bluuebunny/crossref_metadata_2025 huggingface dataset:
Probing the Response of the Amphibious Plant Butomus umbellatus to Nutrient Enrichment and Shading by Integrating Eco-Physiological With Metabolomic Analyses
Authors: Manolaki Paraskevi , Tooulakou Georgia , Byberg Caroline Urup , Eller Franziska , Sorrell Brian K. , Klapa Maria I. , Riis Tenna
Published: January 2021

Amphibious plants, living in land-water ecotones, have to cope with challenging and continuously changing growth conditions in their habitats with respect to nutrient and light availability. They have thus evolved a variety of mechanisms to tolerate and adapt to these changes. Therefore, the study of these plants is a major area of ecophysiology and environmental ecological research. However, our understanding of their capacity for physiological adaptation and tolerance remains limited and requires systemic approaches for comprehensive analyses. To this end, in this study, we have conducted a mesocosm experiment to analyze the response of Butomus umbellatus, a common amphibious species in Denmark, to nutrient enrichment and shading. Our study follows a systematic integration of morphological (including plant height, leaf number, and biomass accumulation), ecophysiological (photosynthesis-irradiance responses, leaf pigment content, and C and N content in plant organs), and leaf metabolomic measurements using gas chromatography-mass spectrometry (39 mainly primary metabolites), based on bioinformatic methods. No studies of this type have been previously reported for this plant species. We observed that B. umbellatus responds to nutrient enrichment and light reduction through different mechanisms and were able to identify its nutrient enrichment acclimation threshold within the applied nutrient gradient. Up to that threshold, the morpho-physiological response to nutrient enrichment was profound, indicating fast-growing trends (higher growth rates and biomass accumulation), but only few parameters changed significantly from light to shade [specific leaf area (SLA); quantum yield (φ)]. Metabolomic analysis supported the morpho-physiological results regarding nutrient overloading, indicating also subtle changes due to shading not directly apparent in the other measurements. The combined profile analysis revealed leaf metabolite and morpho-physiological parameter associations. In this context, leaf lactate, currently of uncertain role in higher plants, emerged as a shading acclimation biomarker, along with SLA and φ. The study enhances both the ecophysiology methodological toolbox and our knowledge of the adaptive capacity of amphibious species. It demonstrates that the educated combination of physiological with metabolomic measurements using bioinformatic approaches is a promising approach for ecophysiology research, enabling the elucidation of discriminatory metabolic shifts to be used for early diagnosis and even prognosis of natural ecosystem responses to climate change.
How Population Structure Impacts Genomic Selection Accuracy in Cross-Validation: Implications for Practical Breeding
Authors: Werner Christian R. , Gaynor R. Chris , Gorjanc Gregor , Hickey John M. , Kox Tobias , Abbadi Amine , Leckband Gunhild , Snowdon Rod J. , Stahl Andreas
Published: January 2021

Over the last two decades, the application of genomic selection has been extensively studied in various crop species, and it has become a common practice to report prediction accuracies using cross validation. However, genomic prediction accuracies obtained from random cross validation can be strongly inflated due to population or family structure, a characteristic shared by many breeding populations. An understanding of the effect of population and family structure on prediction accuracy is essential for the successful application of genomic selection in plant breeding programs. The objective of this study was to make this effect and its implications for practical breeding programs comprehensible for breeders and scientists with a limited background in quantitative genetics and genomic selection theory. We, therefore, compared genomic prediction accuracies obtained from different random cross validation approaches and within-family prediction in three different prediction scenarios. We used a highly structured population of 940 Brassica napus hybrids coming from 46 testcross families and two subpopulations. Our demonstrations show how genomic prediction accuracies obtained from among-family predictions in random cross validation and within-family predictions capture different measures of prediction accuracy. While among-family prediction accuracy measures prediction accuracy of both the parent average component and the Mendelian sampling term, within-family prediction only measures how accurately the Mendelian sampling term can be predicted. With this paper we aim to foster a critical approach to different measures of genomic prediction accuracy and a careful analysis of values observed in genomic selection experiments and reported in literature.
Disrupting the Homeostasis of High Mobility Group Protein Promotes the Systemic Movement of Bamboo mosaic virus
Authors: Alazem Mazen , He Meng-Hsun , Chang Chih-Hao , Cheng Ning , Lin Na-Sheng
Published: January 2021

