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  1. Dawe K, Montgomery A, McGee H, Panagopoulou E, Morgan K, Hackshaw L, et al.
    J Health Psychol, 2016 05;21(5):607-18.
    PMID: 24829376 DOI: 10.1177/1359105314532970
    We synthesised evidence on biological correlates of psychological stress in hospital-based healthcare professionals, and examined whether there was evidence of consistent biological changes. Electronic databases were searched for empirical studies; 16 articles (0.6%) met the inclusion criteria. Evidence of a relationship between indices of psychological stress and biological parameters was limited and inconsistent. There was some evidence of a consistent relationship between natural killer cells and lymphocyte subpopulations. Considerable heterogeneity in the methods used was seen. Future prospective studies examining the relationship between indices of psychological stress and natural killer cells, including lymphocyte subsets, is required.
    Matched MeSH terms: Stress, Psychological/physiopathology*
  2. Teoh AN, Hilmert C
    Br J Health Psychol, 2018 11;23(4):1040-1065.
    PMID: 30084181 DOI: 10.1111/bjhp.12337
    PURPOSE: The stress-buffering hypothesis (Cohen & McKay, 1984, Handbook of psychology and health IV: Social psychological aspects of health (pp. 253-256). Hillsdale, NJ: Lawrence Erlbaum) suggests that one way social support enhances health is by attenuating cardiovascular reactivity (CVR) to stress. Research that has tested this hypothesis has reported inconsistent findings. In this review, we systematically reviewed those findings and proposed a dual-effect model of social support and CVR as a potential explanation for the inconsistency in the literature. Specifically, we proposed that when participants are more engaged during a stressor, social support acts primarily as social comfort, attenuating CVR; and when participants are not engaged, social support acts primarily as social encouragement, elevating CVR.

    METHODS: We reviewed 22 previous studies that (1) empirically manipulated social support in a stressful situation, (2) measured CVR, and (3) tested a moderator of social support effects on CVR.

    RESULTS: Although a majority of studies reported a CVR-mitigating effect of social support resulting in an overall significant combined p-value, we found that there were different effects of social support on CVR when we considered high- and low-engagement contexts. That is, compared to control conditions, social support lowered CVR in more engaging situations but had no significant effect on CVR in less engaging situations.

    CONCLUSION: Our results suggest that a dual-effect model of social support effects on CVR may better capture the nature of social support, CVR, and health associations than the buffering hypothesis and emphasize a need to better understand the health implications of physiological reactivity in various contexts. Statement of contribution What is already known on this subject? According to the stress-buffering hypothesis (Cohen & McKay, ), one pathway social support benefits health is through mitigating the physiological arousal caused by stress. However, previous studies that examined the effects of social support on blood pressure and heart rate changes were not consistently supporting the hypothesis. Some studies reported that social support causes elevations in cardiovascular reactivity (CVR) to stress (Anthony & O'Brien, ; Hilmert, Christenfeld, & Kulik, ; Hilmert, Kulik, & Christenfeld, ) and others showed no effect of social support on CVR (Christian & Stoney, ; Craig & Deichert, ; Gallo, Smith, & Kircher, ). What does this study add? When participants were in more engaging conditions, social support decreased CVR relative to no support. When participants were in less engaging conditions, social support did not have a significant effect on CVR. Provide an alternative way to explain the ways social support affects cardiac health.

