The Road So Far Integrated Human Practices Survey

HUMAN PRACTICES

Our project involves working with humans and creating a product that will assist them in their daily life. As such, we wished to create a cortisol monitoring patch that is influenced by experts and the public opinion. In order to approach our project better, we addressed the main iGEM human practice principles on the project's influence on the world and the world's influence on our project. We spent the first part of our project, discussing ideas with all the members of the team, with one particular project standing out to us.

In order to approach our project better, we addressed the main iGEM human practice principles on the project's influence on the world and the world's influence on our project.

We spent the first part of our project discussing ideas with all the members of the team and our supervisors, with one particular project standing out to us. We spent two weeks settling on the final details of the project but we were very motivated to work with a project that would make a difference for a community and the world. We began with 5 potential projects and after a democratic voting, we chose our current project ´DetectiMOL - a cortisol monitoring device´.

We presented our project to our main principal investigators (PIs) Athanasios Saragliadis(Researcher - Bacterial adhesins) and Dirk Linke(Professor - Genetics and Evolutionary Biology), as well as our supervisor Kirsten Borse Haraldsen(Senior Academic Librarian), who gave us valuable feedback from the beginning and guided us closely throughout our project. Our supervisors also began recommending relevant researchers to contact as well as communities we could reach out to discuss our project and receive valuable feedback on its development.

Our goal is to develop a monitoring patch that can measure cortisol during the day and night cycle (circadian rhythm). That is achieved by a small round device attached to the user's arm, in order to have access to the cortisol in the interstitial fluid. In order to better understand how this patch would be used, if we should focus on a single or continuous type of monitoring, and if there are any issues with the patch in practice, we turned to the public and our academic community. We discussed with researchers who have worked with relevant monitoring devices, visited hospitals that perform cortisol testing, as well as talk to people affected by stress in our immediate community, the University of Oslo, in order to understand how they perceive our idea of a monitoring patch.

The Road So Far

Martin Petkovich

30-05-2024

Advisor to past iGEM Canada Team, QGEM 2018, Professor at the Department of Biomedical and Molecular Sciences in Queen's University, Canada.

One of the first researchers we talked to was Dr Martin Petkovich, who was a valuable research advisor of the Canadian iGEM Team of 2018, QGEM. QGEM has also worked on creating a monitoring device for cortisol, however using saliva. Dr. Martin gave us general advice about our project as well as going into depth about the possible use of chimeric proteins to simplify our design. He mentioned his own research and his use of estrogen receptors with specific chimeric proteins that could be relevant and he shared many relevant research papers with us.

Martin Petkovich

Hanne Cecilie Winther-Larsen

07-06-2024

Professor - Section for Pharmacology and Pharmaceutical Biosciences

We had received great ideas and inspirations from the last researchers, however we needed to understand the methods better. We contacted Professor Winther-Larsen in order to get more advice during the early conceptualization of the project and to discuss ideas including the use of artificial membranes, as well as which methods of implementation would be more useful.

Hanne Cecilie Winther-Larsen

Bjørn Dalhus

07-06-2024 and 26-07-2024

Researcher - Department of Medical Biochemistry

As we were considering what methods to use to detect our cortisol when we reached the last stage of our cortisol monitoring device, we contacted Bjørn Dalhus. We focused our conversation on the surface plasmon resonance and the possibility of using this method to detect the binding of the target protein. Later, we also contacted him to perform a Microscale Thermophoresis assay (MST assay) to demonstrate that our protein receptors GR binds to cortisol successfully (will be performed during October 2024).

Bjørn Dalhus

Rein Aasland

06-09-2024 and 26-09-2024

Professor - Section for Genetics and Evolutionary Biology

After summer and our intense lab work experiments, we had a presentation with Rein about the final version of our project and the updates that we had at the moment. We discussed better ways to communicate our ideas, the results and updates that we had done so far and how to pitch our ideas to different audiences.

Rein Aasland

Nicolay Barard-Andersen (veksthuset)

26-09-2024

Senior Innovation Advisor in the Growth House(Veksthuset)

We met with Nicolay Berard-Andersen, who is the Senior Innovation Advisor in the Growth House(Veksthuset) affiliated with the University of Oslo, to present to him our research and how far we have come with our idea. He gave us valuable feedback on what more is needed to be accomplished to get a successful presentation as well as give us more resources on people to contact for further advice.