Viruses hijack various organelles and machineries for their replication and movement. Ever more lines of evidence indicate that specific nuclear factors are involved in systemic trafficking of several viruses. However, how such factors regulate viral systemic movement remains unclear. Here, we identify a novel role for Nicotiana benthamiana high mobility group nucleoprotein (NbHMG1/2a) in virus movement. Although infection of N. benthamiana with Bamboo mosaic virus (BaMV) decreased NbHMG1/2a expression levels, nuclear-localized NbHMG1/2a protein was shuttled out of the nucleus into cytoplasm upon BaMV infection. NbHMG1/2a knockdown or even overexpression did not affect BaMV accumulation in inoculated leaves, but it did enhance systemic movement of the virus. Interestingly, the positive regulator Rap-GTPase activation protein 1 was highly upregulated upon infection with BaMV, whereas the negative regulator thioredoxin h protein was greatly reduced, no matter if NbHMG1a/2a was silenced or overexpressed. Our findings indicate that NbHMG1/2a may have a role in plant defense responses. Once its homeostasis is disrupted, expression of relevant host factors may be perturbed that, in turn, facilitates BaMV systemic movement.
Co-expression Networks From Gene Expression Variability Between Genetically Identical Seedlings Can Reveal Novel Regulatory Relationships
Authors: Cortijo Sandra , Bhattarai Marcel , Locke James C. W. , Ahnert Sebastian E.
Published: January 2021

Co-expression networks are a powerful tool to understand gene regulation. They have been used to identify new regulation and function of genes involved in plant development and their response to the environment. Up to now, co-expression networks have been inferred using transcriptomes generated on plants experiencing genetic or environmental perturbation, or from expression time series. We propose a new approach by showing that co-expression networks can be constructed in the absence of genetic and environmental perturbation, for plants at the same developmental stage. For this, we used transcriptomes that were generated from genetically identical individual plants that were grown under the same conditions and for the same amount of time. Twelve time points were used to cover the 24-h light/dark cycle. We used variability in gene expression between individual plants of the same time point to infer a co-expression network. We show that this network is biologically relevant and use it to suggest new gene functions and to identify new targets for the transcriptional regulators GI, PIF4, and PRR5. Moreover, we find different co-regulation in this network based on changes in expression between individual plants, compared to the usual approach requiring environmental perturbation. Our work shows that gene co-expression networks can be identified using variability in gene expression between individual plants, without the need for genetic or environmental perturbations. It will allow further exploration of gene regulation in contexts with subtle differences between plants, which could be closer to what individual plants in a population might face in the wild.
Genotyping-by-Sequencing Identifies Historical Breeding Stages of the Recently Domesticated American Cranberry
Authors: Diaz-Garcia Luis , Covarrubias-Pazaran Giovanny , Johnson-Cicalese Jennifer , Vorsa Nicholi , Zalapa Juan
Published: January 2021

The cranberry (Vaccinium macrocarpon Ait.) is a North American fruit crop domesticated less than 200 years ago. The USDA began the first cranberry breeding program in response to false-blossom disease in 1929, but after the first generation of cultivars were released in the 1950s, the program was discontinued. Decades later, renewed efforts for breeding cranberry cultivars at Rutgers University and the University of Wisconsin yielded the first modern cultivars in the 2000’s. Phenotypic data suggests that current cultivars have changed significantly in terms of fruiting habits compared to original selections from endemic populations. However, due to the few breeding and selection cycles and short domestication period of the crop, it is unclear how much cultivated germplasm differs genetically from wild selections. Moreover, the extent to which selection for agricultural superior traits has shaped the genetic and phenotypic variation of cranberry remains mostly obscure. Here, a historical collection composed of 362 accessions, spanning wild germplasm, first-, second-, and third-generation selection cycles was studied to provide a window into the breeding and domestication history of cranberry. Genome-wide sequence variation of more than 20,000 loci showed directional selection across the stages of cranberry domestication and breeding. Diversity analysis and population structure revealed a partially defined progressive bottleneck when transitioning from early domestication stages to current cranberry forms. Additionally, breeding cycles correlated with phenotypic variation for yield-related traits and anthocyanin accumulation, but not for other fruit metabolites. Particularly, average fruit weight, yield, and anthocyanin content, which were common target traits during early selection attempts, increased dramatically in second- and third-generation cycle cultivars, whereas other fruit quality traits such as Brix and acids showed comparable variation among all breeding stages. Genome-wide association mapping in this diversity panel allowed us to identify marker-trait associations for average fruit weight and fruit rot, which are two traits of great agronomic relevance today and could be further exploited to accelerate cranberry genetic improvement. This study constitutes the first genome-wide analysis of cranberry genetic diversity, which explored how the recurrent use of wild germplasm and first-generation selections into cultivar development have shaped the evolutionary history of this crop species.
Diversified Resistance Mechanisms in Multi-Resistant Lolium spp. in Three European Countries
Authors: Scarabel Laura , Panozzo Silvia , Loddo Donato , Mathiassen Solvejg K. , Kristensen Michael , Kudsk Per , Gitsopoulos Thomas , Travlos Ilias , Tani Eleni , Chachalis Dimosthenis , Sattin Maurizio
Published: January 2021

