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This study aimed to determine whether the three dimensions of academic engagement (cognitive, emotional and behavioral) were positively associated with perceived learning and academic performance. The participants were 301 university students from Lima. Structural equation models were used to test the proposed theoretical relationship between the variables. The results indicated that the model showed satisfactory fit indices (CFI = 0.956, TLI = 0.949, RMSEA = 0.043, SRMR = 0.062). Perceived learning was found to be predicted by cognitive engagement ([beta] = 0.447, p < 0.01) and emotional engagement ([beta] = 0.230, p < 0.05). However, there was no statistically significant relationship between behavioral engagement and perceived learning ([beta] = 0.035, p = 0.840). On the other hand, academic performance was predicted by behavioral engagement ([beta] = 0.393, p < 0.05) but not by cognitive ([beta] = -0.164, p = 0.301) or emotional ([beta] = 0.001, p = 0.991) engagement. The study highlights the importance of fostering academic engagement in university students to enhance both their academic performance and perceived learning.

Businesses generate employment and are recognised as catalysts for the economy. A person who creates and manages a business is an entrepreneur and in a continually changing and complex environment, people capable of creative and innovative thinking will tend to become more entrepreneurial. Running a business successfully requires skills and knowledge, and universities are centres where students can acquire the knowledge and skills that enable them to become entrepreneurs. The purpose of this research was to determine the effect of attitude (ATT), subjective norms (SN), and perceived behavioural control (PBC) on the entrepreneurial intention (IE) of Peruvian university students enrolled during the period 2019-2020 and pursuing a variety of career paths. This study is quantitative, cross-sectional, and causal. The sample involved 642 students. The Theory of Planned Behaviour (TPB) is used to explain entrepreneurial intention. Confirmatory factor analysis (CFA) was employed for data analysis. The findings show that subjective norms and perceived behavioural control have a positive effect on entrepreneurial intention. Accordingly, it is suggested that the structure of academic programmes be improved to enhance the competencies and skills of future job creators.

Introduction: Limited studies have explored the impact of cystic fibrosis (CF) transmembrane conductance regulator (CFTR) modulators on glucose tolerance and insulin secretion in patients with CF, yielding varied results. This study aims to assess alterations in glucose metabolism and insulin secretion over 24 and 52 weeks following CFTR modulator initiation in a cohort of pediatric and adult patients with CF. Materials and Methods: A prospective longitudinal study conducting oral glucose tolerance test (OGTT) with C-peptide and insulin levels. The insulin secretion rate at 60 min (ISR60) and the insulinogenic index (IGI) were calculated during the first 60 and 30 min of the OGTT, respectively. Glucose metabolism status was categorized as normal (NGT), indeterminate (INDET), impaired glucose tolerance (IGT), or cystic fibrosis-related diabetes (CFRD). Additionally, continuous glucose monitoring (CGM) was performed for 14 days at each visit. We employed a repeated-measures general linear model to assess changes in insulin secretion and CGM metrics, with glucose tolerance status as the between-subjects factor and visit (baseline, 24 and 52 weeks) as the within-subjects factor. Results: The study comprised 25 patients (11 adults and 14 pediatrics). At baseline, 2 patients (8%) had NGT, 8 (32%) had INDET, 10 (40%) had IGT, and 5 (20%) had CFRD. Overall, there were no significant changes in insulin and C-peptide area under the curve (AUC), IGI and DI after 52 weeks. However, we observed an increase in ISR60 among NGT patients (mean change: 1.766; 95% CI: 1.414; 2.118, p < 0.001). Consistently, average glucose exhibited a significant decrease in NGT patients between 24 and 52 weeks (mean change: −5.645; 95% CI: −4.233; −10.866, p = 0.028). Conclusions: Treatment with CFTR modulators potentially enhances insulin secretion in patients with CF NGT. Early initiation of treatment, as evaluated through long-term prospective trials, is essential to further investigate whether decreased glucose control is preventable or reversible.

