Capturing the multidimensionality of motivation in physical education: A self-organizing maps approach to profiling students

This study aimed to capture the multidimensionality of adolescents' motivation in the physical education (PE) setting, within self-determination theory, by employing self-organizing maps (SOM) analysis. Particularly, it examined the topological relationships among students' basic psychological needs satisfaction, their perception of more or less self-determined motivation and the affective and behavioural consequences in PE lessons across several sociodemographic variables. A nationally representative sample of 3029 Spanish students (51% girls), aged 12 to 18 years, was surveyed. SOM mapped well-defined students' profiles that embraced interrelatedly a considerable number of students' motivational characteristics. Four target profiles, out of 10, were explored. The first two profiles, highly motivated to be active girls and boys, mainly experienced senses of self-determination, but also controlled reasons for participating in PE lessons, high perceived competence, relatedness and autonomy fulfilment, perceived exerted effort and satisfaction. However, the reluctance to be physically active presented two gendered motivational profiles. Barely motivated to be active girls showed the lowest levels of self-determined motivation, including introjected regulation, low perceptions of competence, autonomy, relatedness, and dissatisfaction in PE. Vaguely motivated to be active boys revealed that despite their perceptions of competence the neglect of the other two psychological needs was more likely to determine a controlled motivation and, consequently, maladaptive outcomes. SOM proved to be a more robust and accurate clustering technique than the k-means algorithm and helped to portray and visualize the complexity behind the decision to become an active person considering the motivational processes in PE. Implications are provided for practitioners. [ FROM AUTHOR] Copyright of European Physical Education Review is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

An international consortium in epilepsy surgery education: Clinical case-based discussions between Latin-American and Canadian Epilepsy Centers.

An international consortium with a focus on Epilepsy Surgery Education was established with members from different centers in Latin America and Canada. All members of the consortium and attendees from different centers in Latin America and Canada have been meeting to discuss epilepsy surgery cases in a virtual manner. We surveyed all to assess the value of the meetings. The results and description of these meetings are being presented.

Development of Antioxidant and Nutritious Lentil (Lens culinaris) Flour Using Controlled Optimized Germination as a Bioprocess.

Germination is an efficient and natural strategy that allows the modification of the nutritional value and the nutraceutical properties of seeds, enabling one to tailor the process according to its final use. This study aimed at optimization of germination conditions to produce novel lentil flours with improved nutritional and functional features. Response Surface Methodology (RSM) was applied to model the effect of temperature (15-27 °C) and time (1-5 days) on different nutritional and quality parameters of lentil flours including proximate composition, content and profile of fatty acids, content of phytic acid, ascorbic acid and γ-aminobutyric acid (GABA), content and profile of phenolic compounds, antioxidant activity, expected glycemic index (GI) and color during germination. As shown by RSM polynomial models, sprouting promoted the reduction of phytic acid content and enhanced the levels of ascorbic acid, GABA, insoluble phenolic compounds, antioxidant activity and expected GI, and modified the color of the resultant lentil flours. RSM optimization of germination temperature and time using desirability function revealed that the optimal process conditions to maximize the nutritional, bioactive and quality properties of sprouted lentil flours were 21 °C for 3.5 days.

DOES SOVEREIGN RISK IMPACT BANKING RISK IN THE EUROZONE? EVIDENCE FROM THE COVID-19 PANDEMIC

This paper studies the impact of sovereign risk on Eurozone banking risk during a novel crisis such as the COVID-19 pandemic. Spillover effects on volatility are identified using Granger causality tests, a spillover matrix, and BEKK-GARCH models. The results confirm that an increase in Eurozone sovereign risk has impacted banking risk in Eurozone and that there is no evidence that sovereign risk in the countries of the Eurozone periphery is being transmitted to banking risk in the core countries during the crisis. These conclusions are very important for risk management and the design and monitoring of Eurozone financial policies.

Impact of COVID-19 Infection on the Outcome of Patients With Ischemic Stroke.