    Matched MeSH terms: Stress, Psychological/physiopathology*
  3. Das Gupta E, Zailinawati AH, Lim AW, Chan JB, Yap SH, Hla YY, et al.
    Med J Malaysia, 2009 Jun;64(2):111-3.
    PMID: 20058568 MyJurnal
    In Malaysia, it is a common belief among health care workers that females and Indians have lower pain threshold. This experience, although based on anecdotal experience in the healthcare setting, does not allow differentiation between pain tolerance, and pain expression. To determine whether there is a difference in the tolerance to pain between the three main ethnic groups, namely the Malays, Chinese and Indians as well as between males and females. This was a prospective study, using a laboratory pain model (ischaemic pain tolerance) to determine the pain tolerance of 152 IMU medical students. The mean age of the students was 21.8 years (range 18-29 years). All of them were unmarried. The median of ischaemic pain tolerance for Malays, Chinese and Indians were 639s, 695s and 613s respectively (p = 0.779). However, statistically significant difference in ischaemic pain tolerance for males and females Indian students were observed. Possible ethnic difference in pain tolerance in casual observation is not verified by this laboratory pain model. Difference in pain tolerance between genders is shown only for Indians.
    Matched MeSH terms: Stress, Psychological/physiopathology
  4. Eva EO, Islam MZ, Mosaddek AS, Rahman MF, Rozario RJ, Iftekhar AF, et al.
    BMC Res Notes, 2015;8:327.
    PMID: 26223786 DOI: 10.1186/s13104-015-1295-5
    Throughout the world all health professionals face stress because of time-pressures, workload, multiple roles and emotional issues. Stress does not only exist among the health professionals but also in medical students. Bangladesh has currently 77 medical colleges 54 of which are private. This study was designed to collect baseline data of stress-level among Bangladeshi students, which we believe will form the basis for further in depth studies.
    Matched MeSH terms: Stress, Psychological/physiopathology
  5. Chen PC
    Ann Acad Med Singap, 1987 Jan;16(1):110-4.
    PMID: 3592576
    Consequent to rapidly declining mortality and birth rates, developing countries, including Malaysia, can expect a rapid increase in the population aged 60 years and above. The health of the elderly is intimately tied up with both biophysical as well as psychosocial factors which include status loss, loneliness, fear of illness and death, poverty, harmful life-styles and deterioration of the quality of life. The effects of these psychosocial factors can manifest as sleep difficulties, worry and anxiety, depression, loss of interest, and a feeling of tiredness. In extreme cases, there may be auditory or visual hallucinations or paranoia. In the present paper, which is based upon a WHO sponsored study of 1001 elderly Malaysians, it is noted that 36% of the elderly have sleep difficulties, 47% "feel tired", 31% have a "loss of interest" and 22% are "worried tense". However 71% of the elderly are able to correctly perform at least 12 of 15 cognitive tests. 20% of elderly men smoke 15 or more cigarettes a day while 44% smoke at least one cigarette a day. 40% of elderly men indicate that their families complain about the amount of alcohol they drink. Undoubtedly primary health care programmes need to be re-oriented to the problems and needs of the elderly in countries such as Malaysia.
    Matched MeSH terms: Stress, Psychological/physiopathology*
  6. Ubuka T, Trudeau VL, Parhar I
    PMID: 32582033 DOI: 10.3389/fendo.2020.00366
    Matched MeSH terms: Stress, Psychological/physiopathology
  7. Rahma MS, Mustafa BE, Razali A, Shamsuddin N, Althunibat OY
    Noise Health, 2013 Nov-Dec;15(67):375-8.
    PMID: 24231415 DOI: 10.4103/1463-1741.121223
    Several epidemiologic studies have reported that exposure to noise is associated with cardiovascular disease. The increased body weight is often associated with metabolic as well as increased blood pressure. The aim of this study is to investigate the correlation between the elevation of blood pressure and serum leptin hormones due to the effects of noise in the work place. A total of 80 volunteer males where included in this study with an age range between of 20 and 45 years, they were divided in two groups equally, the 1 st group were exposed to noise in the workplace while the 2 nd group were not. The individual noise exposure was determined by using a sound level meter. The range of noise was 80-100 dBA. Body Mass Index was also taken for each individual by a standard measure, blood pressure was measured by OMRON sphygmomanometer and serum leptin was measured through venous blood sample analysis enzyme linked immunosorbent assay. Spearman rank order correlation was used to examine the correlations between Blood pressure value (Systolic, Diastolic) and Leptin. All the relationships between parameters showed a positive correlation. Systolic and diastolic blood pressure values had a significant correlation to leptin hormone level in comparison to the control. There was a significant relation between leptin and blood pressure. leptin effects on the sympathetic nervous system may provide a partial explanation. Therefore, Leptin might have diverse cardiovascular actions.