Nicolay

Amruthaa Kishora (insj)

28-09-2024

Leader of the Insj group, University of Oslo

We had a wonderful discussion with Amruutha Kishore, leader of the Insj group at the University of Oslo, by email, discussing the different aspects of the project and how to communicate our idea to the university students that are interested in innovation. Amrutha gave us feedback on our presentation, our idea pitch and gave us the opportunity to present at the opening of the University of Oslo iHUB Student Innovation Office Space.

Anamika Chatterjee

29-09-2024

Senior Adviser at the Centre for Digital Life Norway (DLN)r

Anamika Chatterjee, Senior Adviser at the Centre for Digital Life Norway (DLN), was one of our last contacts during our project and gave us tremendous feedback on the ethics and possible pitfalls of a wearable cortisol monitoring device. She discussed the importance of inclusion, autonomy and privacy that is involved with making a complicated medical device such as our cortisol monitoring device, and the effect it could have on the everyday user. Our response to her feedback is under Hardware.

Cesar Augusto Medina Culma

31-05-2024

PhD Researcher at University of Minnesota

We contacted Dr. Culma in the beginning of our project due to his experience with relevant projects. He is a PhD Researcher at University of Minnesota. His experience allowed us to receive multiple different techniques that he has worked with that can be valuable for our project. The meeting helped us with an early conceptualization of the project and to decide the method that we will use for our binding assay, between protein binding (GR), aptamers, Immunostaining or MIP.

Cesar Culma

Joseph Azumah

07-06-2024

Lecturer - Section for Pharmaceutics and Social Pharmacy

We talked to Joseph Azumah and received his help with the early conceptualization of the project and to discuss ideas including the use of artificial membranes that could be possibly used on a final version of the device. He encouraged us to further investigate our idea to use artificial membranes and lipid bilayers. Since then, we decided not to go that path with this particular project but meeting him was nonetheless interesting and encouraging.

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Jens Petter Berg

20-06-2024

Professor of medicine - Clinical biochemistry

We talked to Jens Petter Berg at an early stage of our project and received the most important and helpful guidance from him. We referred to him to conceptualize our idea into using a protein binding approach as the best way to produce constant measurement of cortisol levels in the interstitial fluid. We narrowed down our idea to a continuous monitoring method with his help as well as getting to explore hospital grade cortisol testing. In this talk we also shared ideas regarding how the detection patch would be able to have a longer useful lifespan and a lower saturation process on the cortisol ligand process.

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Gro Ellefsen

10-09-2024

Communication Officer at Science and Technology Museum of Oslo

Gro Ellefsen, the communication officer of the Science and Technology Museum of Oslo, invited our team for a potential collaboration and to join the 3-day stand days, in order to better promote our project. Gro provided us with tips on how to promote our events on social media as well as instigate a sponsorship deal between the museum and our team.

Gerbrand Koster

26-09-2024

Advisor for Invent2

We met Gerbrand Koster, who is an Advisor for Invent2 affiliated with the University of Oslo, and received valuable feedback on our presentation and our idea pitch. Gerbrand helped us recognise some communication mistakes in our presentation as well as help us with feedback on our 3D-Print of our device, which he firmly believed we should make samples of with the available data we have.

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Integrated Human Practices

The DetectiMOL team has had many ideas on how to work on this project, however we would not be anywhere without the supervisors, stakeholders, researchers and the community.

Our project was quite complicated to work on, both in terms of ethics and in terms of biology. Receiving experts' opinions and scientific feedback helped us shape the project we wanted in the most ethical, quick and affordable way. Although we had a concrete idea of what we wished to work with and reached out to the researchers with a solid plan on either continuous or single time monitoring, their final feedback and recommendations helped us reach the current level of achievement in our project. The most challenging questions being which methods to use for binding cortisol, either continuous or single time measurements, as well as how to create a system that binds cortisol and can be used in a working real life monitoring device.

We discussed not only diagnostics questions, but also received feedback on our pitch, on how to have a successful presentation and how to communicate our research and ideas to the general public.

Human Practices Interviews

Advisor to past iGEM Canada Team, QGEM 2018, Professor at the Department of Biomedical and Molecular Sciences in Queen's University, Canada.

Points of discussion: Our team needed feedback on what methods of monitoring to work with, either continuous or single time measurements for our cortisol patch. We gathered all the relevant research we had and presented it to Dr. Martin in order to hear his feedback on the question at hand.

Summary of meeting: Our meeting happened on Zoom and attended by two of our team members. Dr. Martin gave us general advice about our project as well as going into depth about the possible use of chimeric proteins to simplify our design. He mentioned his own research and his use of estrogen receptors with specific chimeric proteins that could be relevant and he shared many relevant research papers with us.