BACKGROUND AND PURPOSE: We evaluated whether stroke severity, functional outcome, and mortality are different in patients with ischemic stroke with or without coronavirus disease 2019 (COVID-19) infection. METHODS: A prospective, observational, multicentre cohort study in Catalonia, Spain. Recruitment was consecutive from mid-March to mid-May 2020. Patients had an acute ischemic stroke within 48 hours and a previous modified Rankin Scale (mRS) score of 0 to 3. We collected demographic data, vascular risk factors, prior mRS score, National Institutes of Health Stroke Scale score, rate of reperfusion therapies, logistics, and metrics. Primary end point was functional outcome at 3 months. Favourable outcome was defined depending on the previous mRS score. Secondary outcome was mortality at 3 months. We performed mRS shift and multivariable analyses. RESULTS: We evaluated 701 patients (mean age 72.3±13.3 years, 60.5% men) and 91 (13%) had COVID-19 infection. Median baseline National Institutes of Health Stroke Scale score was higher in patients with COVID-19 compared with patients without COVID-19 (8 [3-18] versus 6 [2-14], P=0.049). Proportion of patients with a favourable functional outcome was 33.7% in the COVID-19 and 47% in the non-COVID-19 group. However, after a multivariable logistic regression analysis, COVID-19 infection did not increase the probability of unfavourable functional outcome. Mortality rate was 39.3% among patients with COVID-19 and 16.1% in the non-COVID-19 group. In the multivariable logistic regression analysis, COVID-19 infection was a risk factor for mortality (hazard ratio, 3.14 [95% CI, 2.10-4.71]; P<0.001). CONCLUSIONS: Patients with ischemic stroke and COVID-19 infection have more severe strokes and a higher mortality than patients with stroke without COVID-19 infection. However, functional outcome is comparable in both groups.

COVID-19 Pandemic Effect on Energy Consumption in State Universities: Michoacan, Mexico Case Study

The COVID-19 pandemic has generated multiple impacts. In particular, in the educational sector, the virtual class modality generated changes in the patterns of energy consumption at the institutional level;the identification of this consumption will allow us to reflect on new energy saving and efficient use strategies. In this research, we present a case study of the effects of the COVID-19 pandemic on electricity consumption in 13 state universities in Michoacán, Mexico. Electric energy consumption has been evaluated before and during the presence of the COVID-19 between 2019 and 2020. The comparative analysis estimated the reduction in energy consumption and its economic and environmental impact. The results show a considerable decrease in electricity consumption, generating an average saving of 76.24 MWh/month, which translates into an annual emission reduction from 2019 to 2020 of approximately 497 TnCO2e, and in economic terms of $8,882.25 USD each month. In general, it was identified that consumption patterns in the use of machinery and computer equipment for administrative activities were drastically reduced. If education continues in virtual or hybrid modes, energy consumption schemes will continue to decline and institutions could move towards resilient, affordable, and sustainable models of energy production and consumption.

Measuring the Impact of Infectious Diseases on Tourists’ Willingness to Pay to Visit Island Destinations

The occurrence of infectious diseases may change tourists’ perceptions of a destination’s image and value. This article proposes and empirically tests a choice model to measure the effect of the risk of infectious disease outbreaks caused by climate change on tourists’ willingness to pay for holidays to island destinations. With this aim, an online survey was administrated to 2538 European frequent travellers at their country of residence. Tourists were presented with a hypothetical situation whereby they had to choose among eleven well-known European island destinations for their next holiday. The choice cards included the probability of the occurrence of infectious disease events in the context of other potential risks caused by climate change (i.e., forest fires, floods, heat waves, etc.). The results show infectious disease is the risk that more negatively affects tourists’ willingness to pay to visit islands, followed by forest fires. The results have implications for tourism policy, highlighting the importance of prevention and response strategies, and the design of climate-oriented services, which may raise opportunities to work towards the enhancement of those health and environmental conditions of tourist destinations that ensure their sustainability in the longer term.