    Matched MeSH terms: Stress, Psychological/physiopathology
  8. Mairami FF, Warren N, Allotey PA, Mak JS, Reidpath DD
    Disabil Rehabil, 2020 01;42(1):102-113.
    PMID: 30183424 DOI: 10.1080/09638288.2018.1493544
    Purpose: Stroke is an abrupt event that often leaves survivors with long term disabilities, causing role changes, and financial strains on households. The profound impact of stroke on survivors may lead to a decline in quality of life due to the physical, psychological, and social difficulties they experience. Taking Malaysia as an example, this study aimed to explore the impact of stroke on survivors and how health services influence their recovery in low and middle-income countries (LMIC).Method: An ethnographic approach with data obtained primarily through in-depth interviews was used. Twenty-seven participants identified as having suffered a stroke were drawn from a health and demographic surveillance system in Malaysia.Results: The physical and social disruption of the lives of stroke survivors was intensified by the resultant financial constraints placed upon individuals, families and households, compounded by inadequate support from the health, and welfare systems. Despite the disruption to their lives, most participants were, at least in part, able to reestablish their lives through various factors that include a strong family support and active coping strategies.Conclusion: In LMIC, recovery can be shaped by the family unit and through active coping strategies especially those in relation to spirituality.Implications for rehabilitationThe impact of stroke on survivors and lack of specialized stroke care compromise the recovery process and quality of life for stroke survivors in low and middle-income countries.Support from the family and reinforcement of religious coping were judged to successfully aid recovery.Physical and emotional impairments as well as psychosocial wellbeing of survivors in the context of environmental factors need to be addressed.
    Matched MeSH terms: Stress, Psychological/physiopathology
  9. Aimie-Salleh N, Malarvili MB, Whittaker AC
    Med Biol Eng Comput, 2019 Jun;57(6):1229-1245.
    PMID: 30734153 DOI: 10.1007/s11517-019-01958-3
    Adverse childhood experiences have been suggested to cause changes in physiological processes and can determine the magnitude of the stress response which might have a significant impact on health later in life. To detect the stress response, biomarkers that represent both the Autonomic Nervous System (ANS) and Hypothalamic-Pituitary-Adrenal (HPA) axis are proposed. Among the available biomarkers, Heart Rate Variability (HRV) has been proven as a powerful biomarker that represents ANS. Meanwhile, salivary cortisol has been suggested as a biomarker that reflects the HPA axis. Even though many studies used multiple biomarkers to measure the stress response, the results for each biomarker were analyzed separately. Therefore, the objective of this study is to propose a fusion of ANS and HPA axis biomarkers in order to classify the stress response based on adverse childhood experience. Electrocardiograph, blood pressure (BP), pulse rate (PR), and salivary cortisol (SCort) measures were collected from 23 healthy participants; 11 participants had adverse childhood experience while the remaining 12 acted as the no adversity control group. HRV was then computed from the ECG and the HRV features were extracted. Next, the selected HRV features were combined with the other biomarkers using Euclidean distance (ed) and serial fusion, and the performance of the fused features was compared using Support Vector Machine. From the result, HRV-SCort using Euclidean distance achieved the most satisfactory performance with 80.0% accuracy, 83.3% sensitivity, and 78.3% specificity. Furthermore, the performance of the stress response classification of the fused biomarker, HRV-SCort, outperformed that of the single biomarkers: HRV (61% Accuracy), Cort (59.4% Accuracy), BP (78.3% accuracy), and PR (53.3% accuracy). From this study, it was proven that the fused biomarkers that represent both ANS and HPA (HRV-SCort) able to demonstrate a better classification performance in discriminating the stress response. Furthermore, a new approach for classification of stress response using Euclidean distance and SVM named as ed-SVM was proven to be an effective method for the HRV-SCort in classifying the stress response from PASAT. The robustness of this method is crucial in contributing to the effectiveness of the stress response measures and could further be used as an indicator for future health. Graphical abstract ᅟ.
    Matched MeSH terms: Stress, Psychological/physiopathology*
  10. Hussain J, Sundaraj K, Subramaniam ID
    PLoS One, 2020;15(1):e0228089.
    PMID: 31999750 DOI: 10.1371/journal.pone.0228089
    INTRODUCTION: Cognitive stress (CS) changes the peripheral attributes of a muscle, but its effect on multi-head muscles has not been investigated. The objective of the current research was to investigate the impact of CS on the three heads of the triceps brachii (TB) muscle.