Annual ryegrass species (Lolium spp.) infest cereal crops worldwide. Ryegrass populations with multiple resistance to the acetyl coenzyme A carboxylase (ACCase) and acetolactate synthase (ALS) inhibitors are an increasing problem in several European countries. We investigated the resistance pattern and level of resistance in ryegrass populations collected in Denmark, Greece and Italy and studied the diversity of mechanisms endowing resistance, both target-site and metabolism based. All populations showed high resistance indexes (RI) to the ALS inhibitors, iodosufuron-methyl-sodium + mesosulfuron-methyl (RI from 8 to 70), whereas the responses to the two ACCase inhibitors, clodinafop-propargyl and pinoxaden, differed. The Greek and Italian populations were moderately to highly resistant to clodinafop (RI > 8) and showed low to moderate resistance to pinoxaden (RI ranged from 3 to 13) except for one Italian population. In contrast, the Danish Lolium populations showed low to moderate resistance to clodinafop (RI ranged from 2 to 7) and only one population was resistant to pinoxaden. Different mutant ACCase alleles (Leu1781, Cys2027, Asn2041, Val2041, Gly2078, Arg2088, Ala2096) and ALS alleles (Gly122, Ala197, Gln197, Leu197, Ser197, Thr197, Val205, Asn376, Glu376, Leu574) endowing resistance were detected in the Greek and Italian populations. In several plants, no mutated ALS and ACCase alleles were found showing a great heterogeneity within and among the Greek and Italian populations. Conversely, no mutant ACCase alleles were identified in the four Danish populations and only one mutant ALS allele (Leu574) was detected in two Danish populations. The expression level of nitronate monooxygenase (NMO), glutathione S-transferase (GST) and cytochrome P450s (CYP72A1 and CYP72A2) varied broadly among populations and individual plants within the populations. Constitutive up-regulation of GST, CYP72A1 and CYP72A2 was detected in resistant plants respect to susceptible plants in one Danish and one Italian population. It appears that the mechanisms underlying resistance are rather complex and diversified among Lolium spp. populations from the three countries, coevolution of both target-site resistance and metabolic based herbicide resistance appears to be a common feature in Denmark and Italy. This must be considered and carefully evaluated in adopting resistance management strategies to control Lolium spp. in cereal crops.
Relationship Between Problematic Social Media Usage and Employee Depression: A Moderated Mediation Model of Mindfulness and Fear of COVID-19
Authors: Majeed Mehwish , Irshad Muhammad , Fatima Tasneem , Khan Jabran , Hassan Muhammad Mubbashar
Published: January 2021

Social media plays a significant role in modern life, but excessive use of it during the COVID-19 pandemic has become a source of concern. Supported by the conservation of resources theory, the current study extends the literature on problematic social media usage during COVID-19 by investigating its association with emotional and mental health outcomes. In a moderated mediation model, this study proposes that problematic social media use by workers during COVID-19 is linked to fear of COVID-19, which is further associated with depression. The current study tested trait mindfulness as an important personal resource that may be associated with reduced fear of COVID-19 despite problematic social media use. The study collected temporally separate data to avoid common method bias. Pakistani employees (N = 267) working in different organizations completed a series of survey questionnaires. The results supported the moderated mediation model, showing that problematic social media use during the current pandemic is linked to fear of COVID-19 and depression among employees. Furthermore, trait mindfulness was found to be an important buffer, reducing the negative indirect association between problematic social media use and depression through fear of COVID-19. These results offer implications for practitioners. The limitations of this study and future research directions are also discussed.
The Roles of Fluid Intelligence and Emotional Intelligence in Affective Decision-Making During the Transition to Early Adolescence
Authors: Li Danfeng , Wu Mengli , Zhang Xingli , Wang Mingyi , Shi Jiannong
Published: January 2021

The current study mainly explored the influence of fluid intelligence (IQ) and emotional intelligence (EI) on affective decision-making from a developmental perspective, specifically, during the transition from childhood into early adolescence. Meanwhile, their age-related differences in affective decision-making were explored. A total of 198 participants aged 8–12 completed the Iowa Gambling Task (IGT), the Cattell’s Culture Fair Intelligence Test and the Trait Emotional Intelligence Questionnaire-Child Form. Based on the net scores of IGT, the development of affective decision-making ability did not increase monotonically with age, and there was a developmental trend of an impaired IGT performance in early adolescence (aged 11–12), especially in the early learning phase (first 40 trials) of the IGT. More importantly, IQ and EI played different roles for children and early adolescents: IQ and EI jointly predicted the IGT performance for 8–10 years old children, whereas only EI contributed to the IGT performance of 11–12 years old early adolescents. The present study extends the evidence how cognitive processing and emotional processing interact in affective decision-making from the developmental perspective. Furthermore, it provides insights of future research and intervention with early adolescents’ poor affective decision-making.
art.pics Database: An Open Access Database for Art Stimuli for Experimental Research
Authors: Thieleking Ronja , Medawar Evelyn , Disch Leonie , Witte A. Veronica
Published: January 2021