The design of converters is essential for the proper use of electrical energy. Half-bridge topology represents a suitable conversion scheme to implement a boost rectifier converter. Consequently, this article proposes the parameter optimization of a proportional-integral-derivative (with filter) controller for a half-bridge boost rectifier with a high power factor. Regarding the high simulation time for the converter, stochastic hill-climbing and simulated annealing algorithms are employed for the optimization process. The results display that the optimized controller allows suitable values for the power factor and output waveform. The controller parameters obtained through optimization algorithms result in a high power factor of 0.9934 when the half-bridge boost rectifier is operating at full load.

Abstract Patritumab deruxtecan (HER3-DXd) exhibits promising efficacy in breast cancer, with its activity not directly correlated to baseline ERBB3/HER3 levels. This research investigates the genetic factors affecting HER3-DXd’s response in women with early-stage hormone receptor-positive and HER2-negative (HR+/HER2-) breast cancer. In the SOLTI-1805 TOT-HER3 trial, a single HER3-DXd dose was administered to 98 patients across two parts: 78 patients received 6.4 mg/kg (Part A), and 44 received a lower 5.6 mg/kg dose (Part B). The CelTIL score, measuring tumor cellularity and infiltrating lymphocytes from baseline to day 21, was used to assess drug activity. Part A demonstrated increased CelTIL score after one dose of HER3-DXd. Here we report CelTIL score and safety for Part B. In addition, the exploratory analyses of part A involve a comprehensive study of gene expression, somatic mutations, copy-number segments, and DNA-based subtypes, while Part B focuses on validating gene expression. RNA analyses show significant correlations between CelTIL responses, high proliferation genes (e.g., CCNE1, MKI67), and low expression of luminal genes (e.g., NAT1, SLC39A6). DNA findings indicate that CelTIL response is significantly associated with TP53 mutations, proliferation, non-luminal signatures, and a distinct DNA-based subtype (DNADX cluster-3). Critically, low HER2DX ERBB2 mRNA, correlates with increased HER3-DXd activity, which is validated through in vivo patient-derived xenograft models. This study proposes chemosensitivity determinants, DNA-based subtype classification, and low ERBB2 expression as potential markers for HER3-DXd activity in HER2-negative breast cancer.

Applying to graduate school can be particularly challenging for students from historically minoritized backgrounds due to a hidden curriculum in the graduate admissions process. To address this issue, a team of volunteer STEM trainees established the Científico Latino Graduate Student Mentorship Initiative (CL-GSMI) in 2019 to support applicants from historically minoritized backgrounds. CL-GSMI is designed to improve access to critical resources, including information, mentorship, and financial support, and has assisted 443 students in applying and matriculating to graduate school. Using program evaluation data from 2020 to 2021, we highlight areas in graduate school admissions that can be improved to promote equity and inclusion.

The current scenario of water scarcity leads to a seek for new irrigation strategies that maintain agricultural productivity while reducing the pressure on freshwater resources, especially in the Mediterranean region, which has a structural deficit of water sources. In this study, the effects of irrigation with water from different origins were assessed over six consecutive years in soil salinity indicators, tree physiology and yield of mandarin trees in south east Spain. The following treatments were considered: i) freshwater from the “Tagus-Segura” water-transfer canal (TW or Control); ii) reclaimed water from a wastewater-treatment plant (RW); iii) irrigation with TW, except in stage II of fruit development when RW was used (TWc); and iv) irrigation with RW except in stage II when TW was used (RWc). Soil salinity indicators increased in all treatments with respect to Control, except for TWc in winter. However, this increase only led to reductions in net photosynthesis and stomatal conductance in the RW treatment, while gas exchange parameters of trees from TWc and RWc were not negatively affected. Tree vegetative growth was only affected in the long-term, with trees from the RWc treatment having greater canopies. Yield was increased in the TWc and RWc treatments by 23.1 % and 29.5 %, respectively; while it was reduced by 23.5 % in RW when compared to TW. Likewise, differences among treatments in fruit quality traits were also detected. Our results suggest that combining water from different sources could be a viable alternative for irrigating mandarin trees under semiarid conditions with savings of approximately 50 % of fresh water, although the sustainability of soil health should be ensured. In addition, further research is needed to adapt these strategies to other species and cultivar-rootstock combinations.

