•932 UK participants during COVID-19 self-isolation were included.•The prevalence of poor mental health was 36.8% in the population.•Females, younger age, lower annual income, smokers and physical ...multimorbidity were associated with higher levels of poor mental health.•Intervention efforts should target women, youth, smokers, those with low income & those with multimorbidity.
Background: The aim was to assess the impact of COVID-19 self-isolation/social distancing on mental health, and potential correlates, among a sample of the UK population.
Methods: A cross-sectional study. Mental health was measured using the Beck Anxiety and Depression Inventory. Mental wellbeing was measured using The Short Warwick-Edinburgh Mental Well-being Scale. Data collected on predictors included sex, age, marital status, employment, annual income, region, current smoking, current alcohol consumption, physical multimorbidity, any physical symptoms experienced during self-isolation/social distancing, and the number of days of self-isolation/social distancing. The association between potential predictors and poor mental health was studied using a multivariable logistic regression.
Results: 932 participants were included. Factors associated with poor mental health were sex (reference: male; female: OR=1.89, 95%CI=1.34-2.68), age (18-24 years: reference;45-54 years: OR=0.27, 95%CI=0.14-0.53; 55-64 years: OR=0.24, 95%CI=0.12-0.47; 65-74years: OR=0.10, 95% CI=0.05-0.22; and ≥75years: OR=0.08,95% CI=0.03-0.24),annual income (<£15,000: reference; £25,000-<£40,000: OR=0.54, 95% CI=0.31-0.93; £40,000-<£60,000: OR=0.39, 95% CI=0.22-0.69; and ≥£60,000: OR=0.38, 95% CI=0.21-0.67), current smoking (yes: OR=2.59, 95%CI=1.62-4.20), and physical multimorbidity (OR=2.35, 95%CI=1.61-3.46).
Conclusions: In this sample of UK adults self-isolating/social distancing females, younger age groups, those with a lower annual income, current smokers and those with physical multimorbidity were associated with higher levels of poor mental health.
Adult learners demand teaching innovations that are ever more rapid and attractive. As a response to these demands and the challenges of skills training, this article presents a conceptual analysis ...that introduces competitive debate as an impact training model. The aim is to learn whether debate can be considered to fall within the frame of gamification, so that the full potential of debate as gamification can be exploited. There is a significant research gap regarding competitive debate as a game, with the training mechanics for adult learners remaining practically unexplored. Through a conceptual analysis of game, game experience, and gamification, and their respective characteristics, we conclude that competitive debate is an ideal instrument for gamification.
Students demand more active and participating teaching innovation methods, and activities such as presentations are not enough to satisfy those demands. In this research, competitive debate is used ...as inter-team gamification with third year students from a Business School studying the Human Resources Management subject. Out of this experience, qualitative and quantitative data are obtained. Results reinforce the continuation of classroom competitive debate due to the evidence of its motivational, learning, and communication skills improvement, and knowledge acquisition effects. The possibility of application with actual professionals is seriously considered.
This paper details a decision model to implement direct load control (DLC) on battery charging processes at electric vehicle charging points located at parking areas. The programming model combines ...optimally three types of energy management decisions: grid-to-vehicle charges, vehicle-to-grid discharges, and novel vehicle-to-vehicle energy exchanges. The objective function maximizes the net energy supplied to batteries minimizing simultaneously the global energy cost. A 50-plug-in vehicle park case is analyzed for three possible mobility patterns: household, commercial and mixed. Outputs from the DLC model are compared with the ones using a dumb charging policy from the service quality and economic points of view. Finally, a sensitivity analysis has been done to evaluate the economic impact of the Depth of Discharge condition to preserve battery lifecycle of electric vehicles.
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•Fermented orange juice (FOJ) intake increases urine 6-sulfatoxymelatonin (6-SMT).•Urine antioxidant activity is higher after FOJ consumption than after OJ consumption.•Urine ...antioxidant activity after FOJ intake would be mainly due to 6-SMT content.•FOJ could be a good source of bioavailable melatonin.