A proteomic survival predictor for COVID-19 patients in intensive care (preprint)

Global healthcare systems are challenged by the COVID-19 pandemic. There is a need to optimize allocation of treatment and resources in intensive care, as clinically established risk assessments such as SOFA and APACHE II scores show only limited performance for predicting the survival of severely ill COVID-19 patients. Comprehensively capturing the host physiology, we speculated that proteomics in combination with new data-driven analysis strategies could produce a new generation of prognostic discriminators. We studied two independent cohorts of patients with severe COVID-19 who required intensive care and invasive mechanical ventilation. SOFA score, Charlson comorbidity index and APACHE II score were poor predictors of survival. Plasma proteomics instead identified 14 proteins that showed concentration trajectories different between survivors and non-survivors. A proteomic predictor trained on single samples obtained at the first time point at maximum treatment level (i.e. WHO grade 7) and weeks before the outcome, achieved accurate classification of survivors in an exploratory (AUROC 0.81) as well as in the independent validation cohort (AUROC of 1.0). The majority of proteins with high relevance in the prediction model belong to the coagulation system and complement cascade. Our study demonstrates that predictors derived from plasma protein levels have the potential to substantially outperform current prognostic markers in intensive care.

Corporate Well-Being Programme in COVID-19 Times. The Mahou San Miguel Case Study

Employees’ health is being affected not only by the possibility of contracting COVID-19, but by all the negative consequences that this pandemic has brought, such as confinement, social distancing, and self-isolation. In recent decades, more companies have opted for corporate well-being programmes in their workplaces, improving the health and quality of life of their employees. The effects generated by the current COVID-19 pandemic require these programmes to adapt to this new situation. The objective of this case study is to analyse the corporate well-being programme, in times of COVID-19, of Mahou San Miguel, a benchmark company in corporate well-being in Spain. A mixed method approach to data collection was used. The findings show the benefits achieved in its adaptation to this new physical-virtual environment. This paper could help other companies around the world to adapt their corporate well-being programmes to the new reality brought about by COVID-19.

Modelling the impact of health-related variables, age, migration, and socio-economic factors in the geographical distribution of early tested case-fatality risks associated with COVID-19 in Mexico (preprint)

COVID-19 is a respiratory disease caused by SARS-CoV-2, which has significantly impacted economic and public healthcare systems world-wide. SARS-CoV-2 is highly lethal in older adults (>65 years old) and in cases with underlying medical conditions including chronic respiratory diseases, immunosuppression, and cardio-metabolic diseases including severe obesity, diabetes, and hypertension. The course of the COVID-19 pandemic in Mexico has led to many fatal cases in younger patients attributable to cardio-metabolic conditions. Here, we aimed to perform an early spatial epidemiological analysis for the COVID-19 outbreak in Mexico to evaluate how tested case-fatality risks (t-CFRs) are geographically distributed and to explore spatial predictors of early t-CFRs considering the variation of their impact on COVID-19 fatality across different states in Mexico, controlling for the severity of the disease. As results, considering health related variables; diabetes and obesity were highly associated with COVID-19 fatality. We identified that both external and internal migration had an important impact over early COVID-19 risks in Mexico, with external migration having the second highest impact when analyzing Mexico as a whole. Physicians-to-population ratio, as a representation of urbanity, population density, and overcrowding households, has the highest impact on t-CFRs, whereas the age group of 10 to 39 years was associated with lower risks. Geographically, the states of Quintana Roo, Baja California, Chihuahua, and Tabasco had higher t-CFRs and relative risks comparing with a national standard, suggesting that risks in these states were above of what was nationally expected; additionally, the strength of the association between some spatial predictors and the COVID-19 fatality risks variates by zone depending on the predictor.