AbstractThe lack of understanding and application of marketing in universities necessitates research to improve satisfaction, permanence, lasting relationships, and brand identity, and to promote creativity and innovation in education. The objective of this research is to identify how higher education management innovates to build brand identity. Methodologically, the conceptual model is tested using data from 231 teachers in seven accredited Colombian universities. For data analysis, the partial least squares structural equation model is used. The study highlights the importance of incorporating teachers as a key factor in the enactment of relational marketing strategies in the management of higher education. Suggestions are provided for universities to build a marketing culture and brand identity. Among the conclusions, the importance of retaining existing students and involving teachers in marketing strategies is highlighted. Emphasis is placed on identity management and relational marketing as key to improving the image and reputation of universities. This study is expected to be a starting point to explore the construct of trust, satisfaction, and loyalty in the academic field, recognizing the strategic role of teachers in marketing strategies.

PURPOSEBreast cancer remains a major public health challenge worldwide, and understanding the trends and changes in breast cancer diagnosis and treatment over time is crucial for improving patient outcomes and guiding public health strategies. The Argentine Society of Mastology has maintained a comprehensive Breast Cancer Registry that provides valuable data for analyzing these trends.MATERIALS AND METHODSThis retrospective analysis of the Breast Cancer Registry database evaluated changes in stages at the time of surgery, patterns of surgical care, and factors associated with higher stage diagnoses in patients with breast cancer in Argentina from January 2000 to December 2019.RESULTSOverall, 13,239 patients met the inclusion criteria. Significant differences were observed in the axillary procedure performed, with sentinel lymph node biopsy increasing from 14.9% (2000-2004) to 69.5% (2015-2019; P < .001). A higher proportion of in situ carcinoma was detected in the last 5-year period compared with the first (11.3% v 9.4%; P = .01) and fewer patients were stage III (17.1% v 14.2%). In multivariate analysis, postmenopausal status (odds ratio [OR], 0.72 [95% CI, 0.64 to 0.80]; P < .001), health coverage (social health insurance OR, 0.53 [95% CI, 0.46 to 0.61]; P < .001 and private insurance OR, 0.36 [95% CI, 0.31 to 0.42]; P < .001), tumor grade (grade 3 OR, 2.97 [95% CI, 2.54 to 3.47]; P < .001), and phenotype (hormone receptor-positive [HR+]/human epidermal growth factor receptor 2 [HER2]+ OR, 1.36 [95% CI, 1.10 to 1.70]; P = .005; HR–/HER2+ OR, 2.14 [95% CI, 1.62 to 2.83]; P < .001; HR–/HER2– OR, 1.40 [95% CI, 1.19 to 1.66]; P < .001) were associated with the risk of diagnosis at stages II-III.CONCLUSIONSignificant advances in the patterns of surgical care were identified. Numerous clinical and pathologic factors correlated with higher stage at diagnosis. However, multivariate analysis failed to show a noteworthy reduction in stage at diagnosis. This observation underscores the imperative to persistently strive to improve breast cancer care in Argentina.