Implementation of discussion points: We implemented Dr. Martin's feedback on focusing mostly on a continuous measuring device as it would be the most beneficial and sharing many relevant articles we could work on. His experience with a past iGEM group allowed us to understand more about the best way to work with results and what parts are most important for synthetic biology and iGEM.

Martin Petkovich

Professor - Section for Pharmacology and Pharmaceutical Biosciences

Points of discussion: We began considering different methods to use in a real life functioning patch and we contacted Professor Winther-Larsen to talk about artificial membranes and how they could be applied in a monitoring device.

Summary of meeting: We had received great ideas and inspirations from the last researchers, however we needed to understand the different ways to create a functioning patch better. We contacted Professor Winther-Larsen in order to get more advice during the early conceptualization of the project and to discuss ideas including the use of artificial membranes, as well as which methods of implementation would be more useful. We discussed artificial membranes and microfluidics with the professor. The idea would be used for the concept of the patch design. We considered how to make sure that the patch is delivering interstitial fluid inside our measuring mechanism and how it binds our receptors inside. We discussed particularly how to include the receptor protein potentially directly in the membrane . The professor also recommended other possible researchers to assist us with the use of artificial membranes.

Implementation of discussion points: Professor Winther-Larsen meant that it will be quite difficult to attach a receptor protein directly inside the membrane in such a short timeline and recommended that we consider other more affordable and quick measuring methods for a real life working cortisol patch. She also gilded us to continue some other relevant researchers to help us along.

Hanne Cecilie Winther-Larsen

Researcher - Department of Medical Biochemistry

Points of discussion: We wished to discuss more concrete methods of measuring the binding of cortisol to its ligand, as a proof of concept until we built a more sturdy model of our cortisol monitoring device as we needed to consider how to make it as affordable as we could and many concepts seemed to not be in the ranges we required.

Summary of meeting: As we were considering what methods to use to show proof of our cortisol binding its ligand, when we reached the last stage of our project idea, we contacted Bjørn Dalhus. We focused our conversation on the surface plasmon resonance and the possibility of using this method to detect the binding of the target protein. We wished to understand the plasmon method better to see if we could utilize it for our patch idea. He helped us understand that it is not for continuous binding measurements and would not work for our patch. In addition, on June 7th when talking about surface plasmon resonance, he helped us realize that while this method is used to detect if a ligand had bound the target protein, it does not quantify the amount of bound ligand

Later, we also contacted him to perform a Microscale Thermophoresis assay (MST assay) to demonstrate that our protein receptors GR binds to cortisol successfully (will be performed during October 2024).

Implementation of discussion points: We ended up working with Bjørn Dalhus on the MST assay to show proof of our ligand binding cortisol in a laboratory setting, which will help us have a good proof of concept while we are considering other methods to apply for our real life cortisol measuring device.

Bjørn Dalhus

Professor - Section for Genetics and Evolutionary Biology

Points of discussion: We contacted Rein to practice our presentation and present our results so far after our summer in the laboratory in order to receive his feedback and insight as he has helped many past iGEM teams at the University of Oslo.

Summary of meeting: After summer and our intense lab work experiments, we had a presentation with Rein about the final version of our project and the updates that we had at the moment. We discussed better ways to communicate our ideas, the results and updates that we had done so far and how to pitch our ideas to different audiences.

Implementation of discussion points: We adjusted some data points that were not complete and changed the layout of our presentation following the feedback from Rein.

Rein Aasland

Senior Innovation Advisor in the Growth House(Veksthuset)

Points of discussion: We wished to receive feedback on our presentation and our work so far as well as hardware that we had considered building using 3D to have as a model for our cortisol patch.

Summary of meeting: We met with Nicolay Berard-Andersen, who is the Senior Innovation Advisor in the Growth House(Veksthuset), affiliated with the University of Oslo, to present to him our research and how far we have come with our idea. He gave us valuable feedback on what more is needed to be accomplished to get a successful presentation as well as give us more resources on people to contact for further advice. He also advised us on our 3D design and gave us relevant resources to work with.

Implementation of discussion points: We began our 3D print model after our discussion and improved parts of our presentation that were not relevant to our work so far.