While art is omnipresent in human history, the neural mechanisms of how we perceive, value and differentiate art has only begun to be explored. Functional magnetic resonance imaging (fMRI) studies suggested that art acts as secondary reward, involving brain activity in the ventral striatum and prefrontal cortices similar to primary rewards such as food. However, potential similarities or unique characteristics of art-related neuroscience (or neuroesthetics) remain elusive, also because of a lack of adequate experimental tools: the available collections of art stimuli often lack standard image definitions and normative ratings. Therefore, we here provide a large set of well-characterized, novel art images for use as visual stimuli in psychological and neuroimaging research. The stimuli were created using a deep learning algorithm that applied different styles of popular paintings (based on artists such as Klimt or Hundertwasser) on ordinary animal, plant and object images which were drawn from established visual stimuli databases. The novel stimuli represent mundane items with artistic properties with proposed reduced dimensionality and complexity compared to paintings. In total, 2,332 novel stimuli are available open access as “art.pics” database at https://osf.io/BTWNQ/ with standard image characteristics that are comparable to other common visual stimuli material in terms of size, variable color distribution, complexity, intensity and valence, measured by image software analysis and by ratings derived from a human experimental validation study [n = 1,296 (684f), age 30.2 ± 8.8 y.o.]. The experimental validation study further showed that the art.pics elicit a broad and significantly different variation in subjective value ratings (i.e., liking and wanting) as well as in recognizability, arousal and valence across different art styles and categories. Researchers are encouraged to study the perception, processing and valuation of art images based on the art.pics database which also enables real reward remuneration of the rated stimuli (as art prints) and a direct comparison to other rewards from e.g., food or money.

Key Messages: We provide an open access, validated and large set of novel stimuli (n = 2,332) of standardized art images including normative rating data to be used for experimental research. Reward remuneration in experimental settings can be easily implemented for the art.pics by e.g., handing out the stimuli to the participants (as print on premium paper or in a digital format), as done in the presented validation task. Experimental validation showed that the art.pics’ images elicit a broad and significantly different variation in subjective value ratings (i.e., liking, wanting) across different art styles and categories, while size, color and complexity characteristics remained comparable to other visual stimuli databases.
Electrical Brain Activity and Its Functional Connectivity in the Physical Execution of Modern Jazz Dance
Authors: Wind Johanna , Horst Fabian , Rizzi Nikolas , John Alexander , Schöllhorn Wolfgang I.
Published: January 2021

Besides the pure pleasure of watching a dance performance, dance as a whole-body movement is becoming increasingly popular for health-related interventions. However, the science-based evidence for improvements in health or well-being through dance is still ambiguous and little is known about the underlying neurophysiological mechanisms. This may be partly related to the fact that previous studies mostly examined the neurophysiological effects of imagination and observation of dance rather than the physical execution itself. The objective of this pilot study was to investigate acute effects of a physically executed dance with its different components (recalling the choreography and physical activity to music) on the electrical brain activity and its functional connectivity using electroencephalographic (EEG) analysis. Eleven dance-inexperienced female participants first learned a Modern Jazz Dance (MJD) choreography over three weeks (1 h sessions per week). Afterwards, the acute effects on the EEG brain activity were compared between four different test conditions: physically executing the MJD choreography with music, physically executing the choreography without music, imaging the choreography with music, and imaging the choreography without music. Every participant passed each test condition in a randomized order within a single day. EEG rest-measurements were conducted before and after each test condition. Considering time effects thephysically executed dance without musicrevealed in brain activity analysis most increases in alpha frequency and in functional connectivity analysis in all frequency bands. In comparison,physically executed dance with musicas well asimagined dance with musicled to fewer increases andimagined dance without musicprovoked noteworthy brain activity and connectivity decreases at all frequency bands. Differences between the test conditions were found in alpha and beta frequency betweenthe physically executed danceandthe imagined dance without musicas well as between thephysically executed dance withandwithout musicin the alpha frequency. The study highlights different effects of a physically executed dance compared to an imagined dance on many brain areas for all measured frequency bands. These findings provide first insights into the still widely unexplored field of neurological effects of dance and encourages further research in this direction.
An Investigation of the Effectiveness of Arts Therapies Interventions on Measures of Quality of Life and Wellbeing: A Pilot Randomized Controlled Study in Primary Schools
Authors: Moula Zoe , Powell Joanne , Karkou Vicky
Published: January 2021

Background

Over the last decades there has been a change in the way schooling is perceived recognizing that children’s learning is closely linked to children’s health. Children spend most of their time at school, which is often the place where problems are identified and interventions are offered, not only for treatment but also prevention. Embedding arts therapies into the educational system may help address children’s emerging needs and have a positive impact on their wellbeing.

Methods

A pilot cross-over randomized controlled design was employed to investigate the effectiveness of an arts therapies intervention on a series of child- and teacher-reported outcome measures, specifically, health related quality of life (assessed using a HRQOL scale; EQ-5D-Y), wellbeing and life functioning (assessed using the child outcome rating scale; CORS), emotional and behavioral difficulties (assessed using the strengths and difficulties questionnaire; SDQ), as well as duration of sleep (assessed using Fitbits). Sample size calculations for future large-scale studies were also performed, and the sustained impact of the intervention was evaluated at 3, 6, and 12 months follow-up. The pluralistic theoretical and therapeutic framework of this intervention was informed by a systematic review on school-based arts therapies interventions and is presented in detail in the study protocol. Participants were 62 children with mild emotional and behavioral difficulties.

