review of many thousands of images, with lesions often limited to just a few frames. In this study we aim to determine whether lesion detection declines according to the number of capsule videos read., Methods: 32 participants, 16 of which were novices (NR) and 16 experienced (ER) capsule readers took part in this prospective evaluation study. Participants read six capsule cases with a variety of lesions, in a randomly assigned order during a single sitting. Psychomotor Vigilance Tests and Fatigue Scores were recorded prior to commencing and then after every two capsules read. Changes in lesion detection and measures of fatigue were assessed across the duration of the study., Results: Mean agreement with the predefined lesions was 48.3% (SD:16.1), and 21.3% (SD:15.1) for the experienced and novice readers respectively. Lesion detection declined amongst experienced reader after the first study (p = 0.01), but remained stable after subsequent capsules read, while NR accuracy was unaffected by capsule numbers read. Objective measures of fatigue did not correlate with reading accuracy., Conclusion: This study demonstrates that reader accuracy declines after reading just one capsule study. Subjective and objective measures of fatigue were not sufficient to predict the onset of the effects of fatigue., Competing Interests: Declaration of Competing Interest None., (Crown Copyright © 2021. Published by Elsevier Ltd. All rights reserved.)

Objective: The aim of this study was to evaluate the relationship between the severity of menopausal symptoms and everyday cognitive decline in Chinese peri and postmenopausal women., Methods: The peri and postmenopausal Chinese Han female who first visited the menopausal clinic of Shanghai Jiao Tong University Affiliated Sixth People's Hospital was selected as the study participants. The general questionnaire was used to obtain the sociodemographic characteristics of the study participants. The menopausal rating scale (MRS) was used to assess the severity of menopausal symptoms. The short version of the Everyday Cognition (ECog-12) scales was used to assess everyday cognitive performance., Results: A total of 295 women were included, with an average age of 51.12 ± 5.15 years. The average ECog scores were 1.51 ± 0.49 and the average MRS scores were 6.89 ± 4.77. In multiple linear regression analysis, after adjusting for confounding factors age, body mass index (BMI), monthly income, occupational status, education level, menopausal status, parity, regular exercise, and history of chronic diseases, complaints of anxiety and physical/mental fatigue were positively correlated with everyday cognitive decline., Conclusions: Menopausal anxiety and physical/mental fatigue were the independent predictors of everyday cognition.

The phenomenon of mental fatigue has recently been investigated extensively by means of the EEG. Studies deploying spectral analysis consistently reported an increase of spectral power in the lower frequencies with increasing time-on-task, whereas event-related studies observed decreases in various measures related to task engagement and attentional resources. The results from these two lines of research cannot be aligned easily. (Frontal) theta power has been linked to cognitive control and was found to increase with time-on-task. In contrast, theoretical frameworks on mental fatigue suggest a decline in task-engagement as causal for the performance decline observed in mental fatigue. The goal of the present study was to investigate mental fatigue in time-frequency space using linear regression on single-trial data in order to obtain a better understanding about how time-on-task affects theta oscillatory activity. A data-driven analysis approach indicated an increase of alpha and theta power during the intertrial interval. In contrast, task-related theta activity declined. This reduction of stimulus-locked theta power may be interpreted as a reduction of task engagement with increasing mental fatigue. The increase of theta spectral power in the intertrial interval, moreover, could possibly be explained by an increased idling of cognitive control networks. Alternatively, it might be the case that the increase of theta power with time-on-task is a by-product an alpha power increase. As alpha peak frequency systematically decreases with time-on-task, the theta band might be affected as well., (© 2021 The Authors. Psychophysiology published by Wiley Periodicals LLC on behalf of Society for Psychophysiological Research.)