Nicolay

Leader of the Insj group, University of Oslo

Points of discussion: We wished to receive feedback on our presentation and our pitch so far, due to her experience with working in Insj

Summary of meeting: We had a wonderful discussion with Amruutha Kishore, leader of the Insj group at the University of Oslo, by email, discussing the different aspects of the project and how to communicate our idea to the university students that are interested in innovation. Amrutha gave us feedback on our presentation, our idea pitch and gave us the opportunity to present at the opening of the University of Oslo iHUB Student Innovation Office Space.

Implementation of discussion points: We implemented her feedback on our presentation and will actively work with her and Insj to promote synthetic biology and iGEM further.

Senior Adviser at the Centre for Digital Life Norway (DLN)

Points of discussion: We wished to receive feedback on or work so far, ethics and moral dilemmas that could arise from the use of a cortisol patch on humans as well as our pitch

Summary of meeting: Anamika Chatterjee, Senior Adviser at the Centre for Digital Life Norway (DLN), was one of our last contacts during our project and gave us tremendous feedback on the ethics and possible pitfalls of a wearable cortisol monitoring device. She discussed the importance of inclusion, autonomy and privacy that is involved with making a complicated medical device such as our cortisol monitoring device, and the effect it could have on the everyday user.

Implementation of discussion points: Her feedback was very relevant and highly important. Her feedback made us delve deeper into the meaning of the cortisol patch when it is going to be actively used and not just the idea of the patch. We have addressed her feedback, under Hardware in our wiki.

PhD Researcher at University of Minnesota

Summary of meeting: We contacted Dr. Culma in the beginning of our project due to his experience with relevant projects. His experience allowed us to receive multiple different techniques that he has worked with that can be valuable for our project. The meeting helped us with an early conceptualization of the project and to decide the method that we will use for our binding assay, between protein binding (MR or GR), aptamers, Immunostaining or MIP. He mentioned using Glucocorticoid receptor(GR) binding in a continuous measuring monitoring device, instead of the Mineralocorticoid Receptor we had considered so far in the project.

Implementation of discussion points:We began settling on the idea of using a protein binding continuous measuring monitoring device after our discussion with Dr. Culma and looking into the GR he recommended for us.

Cesar Culma

Lecturer - Section for Pharmaceutics and Social Pharmacy

Points of discussion: We wished to discuss the use of artificial membranes on a working cortisol patch with Professor Azumah

Summary of meeting: We talked to Professor Joseph Azumah and received his help with the early conceptualization of the project and to discuss ideas including the use of artificial membranes that could be possibly used on a final version of the device. He encouraged us to further investigate our idea to use artificial membranes and lipid bilayers, but mentioned the cost and time is greater than we have available. Our main point of discussion was about the usage of artificial lipid bilayers and vesicles as well as protein incorporation in those bilayers. We received generally positive feedback however it seemed like this idea would not fit the synthetic biology concept of iGEM and recommended exploring other routes. Since then, we decided not to go that path with this particular project but meeting him was nonetheless interesting and encouraging

Implementation of discussion points: We did not use artificial membranes as a result of our talk with Professor Azumah as his feedback began pointing us in another direction for our monitoring patch

Joseph Azumah

Professor of medicine - Clinical biochemistry

Points of discussion: We wished to discuss our continuous measuring methods in order to settle on which receptor to use for our project, as well as how we could implement our idea to work with interstitial fluid.

Summary of meeting: We talked to Jens Petter Berg at an early stage of our project and received the most important and helpful guidance from him. We had our longest meeting in our project with Professor Jens Petter Berg, as we referred to him to conceptualize our idea into using a protein binding approach as the best way to produce constant measurement of cortisol levels in the interstitial fluid. We narrowed down our idea to a continuous monitoring method using the Glucocorticoid receptor (GR) with his help as well as getting to explore hospital grade cortisol testing using interstitial fluid that we had not experienced before. In this talk we also shared ideas regarding how the detection patch would be able to have a longer useful lifespan and a lower saturation process on the cortisol ligand process

Implementation of discussion points: Using the feedback from Jens Petter Berg, we settled into our idea and began ordering the necessary equipment needed for us to work with our wet lab procedures. We also settled our project design to include the GR binding of cortisol for our monitoring device.

Jens Petter Berg

Communication officer of the Science and Technology Museum of Oslo

Points of discussion: We discussed how our communication to the public can be more effective, as well as possible collaboration and sponsorships between our team and the Science and Technology Museum of Oslo.

Summary of meeting: Gro Ellefsen, the communication officer of the Science and Technology Museum of Oslo, invited our team for a potential collaboration and to join the 3-day stand days, in order to better promote our project. Gro provided us with tips on how to promote our events on social media and also shared our information with the followers of the museum. She assisted us in instigating a sponsorship deal between the museum and our team.