    METHODS: Twenty-five young and healthy university students performed a triceps push-down exercise at 45% one repetition maximum (1RM) with and without CS until task failure, and the rate of fatigue (ROF), endurance time (ET) and number of repetitions (NR) for both exercises were analyzed. In addition, the first and last six repetitions of each exercise were considered non-fatiguing (NF) and fatiguing (Fa), respectively, and the root mean square (RMS), mean power frequency (MPF) and median frequency (MDF) for each exercise repetition were evaluated.

    RESULTS: The lateral and long head showed significant differences (P<0.05) in the ROF between the two exercises, and all the heads showed significant (P<0.05) differences in the RMS between the two exercises under NF conditions. Only the long head showed a significant difference (P<0.05) in the MPF and MDF between the two exercises. CS increases the ET (24.74%) and NR (27%) of the exercise. The three heads showed significant differences (P<0.05) in the RMS, MPF and MDF under all exercise conditions.

    CONCLUSION: A lower ROF was obtained with CS. In addition, the RMS was found to be better approximator of CS, whereas MPF and MDF were more resistant to the effect of CS. The results showed that the three heads worked independently under all conditions, and the non-synergist and synergist head pairs showed similar behavior under Fa conditions. The findings from this study provide additional insights regarding the functioning of each TB head.

    Matched MeSH terms: Stress, Psychological/physiopathology*
  11. Al-Rahbi B, Zakaria R, Othman Z, Hassan A, Muthuraju S, Wan Mohammad WM
    Biomed Res Int, 2013;2013:493643.
    PMID: 23841073 DOI: 10.1155/2013/493643
    This study aims to compare the effects of social instability stress on memory and anxiety- and depressive-like behaviour between sham-operated controls and ovariectomised (OVX) rats. Forty adult female Sprague-Dawley rats (8 weeks old) were randomly divided into four groups, (n = 10 per group). These were non-stressed sham-operated control rats, stressed sham-operated control rats, non-stressed OVX rats, and stressed OVX rats. The rats were subjected to social instability stress procedure for 15 days. Novel object recognition, open field, and forced swim tests were conducted after the stress procedure. Serum estradiol, ACTH and corticosterone levels were measured using commercially available ELISA kits. Lower serum estradiol level and uterine weight with higher weight gain were observed in OVX rats compared to sham-operated controls. Serum ACTH, and corticosterone levels were higher in stressed compared to non-stressed groups. Memory deficit and anxiety- and depressive-like behaviour were significantly increased in stressed compared to non-stressed OVX rats but these changes were not seen in sham-operated controls. These results suggest that the high circulating corticosterone acts synergistically with low circulating estradiol to exert negative effects on mood and memory function.
    Matched MeSH terms: Stress, Psychological/physiopathology*
  12. Gryzunov YA, Koplik EV, Smolina NV, Kopaeva LB, Dobretsov GE, Sudakov KV
    Stress, 2006 Mar;9(1):53-60.
    PMID: 16753933
    In this study, the hypothesis was tested that behaviour of rats under the open field test condition and effects of subsequent acute stress relate to conformational properties of the main plasma carrier protein, albumin.To evaluate albumin properties, fluorescence intensity of a molecular probe CAPIDAN (N-carboxyphenylimide of dimethylaminonaphthalic acid) at N (at pH 7.4) and F (at pH 4.2) albumin conformations was measured and the N-F signal ratio was calculated. The data obtained showed that CAPIDAN fluoresces selectively from albumin in rat serum and its fluorescence is sensitive to binding of fatty acids and some other ligands to albumin. Behaviour of 78 Wistar male rats was characterized from the fraction of time taken for exploratory and ambulatory activity during the open field test. In rats not subjected to stress (n = 40), a negative correlation was revealed between open field activity and CAPIDAN N-to-F ratio for albumin (r = - 0.55, p < 0.0005). In the group of rats subjected to acute stress (immobilization plus stochastic electrocutaneous stimulation) the correlation between behavioural activity and the albumin conformational properties was significantly positive (r = 0.59, p < 0.0001): the CAPIDAN albumin fluorescence ratio increased in the highly active rats and decreased in the low-activity rats. The mechanisms of the observed effects may involve differences in nonesterified fatty acid production during stress.
    Matched MeSH terms: Stress, Psychological/physiopathology*
  13. Lee MT, Chiu YT, Chiu YC, Hor CC, Lee HJ, Guerrini R, et al.
    J Biomed Sci, 2020 Jan 09;27(1):7.
    PMID: 31915019 DOI: 10.1186/s12929-019-0590-1
    BACKGROUND: Stress-induced analgesia (SIA) is an evolutionarily conserved phenomenon during stress. Neuropeptide S (NPS), orexins, substance P, glutamate and endocannabinoids are known to be involved in stress and/or SIA, however their causal links remain unclear. Here, we reveal an unprecedented sequential cascade involving these mediators in the lateral hypothalamus (LH) and ventrolateral periaqueductal gray (vlPAG) using a restraint stress-induced SIA model.