Mental fatigue measurement techniques utilize one or a combination of the cognitive, affective, and behavioral responses of the body. Eye-tracking and electrooculography, which are used to compute eye-based features, have gained momentum with increases in accuracy and robustness of the lightweight equipment emerging in the markets and can be used for objective and continuous assessment of mental fatigue. The main goal of this systematic review was to summarize the various eye-based features that have been used to measure mental fatigue and explore the relation of eye-based features to mental fatigue. The review process, following the preferred reporting items for systematic reviews and meta-analyses, used the electronic databases Web of Science, Scopus, ACM digital library, IEEE Xplore, and PubMed. Of the 1,385 retrieved documents, 34 studies met the inclusion criteria, resulting in 21 useful eye-based features. Categorizing these into eight groups revealed saccades as the most promising category, with saccade mean and peak velocity providing quick access to the cognitive states within 30 min of fatiguing activity. Complex brain networks involving sympathetic and parasympathetic nervous systems control the relation of mental fatigue to tonic pupil size and have the potential to indicate mental fatigue in controlled experimental conditions. Other categories, like blinks, are derived from the field of sleep research and should be used with caution. Several limitations emerged in the analysis, including varied experimental methods, use of dim lighting during the experiment (that could possibly also induce sleepiness), and use of unclear data analysis techniques, thereby complicating comparisons between studies., (© 2021 Society for Psychophysiological Research.)

Thalamus plays an important role in the pathogenesis of multiple sclerosis-related fatigue (MSrF). However, the thalamus is a heterogeneous structure and the specific thalamic subregions that are involved in this condition are unclear. Here, we used thalamic shape analysis for the detailed localization of thalamic abnormalities in MSrF. Using the Modified Fatigue Impact Scale, we measured fatigue in 42 patients with relapsing-remitting multiple sclerosis (MS). The thalamic shape was extracted from T1w images using an automated pipeline. We investigated the association of thalamic surface deviations with the severity of global fatigue and its cognitive, physical and psychosocial subdomains. Cognitive fatigue was correlated with an inward deformity of the left anteromedial thalamic surface, but no other localized shape deviation was observed in correlation with global, physical or psychosocial fatigue. Our findings indicate that the left anteromedial thalamic subregions are implicated in cognitive fatigue, possibly through their role in reward processing and cognitive and executive functions., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Volleyball is a team sport with high physical and perceptual-cognitive demand, hence, increasing the perception of physical and mental fatigue during a competition. To alleviate fatigue (physical and mental), mindfulness and music have been proposed. The aim of this study was to analyze the effect of mindfulness-based mental versus music training on mental fatigue, physical fatigue, and recovery in elite competitive female volleyball athletes using a randomized two-controlled study with follow-up. Participants were 30 elite female Brazilian volleyball athletes. Athletes were randomly assigned to the following groups: 1) mindfulness-based mental training group (MBMT); 2) music-based training group (MBT); or 3) control group (CG). Three variables were evaluated as follows: 1) recovery based on total quality recovery; 2) mental fatigue visual analog scale; and 3) physical fatigue visual analog scale. Regarding recovery, there was no difference between the MBMT, MBT, and CG groups (p > 0.05). A difference in mental fatigue was noted between MBT and CG at follow-up [F(2,26) = 5.71, p = 0.009; large]. Regarding physical fatigue, there was no difference between the MBMT, MBT, and CG groups (p > 0.05). The mindfulness intervention effectively attenuated the mental fatigue caused by competition in volleyball athletes. These results will assist coaches and staff in providing fatigue management and reinforce the applicability of mental training in sports., (© Journal of Sports Science and Medicine.)

Recovery from work is generally thought to occur outside of the workplace. However, employees may also have the opportunity to recover within the work day via microbreaks during demanding work tasks. Two major strategies for mitigating fatigue include psychological detachment (i.e., mentally disengaging) and replenishing motivational incentives via positive affect. This study examined whether 40-s "microbreaks" improve work recovery and to what extent different microbreak content (mastery vs. relaxation activities) boost performance. Using an experimental study, we randomly assigned individuals to receive a relaxation microbreak ( n  =   59), a mastery microbreak ( n  =   68), or no break ( n  =   72) in the middle of a monotonous work task and assessed work performance. Microbreaks improved task performance and within-task recovery, but only for psychological detachment (not positive affect). Mastery breaks also resulted in more psychological detachment than relaxation breaks, but this increased detachment did not explain performance differences between break types. These results build on existing recovery theories by further demonstrating within-task recovery and provide practical implications for organizations to consider the importance of microbreaks.