Results

Improvements in HRQOL and CORS were greater in those engaged in the arts therapies intervention than the control groups and were maintained at the follow-up stages. Significant improvements were only found for duration of sleep (P = 0.002) and SDQ (P = 0.008). Minimal clinically important differences (MCIDs) as defined in the published protocol were found for CORS, SDQ and duration of sleep, but not HRQOL.

Discussion

Findings indicate that the arts therapies interventions were having a clinically significant effect on life functioning, duration of sleep, emotional and behavioral difficulties. Findings also indicate a small effect size for health related quality of life, suggesting the intervention was having a small positive effect on this outcome measure. The study indicates that all outcome measures assessed here would be suitable for inclusion in a larger randomized controlled study utilizing these arts therapies interventions, and that a sample size of 225 participants would be required if these outcome measures were used.
My Brain Needs a Break: Kindergarteners’ Willpower Theories Are Related to Behavioral Self-Regulation
Authors: Compagnoni Miriam , Sieber Vanda , Job Veronika
Published: January 2021

Is the way that kindergarteners view their willpower – as a limited or as a non-limited resource – related to their motivation and behavioral self-regulation? This study is the first to examine the structure of beliefs about willpower in relation to behavioral self-regulation by interviewing 147 kindergarteners (52% girls) aged 5 to 7 years (M= 6.47,SD= 0.39). A new instrument was developed to assess implicit theories about willpower for this specific age group. Results indicated that kindergarteners who think of their willpower as a non-limited resource showed better behavioral self-regulation than children who adopted a more limited theory, even when controlling for age and gender. This relation was especially pronounced in low achieving children. Mediation and moderation analyses showed that this relation was partly mediated through the children’s willingness to invest effort to reach a learning goal. Findings suggest that fostering metacognitive beliefs in children, such as the belief that willpower is a non-limited resource, may increase behavioral self-regulation for successful adjustment to the demands of kindergarten and school.
The 4Ds of Dealing With Distress – Distract, Dilute, Develop, and Discover: An Ultra-Brief Intervention for Occupational and Academic Stress
Authors: Mansell Warren , Urmson Rebecca , Mansell Louise
Published: January 2021

The Covid-19 crisis has clarified the demand for an ultra-brief single-session, online, theory-led, empirically supported, psychological intervention for managing stress and improving well-being, especially for people within organizational settings. We designed and delivered “4Ds for Dealing with Distress” during the crisis to address this need. 4Ds unifies a spectrum of familiar emotion regulation strategies, resilience exercises, and problem-solving approaches using perceptual control theory and distils them into a simple four-component rubric (Distract–Dilute–Develop–Discover). In essence, the aim is to reduce distress and restore wellbeing, both in the present moment through current actions (distract or dilute), and through expressing longer-term goal conflicts (e.g., through talking, writing, and drawing) to discover new perspectives that arise spontaneously after sufficient time and consideration. The intervention is user-led in that it draws on users’ own idiosyncratic and pre-existing experiences, knowledge, skills and resources to help them apply an approach, or combination of approaches, that are proportionate and timed to the nature and context of the stress they are experiencing. In this article we review the empirical basis of the approach within experimental, social, biological and clinical psychology, illustrate the novel and time-efficient delivery format, describe its relevance to sports and exercise, summarise feedback from the recipients of the intervention to date, and describe the directions for future evaluation.
Test Anxiety in Adolescent Students: Different Responses According to the Components of Anxiety as a Function of Sociodemographic and Academic Variables
Authors: Torrano Rosa , Ortigosa Juan M. , Riquelme Antonio , Méndez Francisco J. , López-Pina José A.
Published: January 2021

Objective

Test anxiety (TA) is a construct that has scarcely been studied based on Lang’s three-dimensional model of anxiety. The objective of this article is to investigate the repercussion of sociodemographic and academic variables on different responses for each component of anxiety and for the type of test in adolescent students.

Method

A total of 1181 students from 12 to 18 years old (M= 14.7 and SD = 1.8) participated, of whom 569 were boys (48.2%) and 612 girls (51.8%). A sociodemographic questionnaire and theCuestionario de Ansiedad ante los examenes-Adaptado (CAEX-A)[Test Anxiety Questionnaire-Adapted] an adaptation for Spanish secondary school levels (ESO) and Bachillerato were administered.

Results

Girls scored higher on the cognitive and physiological components of TA than boys, the intensity of the physiological response increasing with age. Bachillerato level students reported more physiological anxiety than those of ESO level. Students with better marks in the previous year presented more anxiety in the cognitive component, while those who obtained the lower mark presented higher anxiety values in the behavioral component. Participants reported that the types of tests that cause them more anxiety were oral tests in front of the class, oral presentation in front of a panel, and mathematics tests.