A time-resolved proteomic and diagnostic map characterizes COVID-19 disease progression and predicts outcome (preprint)

COVID-19 is highly variable in its clinical presentation, ranging from asymptomatic infection to severe organ damage and death. There is an urgent need for predictive markers that can guide clinical decision-making, inform about the effect of experimental therapies, and point to novel therapeutic targets. Here, we characterize the time-dependent progression of COVID-19 through different stages of the disease, by measuring 86 accredited diagnostic parameters and plasma proteomes at 687 sampling points, in a cohort of 139 patients during hospitalization. We report that the time-resolved patient molecular phenotypes reflect an initial spike in the systemic inflammatory response, which is gradually alleviated and followed by a protein signature indicative of tissue repair, metabolic reconstitution and immunomodulation. Further, we show that the early host response is predictive for the disease trajectory and gives rise to proteomic and diagnostic marker signatures that classify the need for supplemental oxygen therapy and mechanical ventilation, and that predict the time to recovery of mildly ill patients. In severely ill patients, the molecular phenotype of the early host response predicts survival, in two independent cohorts and weeks before outcome. We also identify age-specific molecular response to COVID-19, which involves increased inflammation and lipoprotein dysregulation in older patients. Our study provides a deep and time resolved molecular characterization of COVID-19 disease progression, and reports biomarkers for risk-adapted treatment strategies and molecular disease monitoring. Our study demonstrates accurate prognosis of COVID-19 outcome from proteomic signatures recorded weeks earlier.

Evaluation of Country Dietary Habits Using Machine Learning Techniques in Relation to Deaths from COVID-19

COVID-19 disease has affected almost every country in the world. The large number of infected people and the different mortality rates between countries has given rise to many hypotheses about the key points that make the virus so lethal in some places. In this study, the eating habits of 170 countries were evaluated in order to find correlations between these habits and mortality rates caused by COVID-19 using machine learning techniques that group the countries together according to the different distribution of fat, energy, and protein across 23 different types of food, as well as the amount ingested in kilograms. Results shown how obesity and the high consumption of fats appear in countries with the highest death rates, whereas countries with a lower rate have a higher level of cereal consumption accompanied by a lower total average intake of kilocalories.

Recommendations Based on Evidence by the Andalusian Group for Nutrition Reflection and Investigation (GARIN) for the Pre- and Postoperative Management of Patients Undergoing Obesity Surgery

In order to develop evidence-based recommendations and expert consensus for nutrition management of patients undergoing bariatric surgery and postoperative follow-up, we conducted a systematic literature search using PRISMA methodology plus critical appraisal following the SIGN and AGREE-II procedures. The results were discussed among all members of the GARIN group, and all members answered a Likert scale questionnaire to assess the degree of support for every recommendation. Patients undergoing bariatric surgery should be screened preoperatively for some micronutrient deficiencies and treated accordingly. A VLCD (Very Low-Calorie Diet) should be used for 4-8 weeks prior to surgery. Postoperatively, a liquid diet should be maintained for a month, followed by a semi-solid diet also for one month. Protein requirements (1-1.5 g/kg) should be estimated using adjusted weight. Systematic use of specific multivitamin supplements is encouraged. Calcium citrate and vitamin D supplements should be used at higher doses than are currently recommended. The use of proton-pump inhibitors should be individualised, and vitamin B12 and iron should be supplemented in case of deficit. All patients, especially pregnant women, teenagers, and elderly patients require a multidisciplinary approach and specialised follow-up. These recommendations and suggestions regarding nutrition management when undergoing bariatric surgery and postoperative follow-up have direct clinical applicability.