Many occupations and sports require high levels of manual dexterity under thermal stress and mental fatigue. Yet, multistressor studies remain scarce. We quantified the interactive effects of thermal stress and mental fatigue on manual dexterity. Seven males (21.1 ± 1.3 yr) underwent six separate 60-min trials characterized by a combination of three air temperatures (hot, 37°C; neutral, 21°C; cold, 7°C) and two mental fatigue states (MF, mental fatigue induced by a 35-min cognitive battery; no-MF, no mental fatigue). Participants performed complex (O'Connor test) and simple (hand-tool test) manual tasks pre- and posttrial to determine stressor-induced performance changes. We monitored participants' rectal temperature and hand skin temperature (T hand ) continuously and assessed the reaction time (hand-click test) and subjective mental fatigue (5-point scale). Thermal stress ( P < 0.0001), but not mental fatigue ( P = 0.290), modulated T hand (heat, +3.3°C [95% CI: +0.2, +6.5]; cold, -7.5°C [-10.7, -4.4]). Mental fatigue ( P = 0.021), but not thermal stress ( P = 0.646), slowed the reaction time (∼10%) and increased subjective fatigue. Thermal stress and mental fatigue had an interactive effect on the complex manual task ( P = 0.040), with cold-no-MF decreasing the performance by -22% [-39, -5], whereas neutral-MF, cold-MF, and heat-MF by -36% [-53, -19], -34% [-52, -17], and -36% [-53, -19], respectively. Only mental fatigue decreased the performance in the simple manual task (-30% [-43, -16] across all thermal conditions; P = 0.002). Cold stress-induced impairments in complex manipulation increase with mental fatigue; yet combined stressors' effects are no greater than those of mental fatigue alone, which also impairs simple manipulation. Mental fatigue poses a greater challenge to manual dexterity than thermal stress.

The heterogeneity of COVID-19 experience and response for each individual is irrefutable; nevertheless, similarities can be observed between countries with respect to people's psychological responses. The main aim of this Commentary is to provide a cultural perspective of the sources of trauma, at the individual and social level, in three different countries: Italy, US and UK. The evidence from previous outbreaks, such as SARS, H1N1 flu, Ebola, and the ongoing Italian, the US, and the UK experience of COVID-19 shows that COVID-19 has introduced not only an individual trauma but also a collective trauma, that researchers should attend to now and in future global emergencies. Future clinical interventions should aim to reconnect dissociated parts both in the individual and in society. This commentary discusses four potential sources of trauma: high-stakes decision fatigue in healthcare professionals, traumatic grief, and bereavement in people who have lost loved ones, loss of roles and identity, and social divisions related to economic shutdown.

This study investigated the effect of performing prolonged mental exertion during submaximal cycling exercise on exercise tolerance and fatigue. Participants performed 5 experimental sessions. Session 1: determination of cycling peak power output. Sessions 2 and 3: cycling to exhaustion at 65% peak power output with mental exertion or watching a movie. Sessions 4 and 5: cycling for 45 min at 65% peak power output with mental exertion or while watching a movie. During sessions 2-5, rate of perceived exertion and heart rate were recorded while cycling and cortisol and prolactin concentrations, psychomotor vigilance task performance, and maximal voluntary contraction were measured pre-and post-sessions. During sessions 2 and 3, time to exhaustion was reduced ( p <0.01) and rate of perceived exertion was increased ( p <0.01) in session 2 compared to 3. Cortisol, prolactin and heart rate increased and psychomotor vigilance task and maximal voluntary contraction decreased from pre-to post-sessions with no difference between sessions. Cortisol, prolactin and rate of perceived exertion were higher ( p <0.03) in session 4 than 5. Heart rate increased and maximal voluntary contraction decreased from pre-to post-sessions with no difference between sessions. Prolonged mental exertion during cycling exercise reduces exercise tolerance, which appears to be mediated psychologically rather than physiologically., Competing Interests: The authors declare that they have no conflict of interest., (Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany.)