Implementation of discussion points: We took part in a 3-day Stand organized by Science Days and the Science and Technology Museum after Gros recommendation and sponsorship, which counted towards our excellence medal for Education.

Advisor for Invent2

Points of discussion: We wished to discuss our presentation with Gerbrand as well as receive further feedback on our pitch and our 3D model.

Summary of meeting: We met Gerbrand Koster, who is an Advisor for Invent2 affiliated with the University of Oslo, and received valuable feedback on our presentation and our idea pitch. Gerbrand helped us recognise some communication mistakes in our presentation as well as help us with feedback on our 3D-Print of our device, which he firmly believed we should make different samples of, with the available data we have. He also granted us some good resources to use further.

Implementation of discussion points: We finalized the 3D print idea with Gerbrands help and began printing different 3D prints with materials and models until we found the one that worked best.

Gerbrand Koster

Points of discussion:Early Introduction to iGEM and synthetic Biology, Relevant Tools in Wet Lab and Dry Lab, communicating science behind our project

Summary of meeting:Our team attended a seminar in Denmark in the very beginning of our project in order to learn more about iGEM and how to organize our project in an efficient way. We received two days of seminars from researchers about the different tools that are available for us to use in our project as well as ways to communicate our science with the general public. We heard from past iGEM groups that were invited on how to work on a wiki and we received training on some relevant laboratory procedures in both wet lab and dry lab settings.

Implementation of discussion points:We generously used the tools provided from the BioBrick seminars in our wet lab and dry lab procedures. In addition, we managed to have an easier time working on the flow of the project by learning from past iGEM groups and implementing their feedback.

BioBrick
BioBrick2

Points of discussion: We discussed the subject of using electricity in our real life cortisol monitoring device, as well as how we could set up a working patch with an affordable and easy method.

Summary of meeting: Truls showed us around in his laboratory and showed us the machine that he is working with and how he thinks it can help us in our project. He deviates from the traditional biochemical binding for our patch and recommends that we use gold electrodes that can be the biophysical surface that the GR can be attached to, in order to record the electrical impedance everytime a conformational change occurs in the GR(after binding of cortisol).

Implementation of discussion points: Truls lent us this amazing device for measuring the impedance of electrodes at very small scales that he was working with that we wish to test further in our project in order to test how the condition for our working cortisol patch will be. We received valuable feedback on a real device that we can build upon.

Truls Nordby

Secondary PI, University of Oslo

Points of discussion: We worked with laboratory design and results with Athanasios as well as multiple discussions during all points of our project, either laboratory, feedback on our presentations and pitch or modeling and hardware questions.

Summary of meeting: Our main support and supervisor for the duration of the experiments and beyond. Athanasios Saragliadis assisted us with building our sequence and preparing it for laboratory use, as well as assisting us in creating protocols and following the progress in the laboratory. He has followed us during all the steps of our project and to refine our ideas in each step we have mentioned above. He has provided relevant research articles and feedback, but also his support during the hardest parts of the project.

Implementation of discussion points: During our project we have implemented all the advice Athanasios has given us and we have worked with his feedback during our presentations and project design. His advice is embedded into everything we have worked on and we as a team are very thankful to have worked with him.

Athanasios Saragliadis

Survey: Stress among Students

About the questionnaire

To gain insights on the relevance of stress and stress monitoring in regard to the DetectiMOL project, a questionnaire specified for students as a target group was distributed. 60 students around the world, from high school level to PhD programs, reported their stress and provided feedback on theoretically wearing a continuous cortisol measuring arm patch.

The questionnaire consisted of 12 questions asking for demographic data including place of study (Fig. 1), gender (Fig. 2), and current degree program (Fig. 3) of the survey participant, personal stress evaluation on scales from 1 (not stressed) to 6 (extremely stressed) in the context of certain situations (Fig. 4 & 5), open questions about stress and health (Fig. 6), and wearing a measuring device.

All data was anonymous, no contact data was saved, and no mandatory questions were included in the survey. The information provided by participants was randomized during analysis.

Place of study

Figure 1. Responses to stress survey worldwide by continent The survey was distributed publicly and was filled by 60 participants studying on all continents except Africa and Antarctica, with the vast majority studying in European countries.

Demographics

Demographics

Figure 2. Responses to stress survey worldwide by gender identity The survey reached 60 students with a diverse identity background, with especially female gender.