GLUCOCOVID: A controlled trial of methylprednisolone in adults hospitalized with COVID-19 pneumonia (preprint)

BackgroundWe aimed to determine whether a 6-day course of intravenous methylprednisolone (MP) improves outcome in patients with SARS CoV-2 infection at risk of developing Acute Respiratory Distress Syndrome (ARDS). MethodsMulticentric, partially randomized, preference, open-label trial, including adults with COVID-19 pneumonia, impaired gas exchange and biochemical evidence of hyper-inflammation. Patients were assigned to standard of care (SOC), or SOC plus intravenous MP [40mg/12h 3 days, then 20mg/12h 3 days]. The primary endpoint was a composite of death, admission to the intensive care unit (ICU) or requirement of non-invasive ventilation (NIV). ResultsWe analyzed 85 patients (34, randomized to MP; 22, assigned to MP by clinicians preference; 29, control group). Patients age (mean 68{+/-}12 yr) was related to outcome. The use of MP was associated with a reduced risk of the composite endpoint in the intention-to-treat, age-stratified analysis (combined risk ratio -RR-0.55 [95% CI 0.33-0.91]; p=0.024). In the per-protocol analysis, RR was 0.11 (0.01-0.83) in patients aged 72 yr or less, 0.61 (0.32-1.17) in those over 72 yr, and 0.37 (0.19-0.74, p=0.0037) in the whole group after age-adjustment by stratification. The decrease in C-reactive protein levels was more pronounced in the MP group (p=0.0003). Hyperglycemia was more frequent in the MP group. ConclusionsA short course of MP had a beneficial effect on the clinical outcome of severe COVID-19 pneumonia, decreasing the risk of the composite end point of admission to ICU, NIV or death. O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=142 SRC="FIGDIR/small/20133579v1_ufig1.gif" ALT="Figure 1"> View larger version (42K): org.highwire.dtl.DTLVardef@1adf5f9org.highwire.dtl.DTLVardef@1efecd8org.highwire.dtl.DTLVardef@a65f07org.highwire.dtl.DTLVardef@a8df92_HPS_FORMAT_FIGEXP M_FIG C_FIG

Unequal impact of structural health determinants and comorbidity on COVID-19 severity and lethality in older Mexican adults: Looking beyond chronological aging (preprint)

BACKGROUNDCOVID-19 has had a disproportionate impact on older adults. Mexicos population is younger, yet COVID-19s impact on older adults is comparable to countries with older population structures. Here, we aim to identify health and structural determinants that increase susceptibility to COVID-19 in older Mexican adults beyond chronological aging. METHODSWe analyzed confirmed COVID-19 cases in older adults using data from the General Directorate of Epidemiology of Mexican Ministry of Health. We modeled risk factors for increased COVID-19 severity and mortality, using mixed models to incorporate multilevel data concerning healthcare access and marginalization. We also evaluated structural factors and comorbidity profiles compared to chronological age for improving COVID-19 mortality risk prediction. RESULTSWe analyzed 7,029 confirmed SARS-CoV-2 cases in adults aged [≥]60 years. Male sex, smoking, diabetes, and obesity were associated with pneumonia, hospitalization and ICU admission in older adults, CKD and COPD were associated with hospitalization. High social lag indexes and access to private care were predictors of COVID-19 severity and mortality. Age was not a predictor of COVID-19 severity in individuals without comorbidities and structural factors and comorbidities were better predictors of COVID-19 lethality and severity compared to chronological age. COVID-19 baseline lethality hazards were heterogeneously distributed across Mexican municipalities, particularly when comparing urban and rural areas. CONCLUSIONSStructural factors and comorbidity explain excess risk for COVID-19 severity and mortality over chronological age in older Mexican adults. Clinical decision-making related to COVID-19 should focus away from chronological aging onto more a comprehensive geriatric care approach.