The infection of the novel coronavirus that originated from Wuhan, China in December 2019 converted rapidly into a pandemic by March 11, 2020. Whereas the infection mortality rate is not completely understood, it seems to be significantly beyond that of other recent pandemics (e.g., H1N1 pandemic). This paper discusses moral injury in the context of disaster and epidemic and how easily the moral psychology of individuals and society can be shaken. Moral injury is a multiscientific concept involving psychology, culture, and religion. Amid the outbreak of the novel coronavirus pneumonia, immoral behaviors and events such as violence, injury, and illness have also caused different degrees of impact on the moral standards of individuals, confusing moral cognition, destroying moral emotion, and weakening moral toughness, resulting in varying degrees of moral injury. If there is no national health, there will be no positive society for all. Based on this, the public needs to pay close attention to the moral health of the whole people and effectively avoid the occurrence of moral injury. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Nurses' work-related fatigue has been recognized as a threat to nurse health and patient safety. The aim of this study was to assess the prevalence of fatigue among first-line nurses combating with COVID-19 in Wuhan, China, and to analyze its influencing factors on fatigue. A multi-center, descriptive, cross-sectional design with a convenience sample was used. The statistical population consisted of the first-line nurses in 7 tertiary general hospitals from March 3, 2020 to March 10, 2020 in Wuhan of China. A total of 2667 samples from 2768 contacted participants completed the investgation, with a response rate of 96.35%. Social-demographic questionnaire, work-related questionnaire, Fatigue Scale-14, Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, and Chinese Perceived Stress Scale were used to conduct online survey. The descriptive statistic of nurses' social-demographic characteristics was conducted, and the related variables of work, anxiety, depression, perceived stress and fatigue were analyzed by t-tests, nonparametric test and Pearson's correlation analysis. The significant factors which resulted in nurses' fatigue were further analyzed by multiple linear regression analysis. The median score for the first-line nurses' fatigue in Wuhan was 4 (2, 8). The median score of physical and mental fatigue of them was 3 (1, 6) and 1 (0, 3) respectively. According to the scoring criteria, 35.06% nurses (n=935) of all participants were in the fatigue status, their median score of fatigue was 10 (8, 11), and the median score of physical and mental fatigue of them was 7 (5, 8) and 3 (2, 4) respectively. Multiple linear regression analysis revealed the participants in the risk groups of anxiety, depression and perceived stress had higher scores on physical and mental fatigue and the statistically significant positive correlation was observed between the variables and nurses' fatigue, the frequency of exercise and nurses' fatigue had a statistically significant negative correlation, and average daily working hours had a significantly positive correlation with nurses' fatigue, and the frequency of weekly night shift had a low positive correlation with nurses' fatigue (P<0.01). There was a moderate level of fatigue among the first-line nurses fighting against COVID-19 pandemic in Wuhan, China. Government and health authorities need to formulate and take effective intervention strategies according to the relevant risk factors, and undertake preventive measures aimed at reducing health hazards due to increased work-related fatigue among first-line nurses, and to enhance their health status and provide a safe occupational environment worldwide. Promoting both medical and nursing safety while combating with the pandemic currently is warranted.

