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Fig 1.

Study design and target analytes.

This study was conducted following the scheme shown in A). All participants started fasting from 9 p.m. and sampling was conducted the next morning. Serum, urine, and saliva were obtained from all participants. All participants answered BJSQ and CES-D items and were interviewed by a medical doctor. All participants received laboratory tests. The target urinary neurotransmitters are shown in B) with their metabolism pathway.

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Fig 1 Expand

Fig 2.

Comparison between BJSQ and CES-D.

A scatter plot of BJSQ and CES-D total scores is shown in A) with a fitting curve and 95% CI curves. The ratio of four scores, 1 (low stress) to 4 (high stress) are plotted with bar graph B); black (BJSQ), gray (CES-D).

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Fig 2 Expand

Table 1.

Significant responses of neural transmitters.

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Table 1 Expand

Fig 3.

The expressions of six urinary neurotransmitters and their combined index.

The examinees were divided into two groups based on their total BJSQ scores. The box-whisker plots of 5-HIAA, DA, GABA, HVA, 5-HT, and VMA are shown in A). Student’s t-tests were performed for the six urinary neurotransmitters, and p-values below 0.05 are shown in the plots. To generate the stress index, participants were randomly divided into a training (66) or test (34) set, and all analyte concentrations were logarithmically converted and normalized by zero-mean-centering and unit-variance-scaling. The stress index was generated by a linear combination of six normalized values with weight factors. The weight factors were optimized using the Excel-solver program B).

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Fig 3 Expand

Table 2.

Demographic features.

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Table 2 Expand

Table 3.

Average concentrations of urinary neurotransmitters in high and low stress groups.

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Table 3 Expand