Early estimation of the risk factors for hospitalisation and mortality by COVID-19 in Mexico (preprint)

Background. With its high prevalence of chronic non-degenerative diseases, it is suspected that in Mexico there is a high risk of fatal complications from COVID-19. The present study aims to estimate the risk factors for hospitalisation and death in the Mexican population infected by SARS-CoV-2. Methods and Findings. We used the publicly available data released by the Epidemiological Surveillance System for Viral Respiratory Diseases of the Mexican Ministry of Health (Secretaria de Salud, SS). All records of positive SARS-CoV-2 cases were included. Two multiple logistic regression models were fitted to estimate the association between the hospitalisation and mortality, with other covariables. Data on 10,544 individuals (57.68% men), with mean age 46.47 SD 15.62, were analysed. Men were about 1.54 times as likely to be hospitalized than women (p<0.001, 95% C.I. 1.37-1.74); individuals aged 50-74 and >=74 years were more likely to be hospitalized than people from 25-49 years (OR 2.05, p<0.001, 95% C.I. 1.81-2.32, and OR 23.84, p<0.001, 95% C.I. 2.90-5.15, respectively). People with hypertension, obesity, and diabetes were more likely to be hospitalised than people without these morbidities (p<0.01). Men had more risk of death in comparison to women (OR=1.53, p<0.001, 95% C.I. 1.30-1.81) and individuals aged 50-74 and [≥]75 years were more likely to die than people from 25-49 years (OR 1.96, p<0.001, 95% C.I. 1.63-2.34, and OR 3.74, p<0.001, 95% C.I. 2.80-4.98, respectively). Hypertension, obesity, and diabetes presented in combination, provided a higher risk of dying in comparison to not having these diseases (OR=2.10; p<0.001, 95% C.I. 1.50-2.93). Hospitalisation, intubation and pneumonia conferred a higher risk of dying (OR 5.02, p<0.001, 95% C.I. 3.88-6.50; OR 4.27, p<0.001, 95% C.I. 3.26-5.59, and OR=2.57; p<0.001, 95% C.I. 2.11-3.13, respectively). The main limitation of our study is the lack of information on mild (asymptomatic) or moderate cases of COVID-19. Conclusions. The present study points out that in Mexico, where an important proportion of the population develops two or more chronic conditions simultaneously, high mortality is a sever outcome for those infected by SARS-CoV-2.

When Chronic Diseases Meet Infectious Diseases: A Proposal Toward Healthy Aging: Lessons from COVID-19 Outbreak (preprint)

As the novel COVID-19 disease spreads around the world, the most affected population are those who suffer from the most common chronic diseases, such as obesity, hypertension, and type 2 diabetes, which are quite associated with the so-called age-related diseases. On the other hand, since the Spanish influenza outbreak, humanity has not experienced an infectious disease that synergizes so quickly with chronic diseases, making it mortal for those individuals with comorbidities. In this context, COVID-19 is challenging for health systems all around the world due to the high prevalence of chronic diseases. Nowadays, we are facing the beginning of a new era in which health infectious and chronic diseases meet. Therefore, epidemiologic and biomedical researchers must work together to solve further contingencies, and politicians should direct science-centered decisions on public health. In the present paper, we make an urgent call to learn from the COVID-19 lessons in order to mitigate the chronic diseases prevalence and to address the influence of the infectious diseases on the aging process; since we are about to begin the Decade of Healthy Aging.

When Chronic Diseases Meet Infectious Diseases: A Proposal Toward Healthy Aging: Lessons from COVID-19 Outbreak (preprint)

As the novel COVID-19 disease spreads around the world, the most affected population are those who suffer from the most common chronic diseases, such as obesity, hypertension, and type 2 diabetes, which are quite associated with the so-called age-related diseases. On the other hand, since the Spanish influenza outbreak, humanity has not experienced an infectious disease that synergizes so quickly with chronic diseases, making it mortal for those individuals with comorbidities. In this context, COVID-19 is challenging for health systems all around the world due to the high prevalence of chronic diseases. Nowadays, we are facing the beginning of a new era in which health infectious and chronic diseases meet. Therefore, epidemiologic and biomedical researchers must work together to solve further contingencies, and politicians should direct science-centered decisions on public health. In the present paper, we make an urgent call to learn from the COVID-19 lessons in order to mitigate the chronic diseases prevalence and to address the influence of the infectious diseases on the aging process; since we are about to begin the Decade of Healthy Aging.