Objective/background: To examine the prospective association between work-related mental fatigue and risk of insomnia symptoms, and if leisure time physical activity modifies this association., Participants: A total of 8,464 women and 7,480 men who participated in two consecutive surveys of the Norwegian HUNT study., Methods: The study comprises longitudinal data on persons who were vocationally active and without insomnia symptoms at baseline in 1995-1997. We used a modified Poisson regression model to calculate adjusted risk ratios (RRs) with a 95% confidence interval (CI) for insomnia symptoms at follow-up in 2006-2008 associated with work-related mental fatigue and leisure time physical activity at baseline., Results: Women and men who always experienced mental fatigue after a workday had RRs of insomnia symptoms of 2.55 (95% CI 1.91-3.40) and 2.61 (95% CI 1.80-3.78), respectively, compared to workers who never or seldom had this experience. There was no strong modifying effect of leisure time physical activity on this association, but workers who always experienced mental fatigue had a RR of insomnia symptoms of 3.17 (95% CI 2.28-4.40) if they reported low physical activity and a RR of 2.52 (95% 1.89-3.39) if they reported high physical activity., Conclusion: This study shows that work-related mental fatigue, caused by high cognitive workload, is a strong risk factor for insomnia symptoms. There was no clear modifying effect of leisure time physical activity but workers who experienced excessive work-related fatigue accompanied by low physical activity had the highest risk of insomnia symptoms.

Women experience more stress in middle age than in other life stages, and health in middle age is vital, because it influences the quality of life in old age. In this study, the effects of a forest therapy program on physiological changes in 53 middle-aged women (divided into two groups) who lived in the city were examined. One group participated in a three-day program in the forest, followed by three days in the city; the other group participated in a three-day program in the city, followed by three days in the forest. Forest experiments were conducted in a "healing forest," and urban experiments were conducted near a university campus. Blood tests were performed to evaluate the physiological effects of forest therapy. Differences in serotonin levels and vitamin D levels were verified before and after the forest (experimental group) and urban (control group) programs through paired t -tests. Statistically significant increases in serotonin levels were noted for participants in the forest program; vitamin D levels also increased, but not by statistically significant values. The findings of this study verify that forest therapy programs promote health among middle-aged women, and may prevent disease and improve quality of life.

The aim of this study was to analyse the effect of mental fatigue on passing decision-making in professional soccer athletes. A controlled and counterbalanced cross-over design was adopted consisting of three visits with a 1-week interval between sessions. Twenty professional soccer male athletes participated in three randomized conditions divided into three visits: control, 15-min Stroop task, and 30-min Stroop task. Inhibitory control was accessed by the Stroop task (accuracy and response time) before and after induced mental fatigue protocol. The athletes played a training match (90-min) following the experimental conditions. The Game Performance Assessment Instrument (GPAI) was used for the passing decision-making analysis. The GPAI analysis showed impaired passing decision-making performance following the 30-min Stroop task compared with the 15-min and control condition ( F (2,17)  = 6.99, p  = .01). Moreover, an increase in response time during the Stroop task was found following 30-min Stroop task condition ( F (2,17)  = 6.57, p  = .03) compared to 15-min of Stroop task and control conditions. Prolonged cognitive tasks may be considered a mediating factor in passing decision-making performance in male professional soccer athletes throughout a full-length training match. Thus, athletes should avoid highly demanding-cognitive tasks before a soccer match. Future studies are required to explore more ecological cognitive tasks to induce mental fatigue (i.e. smartphones and video-games) and their effects on other performance indicators (e.g. physical, technical, tactical) in a full-length training match setting.