Fermentation of orange juice (OJ) by Pichia kluyveri enhances the content of melatonin, a molecule with potent antioxidant effect. This study explores the levels of urine 6- sulfatoxymelatonin (6-SMT) in healthy subjects after fermented orange juice (FOJ) intake, and their association with antioxidant activity status. Nine participants ingested 500 mL of FOJ and their urine was collected at baseline and after 2, 5, 10, 15 and 24 h. After a two-week washout period, the intervention was repeated with OJ. 6-SMT levels were quantified by ELISA and antioxidant activity by TAC, FRAP and ORAC assays. A significant increase in both 6-SMT levels and antioxidant activity in urine was observed after FOJ ingestion compared to OJ. A positive correlation between TAC and 6-SMT levels was observed only after FOJ intake. This study shows for the first time that fermentation process increases melatonin bioavailability of OJ associated with an enhancement in antioxidant status.
Novel anthropometric indices have been proposed as an alternative to body mass index (BMI) and waist circumference (WC) to determine visceral adipose tissue and body mass. Little is known about the ...relationship of these new anthropometric indices to subclinical carotid atherosclerosis. The objective of this study was to assess the association of anthropometric indices, both new and traditional, with the presence of subclinical carotid artery arteriosclerosis (SCAA) estimated by Doppler ultrasound. This cross-sectional study analyzed 788 Spanish patients who consecutively attended a vascular risk consultation between June 2021 and September 2022. Traditional anthropometric indices (BMI, WHR and WHtR) and novel indices (ABSI, AVI, BAI, BRI, CI, CUNBAE and WWI) were calculated, and Doppler ultrasound in the carotid artery (cIMT and atherosclerosis plaque) was performed to detect SCAA. All analyzed anthropometric indices, except BMI, BAI and CUNBAE, were significantly higher in patients with SCAA. ABSI, BRI, CI, WHR, WHtR and WWI and were associated with SCAA in the univariate analysis (p<0.05); however, only ABSI (adjusted OR: 1.15; 95% CI: 1.10-2.38; p= 0.042) was significantly associated with SCAA in the multivariate analysis. In conclusion, only ABSI was significantly positively associated with SCAA, independent of other confounders.
The effects of maintaining all classical, vascular risk factors on target among patients with stabilized atherosclerotic cardiovascular disease (ASCVD) are uncertain. Factores de Riesgo y ENfermedad ...Arterial (FRENA) was a prospective registry of consecutive outpatients with coronary, cerebrovascular, or peripheral artery disease. We analyzed the incidence of recurrent events and mortality according to sustained, optimal control of principal risk factors including the following: LDL cholesterol, glucose, blood pressure, and smoking. As of December 2018, 4285 stable outpatients were eligible for this study. Over a median follow-up of 21 months, 664 (15%) maintained all risk factors on target (Group 1), while 3621 (85%) did not (Group 2). During follow-up, no differences in recurrent major adverse cardiovascular events (MACEs) or death were observed between groups. On multivariable analysis, patients with previous known dyslipidemia (hazard ratio HR: 95% confidence interval (95% CI): (HR: 1.20 95% CI, 1.03-1.40), polyvascular disease (HR: 1.98 95% CI, 1.69-2.32), insulin therapy (HR: 1.56 95% CI, 1.24-1.95) and associated conditions (HR: 1.47 95% CI, 1.24-1.74) were associated with a higher risk for subsequent MACE. The presence of associated medical conditions was also strongly associated with all-cause death (HR: 3.49 95% CI, 2.35-5.19). Only a minority of patients with atherosclerotic cardiovascular disease achieved sustained optimal control for all principal risk factors although without discernible clinical, therapeutic benefit. The findings of the present study provide some insights into what factors may be used to guide physicians in adapting intensive, multifactorial therapy to the individual patient in clinical practice.
Over the last few years, novel anthropometric indices have been developed as an alternative to body mass index (BMI) and other traditional anthropometric measurements to enhance the estimate of fat ...proportion and its relationship to a future cardiovascular event. The purpose of this study was to investigate the association of carotid intima-media thickness (c-IMT) estimated by Doppler ultrasound with current anthropometric indices (traditional and novel).
A cross-sectional study was conducted on a total of 789 Spanish patients. Traditional (BMI, WHR, and WHtR) and new (WWI, AVI, ABSI, BRI, BAI, CUN-BAE, and CI) anthropometric indices were determined, and carotid Doppler ultrasound was performed to evaluate c-IMT (≥0.90 mm).