Conclusion

Adolescents show a differential response of TA based on the physiological, cognitive and motor components, mediated by the variables of gender, age, grade, academic performance and type of exam. These results serve to design specific intervention programs to manage anxiety in situations of academic assessment.
Local, Early, and Precise: Designing a Clinical Decision Support System for Child and Adolescent Mental Health Services
Authors: Røst Thomas Brox , Clausen Carolyn , Nytrø Øystein , Koposov Roman , Leventhal Bennett , Westbye Odd Sverre , Bakken Victoria , Flygel Linda Helen Knudsen , Koochakpour Kaban , Skokauskas Norbert
Published: January 2021

Mental health disorders often develop during childhood and adolescence, causing long term and debilitating impacts at individual and societal levels. Local, early, and precise assessment and evidence-based treatment are key to achieve positive mental health outcomes and to avoid long-term care. Technological advancements, such as computerized Clinical Decision Support Systems (CDSSs), can support practitioners in providing evidence-based care. While previous studies have found CDSS implementation helps to improve aspects of medical care, evidence is limited on its use for child and adolescent mental health care. This paper presents challenges and opportunities for adapting CDSS design and implementation to child and adolescent mental health services (CAMHS). To highlight the complexity of incorporating CDSSs within local CAMHS, we have structured the paper around four components to consider before designing and implementing the CDSS: supporting collaboration among multiple stakeholders involved in care; optimally using health data; accounting for comorbidities; and addressing the temporality of patient care. The proposed perspective is presented within the context of the child and adolescent mental health services in Norway and an ongoing Norwegian innovative research project, the Individualized Digital DEcision Assist System (IDDEAS), for child and adolescent mental health disorders. Attention deficit hyperactivity disorder (ADHD) among children and adolescents serves as the case example. The integration of IDDEAS in Norway intends to yield significantly improved outcomes for children and adolescents with enduring mental health disorders, and ultimately serve as an educational opportunity for future international approaches to such CDSS design and implementation.
Metabolic Profiling in Bipolar Disorder Patients During Depressive Episodes
Authors: Ren Yan , Bao Shuang , Jia Yuan , Sun Xiao-li , Cao Xiang-xin , Bai Xiao-ying , Tian Jun-Sheng , Yang Hong
Published: January 2021

Bipolar disorder (BD) is a common and debilitating mental disorder. Bipolar depression is the main episode of BD. Furthermore, there are no objective biomarkers available for diagnosing the disorder. In this research, a Nuclear Magnetic Resonance (NMR) spectroscopy based on a metabonomics technique was used to analyze serum samples from 37 patients with bipolar depression and 48 healthy control participants to determine potential biomarkers for bipolar depression. In total, seven different metabolites were identified that could effectively distinguish patients from healthy controls. The metabolites indicated that disturbances of amino acid and energy metabolisms might be involved in the pathogenesis of BD. Finally, a panel consisting of four potential biomarkers (lactate, trimethylamine oxide, N-acetyl glycoprotein, and α-glucose) was identified, which showed a higher combined diagnostic ability with an area under the curve of 0.893. Our findings may contribute to the development of an objective method for diagnosing bipolar depression.
Insomnia in the Italian Population During Covid-19 Outbreak: A Snapshot on One Major Risk Factor for Depression and Anxiety
Authors: Bacaro Valeria , Chiabudini Marco , Buonanno Carlo , De Bartolo Paola , Riemann Dieter , Mancini Francesco , Baglioni Chiara
Published: January 2021

Objectives: One of the largest clusters of Covid-19 infections was observed in Italy. The population was forced to home confinement, exposing individuals to increased risk for insomnia, which is, in turn, associated with depression and anxiety. Through a cross-sectional online survey targeting all Italian adult population (≥18 yrs), insomnia prevalence and its interactions with relevant factors were investigated.

Methods: The survey was distributed from 1st April to 4th May 2020. We collected information on insomnia severity, depression, anxiety, sleep hygiene behaviors, dysfunctional beliefs about sleep, circadian preference, emotion regulation, cognitive flexibility, perceived stress, health habits, self-report of mental disorders, and variables related to individual difference in life changes due to the pandemic's outbreak.

Results: The final sample comprised 1,989 persons (38.4 ± 12.8 yrs). Prevalence of clinical insomnia was 18.6%. Results from multivariable linear regression showed that insomnia severity was associated with poor sleep hygiene behaviors [β = 0.11, 95% CI (0.07–0.14)]; dysfunctional beliefs about sleep [β = 0.09, 95% CI (0.08–0.11)]; self-reported mental disorder [β = 2.51, 95% CI (1.8–3.1)]; anxiety [β = 0.33, 95% CI (0.25–0.42)]; and depression [β = 0.24, 95% CI (0.16–0.32)] symptoms.