Background: Subarachnoid hemorrhage (SAH) is a devastating disease associated with high mortality and morbidity. Besides neurological sequelae, neuropsychological deficits largely contribute to patients' long-term quality of life. Little is known about the pituitary gland volume (PGV) after SAH compared to healthy referents and the association of PGV with long-term outcome including cognitive function., Methods: Sixty consecutive non-traumatic SAH patients admitted to the neurological intensive care unit between 2010 and 2014 were enrolled. 3-Tesla magnetic resonance imagining was performed at baseline (16 days) and 12 months after SAH to measure PGV semi-automatically using the software iPlan Net 3.5.0. PGV was compared to age and sex matched healthy referents. The difference between baseline and 1-year-PGV was classified as increase (> 20 mm 3 PGV increase), stable (± 20 mm 3 ), or decrease (> 20 mm 3 PGV decrease). In addition, total intracerebral volume was calculated. Neuropsychological testing was applied in 43 SAH patients at 1-year follow up encompassing several domains (executive, attention, memory) and self-assessment (questionnaire for self-perceived deficits in attention [German: FEDA]) of distractibility in mental processes, fatigue and decrease in motivation. Multivariable regression with multivariable generalized linear models was used for comparison of PGVs and for subgroup analysis to evaluate a potential association between PGV and neuropsychological outcome., Results: Patients were 53 years old (IQR = 44-63) and presented with a median Hunt&Hess grade of 2 (IQR = 1-3). SAH patients had a significantly lower PGV both at baseline (360 ± 19 mm 3 , p < 0.001) and 1 year (367 ± 18 mm 3 p < 0.001) as compared to matched referents (mean 505 ± 18 mm 3 ). PGV decreased by 75 ± 8 mm 3 in 28 patients, increased by 120 ± 22 mm 3 in 22 patients and remained stable in 10 patients at 1-year follow-up. PGV in patients with PGV increase at 12 months was not different to healthy referents (p = 0.062). Low baseline PGV was associated with impaired executive functions at 1 year (adjOR = 8.81, 95%-CI = 1.46-53.10, p = 0.018) and PGV decrease within 1 year was associated with self-perceived worse motivation (FEDA; Wald-statistic = 6.6, df = 1, p = 0.010)., Conclusions: Our data indicate significantly lower PGVs following SAH. The association of sustained PGV decrease with impaired neuropsychological long-term outcome warrants further investigations including neuroendocrine hormone measurements.

Introduction: Fatigue is one of the most crucial factors that contribute to a decrease of the operating performance of aircraft pilots and car drivers and, as such, plays a dangerous role in transport safety. To reduce fatigue-related tragedies and to increase the quality of a healthy life, many studies have focused on exploring effective methods and psychophysiological indicators for detecting and monitoring fatigue. However, those fatigue indicators rose many discrepancies among simulator and field studies, due to the vague conceptualism of fatigue, per se, which hinders the development of fatigue monitoring devices., Method: This paper aims to give psychological insight of the existing non-invasive measures for driver and pilot fatigue by differentiating sleepiness and mental fatigue. Such a study helps to improve research results for a wide range of researchers whose interests lie in the development of in-vehicle fatigue detection devices. First, the nature of fatigue for drivers/pilots is elucidated regarding fatigue types and fatigue responses, which reshapes our understanding of the fatigue issue in the transport industry. Secondly, the widely used objective neurophysiological methods, including electroencephalography (EEG), electrooculography (EOG), and electrocardiography (ECG), physical movement-based methods, vehicle-based methods, fitness-for-duty test as well as subjective methods (self-rating scales) are introduced. On the one hand, considering the difference between mental fatigue and sleepiness effects, the links between the objective and subjective indicators and fatigue are thoroughly investigated and reviewed. On the other hand, to better determine fatigue occurrence, a new combination of measures is recommended, as a single measure is not sufficient to yield a convincing benchmark of fatigue. Finally, since video-based techniques of measuring eye metrics offer a promising and practical method for monitoring operator fatigue, the relationship between fatigue and these eye metrics, that include blink-based, pupil-based, and saccade-based features, are also discussed. To realize a pragmatic fatigue detector for operators in the future, this paper concludes with a discussion on the future directions in terms of methodology of conducting operator fatigue research and fatigue analysis by using eye-related parameters., (Copyright © 2020 National Safety Council and Elsevier Ltd. All rights reserved.)