    METHODS: Male C57BL/6 mice of 8-12 week-old were subjected to intra-cerebroventricular (i.c.v.) and/or intra-vlPAG (i.pag.) microinjection of NPS, orexin-A or substance P alone or in combination with selective antagonists of NPS receptors (NPSRs), OX1 receptors (OX1Rs), NK1 receptors (NK1Rs), mGlu5 receptors (mGlu5Rs) and CB1 receptors (CB1Rs), respectively. Antinociceptive effects of these mediators were evaluated via the hot-plate test. SIA in mice was induced by a 30-min restraint stress. NPS levels in the LH and substance P levels in vlPAG homogenates were compared in restrained and unrestrained mice.

    RESULTS: NPS (i.c.v., but not i.pag.) induced antinociception. This effect was prevented by i.c.v. blockade of NPSRs. Substance P (i.pag.) and orexin-A (i.pag.) also induced antinociception. Substance P (i.pag.)-induced antinociception was prevented by i.pag. Blockade of NK1Rs, mGlu5Rs or CB1Rs. Orexin-A (i.pag.)-induced antinociception has been shown previously to be prevented by i.pag. blockade of OX1Rs or CB1Rs, and here was prevented by NK1R or mGlu5R antagonist (i.pag.). NPS (i.c.v.)-induced antinociception was prevented by i.pag. blockade of OX1Rs, NK1Rs, mGlu5Rs or CB1Rs. SIA has been previously shown to be prevented by i.pag. blockade of OX1Rs or CB1Rs. Here, we found that SIA was also prevented by i.c.v. blockade of NPSRs or i.pag. blockade of NK1Rs or mGlu5Rs. Restrained mice had higher levels of NPS in the LH and substance P in the vlPAG than unrestrained mice.

    CONCLUSIONS: These results suggest that, during stress, NPS is released and activates LH orexin neurons via NPSRs, releasing orexins in the vlPAG. Orexins then activate OX1Rs on substance P-containing neurons in the vlPAG to release substance P that subsequently. Activates NK1Rs on glutamatergic neurons to release glutamate. Glutamate then activates perisynaptic mGlu5Rs to initiate the endocannabinoid retrograde inhibition of GABAergic transmission in the vlPAG, leading to analgesia.