Cervical cancer is a significant public health issue in Mexico and many developing countries. Early detection is crucial for combating this disease. The official screening test for cervical cancer is cytology, but this technique faces several barriers, including methodological, educational, and sociocultural challenges. Liquid-based cytology is an improved version of this test, however it does not address the aforementioned complications. Biomarkers for cervical precursor lesions and cervical cancer can improve timely detection of the disease. A previous study from our group identified four circulating human proteins as potential biomarkers for these conditions. For molecular screening, we selected GAPDH as the biomarker for cervical precursor lesions and HNRNPA1 as the biomarker for cervical cancer -chosen from the three previously identified options based on antibody availability- to be detected in sera. Participants underwent a comprehensive panel of tests, including liquid-based cytology, PCR detection of Human papillomavirus (HPV), colposcopy, and histopathology -when applicable-. The last two tests were used as references for determining sensitivity and specificity, with histopathology being the gold standard for cervical cancer diagnosis. All the participants successfully received colposcopies (n = 99) and only those women with visible or suspected cervical lesions/malignancies were biopsied (n = 62). A subset of randomly selected biopsies underwent p16INK4a immunohistochemistry (n = 36). This study compares the performance of liquid-based cytology with the molecular screening. With colposcopy as reference, liquid-based cytology showed 30% sensitivity and 96% specificity, while the molecular screening showed 90% sensitivity and 43% specificity. With histopathology as reference, liquid-based cytology showed 21% sensitivity and 93% specificity, while the molecular screening showed 85% sensitivity and 61% specificity. The molecular screening outperformed the liquid-based cytology in several areas, including detecting true-positive cases, reducing false-negative cases by 34.62%, application time, simplicity of result´s categories, and acceptance among participants. An ideal screening test requires high sensitivity, maintains moderate specificity, and minimizes false negatives. Our proposed screening test meets these criteria, making it an ideal complement -or alternative- for cervical cancer screening.

Background: Our objective was to assess the effect of a hybrid telemedicine approach, in conjunction with face-to-face follow-up, on the quality of life in recent users of an advanced hybrid closed-loop (AHCL) system. Methods: A 1-year open randomized (1:1) clinical trial (ClinicalTrials.gov ID NCT04900636). Participants with type 1 diabetes (T1D) recent users of an AHCL system (Minimed ® 780G) for at least 2–6 months, and ⩾18 years old were eligible. The primary outcome was the change in quality of life measured by the Type 1 Diabetes Life (ViDa1) Questionnaire from baseline to 12 months of hybrid telemedicine plus face-to-face follow-up compared to standard clinical practice. Additionally, impacts on A 1c levels, glucose metrics, advert events, and safety outcomes were assessed. Results: Between January and December 2021, 46 participants were randomly assigned in a 1:1 ratio to either the hybrid telemedicine group ( n = 23) or the control group ( n = 23); 45 participants completed the study, with only 1 from the control group withdrawing before visit 3. At baseline, mean age was 37 ± 15 years and A 1c was 6.9 ± 0.5%. After 12 months, no statistically significant differences in ViDa1 scores between groups were observed. Despite reducing in-person visits in the hybrid follow-up arm, there were no increases in adverse events. Overall, A 1c levels significantly decreased from 6.9 ± 0.5% at baseline to 6.7 ± 0.5% after 12 months ( P = 0.006) without differences between treatment arms, accompanied by reductions in glycemic variability and time below the target range. Conclusion: Our study suggests that there were no significant differences in ViDa1 scores between the two groups at the end of the follow-up. However, among adult patients with T1D who recently adopted an AHCL system, satisfactory glycemic control can be attained through a hybrid follow-up approach, reducing face-to-face visits, without increasing technical complications.

El objetivo de este artículo fue realizar un análisis de la transición de la Gestión de Calidad Total a la Calidad 5.0. Se empleó una metodología de revisión sistemática, sintetizando datos de artículos académicos y estudios de caso publicados entre 1980 y 2023, utilizando el análisis de contenido para identificar temas clave en la gestión de la calidad y las teorías organizacionales. Los hallazgos revelaron que la Calidad 5.0 supera a la Gestión de Calidad Total al incorporar aspectos de sostenibilidad ambiental, personalización y tecnología avanzada, como la inteligencia artificial, presentando un enfoque más integral ante los desafíos contemporáneos, reflejando una evolución hacia un modelo de gestión de calidad más integrador y adaptable. Se concluye que la adopción de Calidad 5.0 facilita una mejor preparación para enfrentar la competencia en ambientes de negocio dinámicos y complejos. Sin embargo, se identifica la necesidad de más investigación empírica para validar los conceptos de Calidad 4.0 y 5.0 en diversos contextos, considerando la variabilidad de la literatura y la rápida evolución tecnológica. Este estudio se distingue por su enfoque exhaustivo al examinar la transición de la Gestión de Calidad Total a Calidad 5.0 y sus implicaciones para la adaptabilidad organizacional.