Stress is prevalent in modern society and can affect human health through its effects on appetite. Therefore, in the present study, we aimed to clarify the neural mechanisms by which acute stress affects appetite in healthy, non-obese males during fasting. In total, 22 volunteers participated in two experiments (stress and control conditions) on different days. The participants performed a stress-inducing speech-and-mental-arithmetic task under both conditions, and then viewed images of food, during which, their neural activity was recorded using magnetoencephalography (MEG). In the stress condition, the participants were told to perform the speech-and-mental-arithmetic task again subsequently to viewing the food images; however, another speech-and-mental-arithmetic task was not performed actually. Subjective levels of stress and appetite were then assessed using a visual analog scale. Electrocardiography was performed to assess the index of heart rate variability reflecting sympathetic nerve activity. The findings showed that subjective levels of stress and sympathetic nerve activity were increased in the MEG session in the stress condition, whereas appetite gradually increased in the MEG session only in the control condition. The decrease in alpha band power in the frontal pole caused by viewing the food images was greater in the stress condition than in the control condition. These findings suggest that acute stress can suppress the increase of appetite, and this suppression is associated with the frontal pole. The results of the present study may provide valuable clues to gain a further understanding of the neural mechanisms by which acute stress affects appetite. However, since the stress examined in the present study was related to the expectation of forthcoming stressful event, our present findings may not be generalized to the stress unrelated to the expectation of forthcoming stressful event., Competing Interests: The authors have declared that no competing interests exist.

Objective: Electroencephalogram (EEG) signals are non-stationary. This could be due to internal fluctuation of brain states such as fatigue, frustration, etc. This necessitates the development of adaptive brain-computer interfaces (BCI) whose performance does not deteriorate significantly with the adversary change in the cognitive state. In this paper, we put forward an unsupervised adaptive scheme to adapt the feature extractor of motor imagery (MI) BCIs by tracking the fatigue level of the user., Approach: Eleven subjects participated in the study during which they accomplished MI tasks while self-reporting their perceived levels of mental fatigue. Out of the 11 subjects, only six completed the whole experiment, while the others quit in the middle because of experiencing high fatigue. The adaptive feature extractor is attained through the adaptation of the common spatial patterns (CSP), one of the most popular feature extraction algorithms in EEG-based BCIs. The proposed method was analyzed in two ways: offline and in near real-time. The separability of the MI EEG features extracted by the proposed adaptive CSP (ADCSP) has been compared with that by the conventional CSP (C-CSP) and another CSP based adaptive method (ACSP) in terms of: Davies Bouldin index (DBI), Fisher score (FS) and Dunn's index (DI)., Main Results: Experimental results show significant improvement in the separability of MI EEG features extracted by ADCSP as compared to that by C-CSP and ACSP., Significance: Collectively, the results of the experiments in this study suggest that adapting CSP based on mental fatigue can improve the class separability of MI EEG features.

Background: The present study describes the intercultural differences in the perception of stress and the preparation of seafarers., Materials and Methods: Three hundred twenty-three seafarers (156 [48.3%] Europeans and 167 [51.7%] Southeast Asians) were interviewed about their subjective stress on board., Results: According to the interviews with ship's officers, mostly represented by Europeans, mental stress was most often due to high responsibilities (82.0%), extensive administrative tasks (81.1%) and lack of qualification of seafarers (64.8%). Subjectively, the Europeans questioned were significantly more likely to experience mental stress on board than the Southeast Asians (74.2% vs. 56.3%), whereas the latter were more prone to being physically stressed. 43.1% of the Southeast Asian seafarers often felt lonely on board compared with 26.2% of the Europeans. Preparation for maritime-specific stress in the form of specific training units is only provided in 1 of the 5 universities surveyed. The most important reason for this is a lack of time. Intercultural leadership training was also only offered at one university., Conclusions: In view of the many psychophysical stressors in daily life on a ship and the lacking respective education, it is recommended to integrate stress management and diversity training in intercultural communication in the higher education of future superiors on board.