    Matched MeSH terms: Stress, Psychological/physiopathology
  14. Liu G, Chong HX, Chung FY, Li Y, Liong MT
    Int J Mol Sci, 2020 Jun 29;21(13).
    PMID: 32610495 DOI: 10.3390/ijms21134608
    We have previously reported that the administration of Lactobacillus plantarum DR7 for 12 weeks reduced stress and anxiety in stressed adults as compared to the placebo group, in association with changes along the brain neurotransmitters pathways of serotonin and dopamine-norepinephrine. We now aim to evaluate the effects of DR7 on gut functions, gut microbiota compositional changes, and determine the correlations between microbiota changes and the pathways of brain neurotransmitters. The administration of DR7 prevented an increase of defecation frequency over 12 weeks as compared to the placebo (p = 0.044), modulating the increase of stress-induced bowel movement. Over 12 weeks, alpha diversity of gut microbiota was higher in DR7 than the placebo group across class (p = 0.005) and order (p = 0.018) levels, while beta diversity differed between groups at class and order levels (p < 0.001). Differences in specific bacterial groups were identified, showing consistency at different taxonomic levels that survived multiplicity correction, along the phyla of Bacteroides and Firmicutes and along the classes of Deltaproteobacteria and Actinobacteria. Bacteroidetes, Bacteroidia, and Bacteroidales which were reduced in abundance in the placebo group showed opposing correlation with gene expression of dopamine beta hydrolase (DBH, dopamine pathway; p < 0.001), while Bacteroidia and Bacteroidales showed correlation with tryptophan hydroxylase-II (TPH2, serotonin pathway; p = 0.001). A correlation was observed between DBH and Firmicutes (p = 0.002), Clostridia (p < 0.001), Clostridiales (p = 0.001), Blautia (p < 0.001), and Romboutsia (p < 0.001), which were increased in abundance in the placebo group. Blautia was also associated with TDO (p = 0.001), whereas Romboutsia had an opposing correlation with TPH2 (p < 0.001). Deltaproteobacteria and Desulfovibrionales which were decreased in abundance in the placebo group showed opposing correlation with DBH (p = 0.001), whereas Bilophila was associated with TPH2 (p = 0.001). Our present data showed that physiological changes induced by L. plantarum DR7 could be associated with changes in specific taxa of the gut microbiota along the serotonin and dopamine pathways.
    Matched MeSH terms: Stress, Psychological/physiopathology
  15. Mitra NK, Nadarajah VD, Siong HH
    Folia Neuropathol, 2009;47(1):60-8.
    PMID: 19353435
    Dermal absorption of chlorpyrifos (CPF), an organophosphate (OP) pesticide, is important because of its popular use. Stress has been reported to exacerbate neurotoxic effects of certain OP pesticides; however, quantitative studies to corroborate this are not reported. This study correlates the changes in acetylcholinesterase (AChE) levels and neuronal counts in areas of the hippocampus to consecutive exposure of stress, heat and CPF. Male mice (60 days) were segregated into six groups: one control, one stress control, and four treated groups (n=10). CPF was applied in doses of 1/2 and 1/5 of dermal LD50 (E1 and E2) over the tail of mice under occlusive bandages for 3 weeks. Stress control [(s) C] mice were subjected to swim stress at 38 degrees C (6 mins/day, 3 weeks). (s) E1 and (s) E2 were subjected to swim stress before CPF application. Blood and brain AChE levels were estimated using a spectrofluorometric method (Amplex Red). Pyramidal neurons of the cornu ammonis of the hippocampus under Nissl stain from histological sections were counted per unit area of section and analyzed statistically using one way ANOVA. Swim stress at 38 degrees C aggravated reduction of serum AChE by dermal exposure to CPF by 19.7%. Neurons of CA3 and CA1 regions of the hippocampus showed significant reduction in neuronal counts in (s) E1 and (s) E2 groups compared to E1 and E2 groups. Whereas application of CPF 1/2 dermal LD50 (E1) showed significant reduction of neuronal counts only in the CA3 area.
    Matched MeSH terms: Stress, Psychological/physiopathology
  16. Kaur D, Bishop GD
    Int J Psychophysiol, 2013 Feb;87(2):130-40.
    PMID: 23206971 DOI: 10.1016/j.ijpsycho.2012.11.011
    Epidemiological studies have shown significant ethnic differences in coronary heart disease death rates with South Asians showing significantly greater coronary heart disease mortality than other groups.
    Matched MeSH terms: Stress, Psychological/physiopathology*
  17. Enkelmann HC, Bishop GD, Tong EM, Diong SM, Why YP, Khader M, et al.
    Int J Psychophysiol, 2005 May;56(2):185-97.
    PMID: 15804452
    This study tested the hypotheses that ambulatory heart rate and blood pressure would be higher for individuals high but not low in hostility when they experienced negative affect or social stress and that this interaction would be stronger for Indians compared with other Singapore ethnic groups. Ambulatory blood pressure monitoring was done on 108 male Singapore patrol officers as they went about their daily duties. After each BP measurement participants completed a computerized questionnaire including items on emotional experience. Individuals high in hostility showed higher systolic blood pressure when reporting negative affect whereas this was not true for those low in hostility. Ethnic differences were obtained such that Indians showed an increase in mean arterial pressure when angered whereas MAP was negatively related to anger for Malays and unrelated for Chinese. Also a three-way interaction between ethnicity, hostility, and social stress indicated that hostility and social stress interacted in their effects on DBP for Indian participants but not for Chinese or Malays. Finally, a three-way interaction was obtained between ethnicity, hostility and negative affect for heart rate in which heart rate increased with increasing levels of negative affect for Chinese high in hostility and Malays low in hostility but decreased with increasing negative affect for all other participants. These data are consistent with higher CHD rates among individuals high in hostility and also provide additional evidence on ethnic differences in cardiovascular reactivity in Singapore.
    Matched MeSH terms: Stress, Psychological/physiopathology
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