Conclusion: An alarming high prevalence of clinical insomnia was observed. Results suggest that clinical attention should be devoted to problems of insomnia in the Italian population with respect to both prevention and treatment.
Association Between Folate and Health Outcomes: An Umbrella Review of Meta-Analyses
Authors: Bo Yacong , Zhu Yongjian , Tao Yuchang , Li Xue , Zhai Desheng , Bu Yongjun , Wan Zhongxiao , Wang Ling , Wang Yuming , Yu Zengli
Published: January 2021

Background: There is no study that has systematically investigated the breadth and validity of the associations of folate and multiple health outcomes. We aimed to evaluate the quantity, validity, and credibility of evidence regarding associations between folate and multiple health outcomes by using umbrella review of meta-analysis.

Methods: We searched the MEDLINE, EMBASE, and Cochrane Library databases from inception to May 20, 2018, to identify potential meta-analyses that examined the association of folate with any health outcome. For each included meta-analysis, we estimated the summary effect size and their 95% confidence interval using the DerSimonian and Laird random-effects model. We used the AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews) to assess methodological quality and the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation working group classification) to assess the quality of evidence for each outcome included in the umbrella review.

Results: Overall, 108 articles reporting 133 meta-analyses of observational studies and 154 meta-analyses of randomized controlled trials (RCTs) were included in the study. Among them, 108 unique exposure–outcome–population triplets (referred to as unique meta-analyses hereafter) of RCTs and 87 unique meta-analyses of observational studies were reanalyzed. Beneficial effects of folate were observed in the all-cause mortality rate and in a number of chronic diseases, including several birth/pregnancy outcomes, several cancers, cardiovascular disease and metabolic-related outcomes, neurological conditions, and several other diseases. However, adverse effects of folate were observed for prostate cancer, colorectal adenomatous lesions, asthma or wheezing, and wheezing as an isolated symptom and depression.

Conclusions: Current evidence allows for the conclusion that folate is associated with decreased risk of all-cause mortality and a wide range of chronic diseases. However, folate may be associated with an increased risk of prostate cancer. Further research is warranted to improve the certainty of the estimates.
The Impact of the Covid-19 Pandemic and the Lockdown on the Health and Living Conditions of Undocumented Migrants and Migrants Undergoing Legal Status Regularization
Authors: Burton-Jeangros Claudine , Duvoisin Aline , Lachat Sarah , Consoli Liala , Fakhoury Julien , Jackson Yves
Published: January 2021

Introduction: Undocumented migrants are at high risk of adverse consequences during crises because of a lack of access to essential securities and sources of support. This study aims to describe the impact of the COVID-19 crisis on the health and living circumstances of precarious migrants in Switzerland and to assess whether those undergoing legal status regularization fared better than undocumented migrants.

Materials and methods: This cross-sectional mixed methods study was conducted during the COVID-19 lockdown in April–May 2020. Undocumented and recently regularized migrants taking part in an ongoing cohort study were asked to respond to an online questionnaire. A subsample was selected to undergo semi-directed phone interviews.

Results: Overall, 117 of the 379 (30.9%) cohort study participants responded to the questionnaire. Seventeen interviews were conducted. Migrants faced cumulative and rapidly progressive difficulties in essential life domains. As a consequence, they showed high prevalence of exposure to COVID-19, poor mental health along with frequent avoidance of health care. Moreover, the loss of working hours and the related income overlapped with frequent food and housing insecurity. Around one participant in four had experienced hunger. Despite these unmet needs, half of the participants had not sought external assistance for reasons that differ by legal status. Both groups felt that seeking assistance might represent a threat for the renewal or a future application for a residency permit. While documented migrants were less severely affected in some domains by having accumulated more reserves previously, they also frequently renounced to sources of support.

Conclusions: The cumulated difficulties faced by migrants in this period of crisis and their limited search for assistance highlight the need to implement trust-building strategies to bridge the access gap to sources of support along with policies protecting them against the rapid loss of income, the risk of losing their residency permit and the exposure to multi-fold insecurities.
Impact of the Healthcare System, Macro Indicator, General Mandatory Quarantine, and Mask Obligation on COVID-19 Cases and Death in Six Latin American Countries: An Interrupted Time Series Study
Authors: Poppe Adriana
Published: January 2021

Background: Different coping strategies have been implemented by various governments worldwide to address the emerging health crisis of COVID-19. While most developed countries count on supporting healthcare and social systems, developing countries face additional challenges due to low macro indicators. The implementation of measurements such as quarantine are shown to be successful to flatten the curve of infection and death. In this context, it is important to test whether those measurements have an impact on the distribution of cases of COVID-19 in developing countries that face additional challenges such as lack of social security due to informal employment. A country comparison for Colombia, Costa Rica, Peru, Ecuador, Mexico, and Chile has therefore been conducted.

Method: The healthcare systems and macro indicator as well as the distribution of death due to COVID-19 per thousand inhabitants are compared descriptively. Using Multiple Interrupted Time Series Analysis with synthetic control units the impact of the General Mandatory Quarantine in Colombia, Peru, and Ecuador as well as the impact of Mask Obligation in public in Colombia and Chile have been tested.