From these figures, it is visible that the results of this survey are in majority by female participants, and those studying in Europe. Just over 15% cover all other continents apart from Europe, with no representation for students in Africa (Fig. 1). With 10% of participants being neither male nor female, relatively many students in this survey represent an otherwise minority (Fig. 2).

Education of Survey Participants

The survey was filled by students of all levels from upper secondary to post-secondary education. Pursuing a higher education degree requires considerable effort and commitment, impacting many aspects of life, including personal life. Most of the survey participants are in their bachelor and master studies (Fig. 3).

Most of the survey participants are in their bachelor and master studies (Fig. 3). Many are going to write a thesis during their degree studies in the next 4 years, of which a great majority will deliver their thesis by 2025 or 2026.

Pursued degree and planned submission year

Figure 3. Participants' pursued degrees and planned year of graduation Most survey participants are in their post-secondary education, with many planning thesis submissions between 2024 and 2026.

Circumstantial Stress Levels

Being a student is a commitment that covers many aspects of life and comes with examinations and gradings. These circumstances have been subject to subjective stress level evaluation in this survey.

Circumstantial stress levels

Figure 4. Participants stress self-evaluation based on situations related to the student's lifeStress related to studies overall is reported to be relevant, while the thesis related stress is experienced especially high by many. Being a student influences all aspects of life, but the personal life is not as strongly contributing to student’s stress experience.

The data shows that stress often affects all 3 categories: studies, thesis, and personal life. Personal life is perceived as less stressful than studies and thesis delivery.

Studies as cause and thesis submission correlation

Figure 5. Percentage of students experiencing stress in dependence of closer coming thesis deadlineIn shades of grey it is shown if students stated to be not or mildly stressed (<3), and in shades of red when they stated to be considerably stressed (>4). Students submitting in 2025 and 2026 were the largest group. General study stress is experienced among all groups of students, with those not having a thesis delivery until 2026 feeling least stressed. 50% of 2024 and 2025 submitting students plus >25% report to be very to extremely stressed (5-6) regarding their thesis delivery. The further the submission deadline is in the future the less stress is reported, with an onset of extreme perceived stress as early as 2 years in advance as seen in students submitting in 2026.

Stress and health conditions

The great majority of participants were already aware that stress can cause serious medical and long-term health conditions. However, 6.7% report having been unaware. Next, they were asked to report how much they felt stress has impacted their health in the past and until today (Fig. 6). Half of them report no or minimal impact, while the other half states to have or had considerable effects on health due to stress.

Stress and health impact

Figure 6. Self-reported impact of stress on health Half of the participants reported minimal impact on their health, while the other half experienced considerable effects.

Most Common Causes of Stress

Feedback on Measuring Device

Feedback on measuring device

Feedback from the survey about potentially wearing a cortisol measuring device.

Participants raised concerns about the discomfort of wearing the device, risks of infection, data privacy, and the potential for stress monitoring to exacerbate stress.

Other Suggestions

Discussion and Conclusion

This survey is using the exact subjective measurement we criticise ourselves to use for stress monitoring, asking participants to point out on a scale how stressed they feel. This evaluation is highly subjective and individual. The survey received 60 answers which is a limited sample size considering the further grouping of those by thesis delivery year or other parameters. The questionnaire asked to specify the year of thesis delivery until 2027 or simply later than that. The group that stated the “year 2027” (total 5) had to be combined with those “later than 2027” (total 3) to reach a larger group by thesis delivery “later than 2026” instead (total 8), which is still not as representative as a scientific study would require. With more survey participants a more precise statistical analysis would have been possible, and potential differences by location of study, type of degree or gender could be investigated. Furthermore, due to the survey being specifically tailored to students the sample group was limited possibly excluding people on other educational paths like apprenticeships, and definitely excluding persons in other phases of their life such as seniors, workers, or parents who do not study anymore or never did.

However, from this simply questionnaire we can already conclude that for the environment of people we are reaching stress is highly relevant. This survey was targeted at students, which is a group that is easily reachable and often voluntarily contributes to research. It is visible that those students know stress is affecting their health and they are especially stressed about topics regarding their studies and future, the thesis seeming to be a highlight. This is underlined by degree students experiencing strong to extreme stress one or two years in advance to their thesis delivery, as shown in figure 6.

While this survey is no scientific study it allows for an estimation of great relevancy for continuous stress monitoring, and hints how it might be accepted by potential patients. The feedback gives a new perspective and helps planning to adjust the design and regulations coming with the data use of the cortisol-measuring patch.