Abstract Cholesterol-dependent cytolysins (CDCs) comprise a large family of pore-forming toxins produced by Gram-positive bacteria, which are used to attack eukaryotic cells. Here, we functionally characterize a family of 2-component CDC-like (CDCL) toxins produced by the Gram-negative Bacteroidota that form pores by a mechanism only described for the mammalian complement membrane attack complex (MAC). We further show that the Bacteroides CDCLs are not eukaryotic cell toxins like the CDCs, but instead bind to and are proteolytically activated on the surface of closely related species, resulting in pore formation and cell death. The CDCL-producing Bacteroides is protected from the effects of its own CDCL by the presence of a surface lipoprotein that blocks CDCL pore formation. These studies suggest a prevalent mode of bacterial antagonism by a family of two-component CDCLs that function like mammalian MAC and that are wide-spread in the gut microbiota of diverse human populations.

Esta disertación parte del objetivo centrado en analizar cómo la mediación do-cente impacta la enseñanza de estudiantes autistas en la educación preescolar del Colegio Calasanz de Cúcuta, Norte de Santander. Su metodología tiene sustento en un enfoque crí-tico-social y en un estudio cualitativo fundamentado en la Investigación Basada en Dise-ño. Los resultados revelan que, en el diagnóstico inicial, las actividades de las docentes de preescolar mostraban un bajo uso de herramientas tecnológicas. Sin embargo, el diseño e implementación de actividades con Exelearning generó expectativas positivas tanto en los investigadores como en los participantes. Durante los grupos de discusión, se llegó a un consenso de que Exelearning es altamente funcional. Se concluye que Exelearning ofrece un espacio interactivo donde los docentes pueden aplicar su creatividad en la enseñanza. Esta interactividad, junto con la facilidad de creación y administración, ha facilitado un trabajo colaborativo entre los docentes en el desarrollo de actividades.

Abstract Background Cardiotoxicity is a recognized complication in breast cancer (BC) patients undergoing chemotherapy with anthracyclines with or without trastuzumab. However, the prognostic value of heart rate variability (HRV) indexes for early cardiotoxicity development remains unknown. Methods Fifty BC patients underwent TTE assessment before and three months after chemotherapy. HRV indexes were obtained from continuous electrocardiograms in supine position with spontaneous breathing, active standing, and supine position with controlled breathing. The magnitude of change (Δ) between supine-standing and supine-controlled breathing was calculated. Variables were compared using t-test or ANOVA. Cardiotoxicity predictive value was assessed by ROC curve analysis. A p value of

Abstract Background Most patients suffering from Leber hereditary optic neuropathy carry one of the three classic pathologic mutations, but not all individuals with these genetic alterations develop the disease. There are different risk factors that modify the penetrance of these mutations. The remaining patients carry one of a set of very rare genetic variants and, it appears that, some of the risk factors that modify the penetrance of the classical pathologic mutations may also affect the phenotype of these other rare mutations. Results We describe a large family including 95 maternally related individuals, showing 30 patients with Leber hereditary optic neuropathy. The mutation responsible for the phenotype is a novel transition, m.3734A > G, in the mitochondrial gene encoding the ND1 subunit of respiratory complex I. Molecular-genetic, biochemical and cellular studies corroborate the pathogenicity of this genetic change. Conclusions With the study of this family, we confirm that, also for this very rare mutation, sex and age are important factors modifying penetrance. Moreover, this pedigree offers an excellent opportunity to search for other genetic or environmental factors that additionally contribute to modify penetrance.