Results: No clear impact of the poverty headcount ratio at the national poverty line and urban population on the percentage of death within the confirmed cases has been found. The out-of-pocked spending within health expenditure as a barrier in access to healthcare can be considered as a determinant of death within the confirmed cases of COVID-19. The implementation of a general mandatory quarantine did not show a curve-flattening effect in Ecuador and Peru but did so in Colombia. The implementation of Mask obligation in public spaced showed positive impact on the distribution of confirmed case in both countries tested.

Conclusion: The implementation of a general mandatory quarantine does not guarantee the curve-flattening effect. Various macro indicators should therefore always be considered while analyzing the effect of policies.
Knowledge, Attitude, and Self-Reported Practice Toward Measures for Prevention of the Spread of COVID-19 Among Ugandans: A Nationwide Online Cross-Sectional Survey
Authors: Ssebuufu Robinson , Sikakulya Franck Katembo , Mambo Simon Binezero , Wasingya Lucien , Nganza Sifa K. , Ibrahim Bwaga , Kyamanywa Patrick
Published: January 2021

Background: The world is facing the Coronavirus pandemic, which is highly infectious. Several measures have been put in place to prevent its spread among the population. However, for these preventive measures to be effective, the population requires appropriate and sufficient knowledge, attitude, and practices. Thus, a survey to assess knowledge, attitude, and self-reported practice toward measures for prevention of the spread of COVID-19 was conducted among Ugandans.

Methods: This was a cross-sectional study conducted among during the lockdown in Uganda. An online structured questionnaire was used, applying a snowballing sampling approach for recruitment of participants 18 years and above and residing in Uganda. Data collection was done from 6th to 15th April 2020, during which 1,763 people participated. We analyzed all data using STATA 14.2, applying appropriate statistical tests.

Results: Out of 1,763 participants, 80% were highly knowledgeable. For attitude, 72.4% reported following recommendations given by the Ministry of health to prevent the spread of COVID-19; 89.0% were worried about contracting COVID-19 and 73.3% agreed that COVID-19 can be cured and 99.3% reported good practice toward measures to prevent the spread of COVID-19. According to ordered logistic regression, health workers were 6 times more knowledgeable [aOR:6 (3.51–10.09), p < 0.001] followed by teachers [aOR:5.2 (2.6–10.32), p < 0.001]; students [aOR:3.2 (1.96–5.33), p < 0.001]. On the contrary, the drivers, business entrepreneurs, and security personnel had less knowledge.

Conclusion: The results show that the participating Ugandans were knowledgeable and had a positive attitude and good practices. However, there is still a gap in knowledge among drivers, business entrepreneurs, and security personnel. Therefore, there is a need to mobilize the country's population to have the same degree of knowledge, which will have an impact on the attitude and practices toward prevention of the spread of COVID-19.
Dielectric Elastomer Actuator Driven Soft Robotic Structures With Bioinspired Skeletal and Muscular Reinforcement
Authors: Franke M. , Ehrenhofer A. , Lahiri S. , Henke E.-F. M. , Wallmersperger T. , Richter A.
Published: January 2021

Natural motion types found in skeletal and muscular systems of vertebrate animals inspire researchers to transfer this ability into engineered motion, which is highly desired in robotic systems. Dielectric elastomer actuators (DEAs) have shown promising capabilities as artificial muscles for driving such structures, as they are soft, lightweight, and can generate large strokes. For maximum performance, dielectric elastomer membranes need to be sufficiently pre-stretched. This fact is challenging, because it is difficult to integrate pre-stretched membranes into entirely soft systems, since the stored strain energy can significantly deform soft elements. Here, we present a soft robotic structure, possessing a bioinspired skeleton integrated into a soft body element, driven by an antagonistic pair of DEA artificial muscles, that enable the robot bending. In its equilibrium state, the setup maintains optimum isotropic pre-stretch. The robot itself has a length of 60 mm and is based on a flexible silicone body, possessing embedded transverse 3D printed struts. These rigid bone-like elements lead to an anisotropic bending stiffness, which only allows bending in one plane while maintaining the DEA's necessary pre-stretch in the other planes. The bones, therefore, define the degrees of freedom and stabilize the system. The DEAs are manufactured by aerosol deposition of a carbon-silicone-composite ink onto a stretchable membrane that is heat cured. Afterwards, the actuators are bonded to the top and bottom of the silicone body. The robotic structure shows large and defined bimorph bending curvature and operates in static as well as dynamic motion. Our experiments describe the influence of membrane pre-stretch and varied stiffness of the silicone body on the static and dynamic bending displacement, resonance frequencies and blocking forces. We also present an analytical model based on the Classical Laminate Theory for the identification of the main influencing parameters. Due to the simple design and processing, our new concept of a bioinspired DEA based robotic structure, with skeletal and muscular reinforcement, offers a wide range of robotic application.