{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T11:02:46Z","timestamp":1775473366192,"version":"3.50.1"},"reference-count":37,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T00:00:00Z","timestamp":1765929600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T00:00:00Z","timestamp":1765929600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>University exams are recognised as naturalistic stressors that may elicit psychosocial and physiological responses in students. This pilot study investigated the short\u2010 and long\u2010term effects of exam\u2010related stress on hypothalamic\u2013pituitary\u2013adrenal (HPA) axis activity, focusing on cortisol production and rhythmicity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twenty\u2010seven undergraduate students (aged 18\u201324 years) from a biological sciences programme participated. Hair cortisol concentrations were analysed for October (non\u2010exam month) and November (exam month), while salivary cortisol was collected during 3 consecutive exam weekdays (Monday to Wednesday) at five daily time points to assess diurnal variation and the cortisol awakening response (CAR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Hair cortisol levels were significantly higher in November than in October, suggesting greater cumulative HPA activation during the exam period. Salivary cortisol displayed a general diurnal pattern and CAR across the week. Morning cortisol values showed a nonsignificant numerical increase across days, though overall daily cortisol output (AUC) remained stable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Exam periods may be accompanied by elevated cumulative cortisol exposure while short\u2010term HPA rhythmicity remains preserved. The combined use of hair and salivary biomarkers offers a multidimensional and feasible approach to investigating acute and cumulative stress responses in students. Larger longitudinal studies incorporating behavioural measures are warranted to confirm these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cen.70083","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T05:01:58Z","timestamp":1766034118000},"page":"436-442","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["University Exams and Psychosocial Stress: Effects on Cortisol Rhythmicity in Students"],"prefix":"10.1111","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5132-9031","authenticated-orcid":false,"given":"Filipy","family":"Borghi","sequence":"first","affiliation":[{"name":"LABEEST\u2010Laboratory of Stress Study, Department of Structural and Functional Biology, Institute of Biology University of Campinas\u2013UNICAMP Campinas S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Priscila Cristina","family":"da Silva","sequence":"additional","affiliation":[{"name":"LABEEST\u2010Laboratory of Stress Study, Department of Structural and Functional Biology, Institute of Biology University of Campinas\u2013UNICAMP Campinas S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elis\u00e2ngela","family":"Farias\u2010Silva","sequence":"additional","affiliation":[{"name":"LABEEST\u2010Laboratory of Stress Study, Department of Structural and Functional Biology, Institute of Biology University of Campinas\u2013UNICAMP Campinas S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernando","family":"Canova","sequence":"additional","affiliation":[{"name":"LABEEST\u2010Laboratory of Stress Study, Department of Structural and Functional Biology, Institute of Biology University of Campinas\u2013UNICAMP Campinas S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aglecio Luiz","family":"Souza","sequence":"additional","affiliation":[{"name":"Unidade Metab\u00f3lica, Faculdade de Ci\u00eancias M\u00e9dicas Universidade Estadual de Campinas (UNICAMP) Campinas S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aline Barbedo","family":"Arouca","sequence":"additional","affiliation":[{"name":"LABEEST\u2010Laboratory of Stress Study, Department of Structural and Functional Biology, Institute of Biology University of Campinas\u2013UNICAMP Campinas S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dora Maria","family":"Grassi","sequence":"additional","affiliation":[{"name":"LABEEST\u2010Laboratory of Stress Study, Department of Structural and Functional Biology, Institute of Biology University of Campinas\u2013UNICAMP Campinas S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,17]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cptl.2014.02.004"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.3138\/jvme.34.2.112"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.physbeh.2019.02.001"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psyneuen.2016.12.017"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-15-0313"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.25011\/cim.v30i5.2894"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.physbeh.2011.02.041"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.paid.2021.110928"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40359-019-0343-7"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sbspro.2011.11.288"},{"issue":"3","key":"e_1_2_8_12_1","first-page":"208","article-title":"Stress, Self\u2010Efficacy, Social Support, and Coping Strategies in University Students","volume":"35","author":"Dwyer A. 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