Most of the anthropometric indices analyzed were significantly higher among patients with pathological c-IMT, except for BMI, BAI, and CUN-BAE. In multiple linear regression analysis, c-IMT was positively related to ABSI, AVI, BRI, CI, and WWI but not to CUN-BAE, BAI, or traditional anthropometric indices. Similarly, in univariate analysis, all indices were associated with a c-IMT of ≥0.90 mm (
< 0.05), except BMI, BAI, and CUN-BAE; however, only ABSI (adjusted OR: 1.61; 95% CI: 1.08-2.40;
= 0.017), CI (adjusted OR: 1.73; 95% CI: 1.15-2.60;
= 0.008), and WWI (adjusted OR: 1.74; 95% CI: 1.14-2.64;
= 0.009) were significantly associated in multivariate analysis. Finally, CI, ABSI, and WWI provided the largest AUC, and BMI and CUN-BAE showed the lowest AUC.
ABSI, CI, and WWI were positively associated with pathological c-IMT (≥0.90 mm), independent of other confounders.
Objectives: The most appropriate targets for systolic blood pressure (SBP) levels to reduce cardiovascular morbidity and mortality in patients with symptomatic artery disease remain controversial. We ...compared the rate of subsequent ischemic events or death according to mean SBP levels during follow-up. Design: Prospective cohort study. FRENA is an ongoing registry of stable outpatients with symptomatic coronary (CAD), cerebrovascular (CVD) or peripheral artery disease (PAD). Setting: 24 Spanish hospitals. Participants: 4789 stable outpatients with vascular disease. Results: As of June 2017, 4789 patients had been enrolled in different Spanish centres. Of these, 1722 (36%) had CAD, 1383 (29%) CVD and 1684 (35%) PAD. Over a mean follow-up of 18 months, 136 patients suffered subsequent myocardial infarction, 125 had ischemic stroke, 74 underwent limb amputation, and 260 died. On multivariable analysis, CVD patients with mean SBP levels 130–140 mm Hg had a lower risk of mortality than those with levels <130 mm Hg (hazard ratio (HR): 0.39; 95% CI: 0.20–0.77), as did those with levels >140 mm Hg (HR: 0.46; 95% CI: 0.26–0.84). PAD patients with mean SBP levels >140 mm Hg had a lower risk for subsequent ischemic events (HR: 0.57; 95% CI: 0.39–0.83) and those with levels 130–140 mm Hg (HR: 0.47; 95% CI: 0.29–0.78) or >140 mm Hg (HR: 0.32; 95% CI: 0.21–0.50) had a lower risk of mortality. We found no differences in patients with CAD. Conclusions: In this real-world cohort of symptomatic arterial disease patients, most of whom are not eligible for clinical trials, the risk of subsequent events and death varies according to the levels of SBP and the location of previous events. Especially among patients with large artery atherosclerosis, PAD or CVD, SBP <130 mm Hg may result in increased mortality. Due to potential factors in this issue, Prospective, well designed studies are warranted to confirm these observational data.
In thin-film silicon solar cells textured interfaces are introduced, leading to improved antireflection and light trapping capabilities of the devices. Thin-layers are deposited on surface-textured ...substrates or superstrates and the texture is translated to internal interfaces. For accurate optical modelling of the thin-film silicon solar cells it is important to define and include the morphology of textured interfaces as realistic as possible. In this paper we present a model of thin-layer growth on textured surfaces which combines two growth principles: conformal and isotropic one. With the model we can predict the morphology of subsequent internal interfaces in thin-film silicon solar cells based on the known morphology of the substrate or superstrate. Calibration of the model for different materials grown under certain conditions is done on various cross-sectional scanning electron microscopy images of realistic devices. Advantages over existing growth modelling approaches are demonstrated—one of them is the ability of the model to predict and omit the textures with high possibility of defective regions formation inside the Si absorber layers. The developed model of layer growth is used in rigorous 3-D optical simulations employing the COMSOL simulator. A sinusoidal texture of the substrate is optimised for the case of a micromorph silicon solar cell. More than a 50 % increase in short-circuit current density of the bottom cell with respect to the flat case is predicted, considering the defect-free absorber layers. The developed approach enables accurate prediction and powerful design of current-matched top and bottom cell.
•New model of non-conformal growth of layers in thin-film solar cells presented.•Two principles of growth combined: conformal and isotropic.•Accurate prediction of morphology of internal interfaces.•Model enables detection of textures leading to defective regions in absorber layers.•With the model increased accuracy in 3D optical simulations of TFSC is achieved.
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