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High dropout rates constitute a major concern for higher education institutions, due to their economic and academic impact. The problem is particularly relevant for institutions offering online courses, where withdrawal ratios are reported to be higher. Both the impact and these high rates motivate the implementation of interventions oriented to reduce course withdrawal and overall institutional dropout. In this paper, we address the identification of populations of learners at risk of withdrawing from higher education online courses. This identification is oriented to design interventions and is carried out using survival analysis. We demonstrate that the method's longitudinal approach is particularly suited for this purpose and provides a clear view of risk differences among learner populations. Additionally, the method quantifies the impact of underlying factors, either alone or in combination. Our practical implementation used an open dataset provided by The Open University. It includes data from more than 30,000 students enrolled in different courses. We conclude that low-income students and those who report a disability comprise risk groups and are thus feasible intervention targets. The survival curves also reveal differences among courses and show the detrimental effect of early dropout on low-income students, worsened throughout the course for disabled students. Intervention strategies are proposed as a result of these findings. Extending the entire refund period and giving greater academic support to students who report disability are two proposed strategies for reducing course withdrawal.

The main objective of this study is the design and validation of an educational methodological model based on the use of immersive technological resources (Augmented Reality -- AR) to improve learning processes in secondary education science subjects (Biology and Geology). The process was developed based on three main quantitative studies: an exploratory study, a study of performance divided into three cases studies, and an attitudinal study. The information obtained was completed with a fourth qualitative study of the training of teachers who participate in educational technology. This research provides empirical evidence that allows validation of the methodological model developed to explain key concepts and to improve the level of motivation and acceptance of AR technology by students. The proposed model can induce improvements in educational processes in the field of STEAM when used with an immersive AR technological resource and an adapted digital evaluation system. It also demonstrates that teachers require specific training in connection with the creation and the adequate use of AR educational resources, and of digital evaluation systems as well. The results of this study have important implications for the field of education, demonstrating the potential of AR technology to improve learning outcomes and the need for teacher training in its use.

Academic institutions dedicate a substantial effort to ensure the academic success of their students. At the course level, teachers recommend learning paths (RLPs) for students to guarantee the achievement of their learning outcomes. In terms of performance, these kinds of approaches are deemed more effective than others based uniquely on performing a collection of independent activities. However, there is neither systematic means to validate if following the learning path (LP) is effective, nor to assess whether and to what extent students adhere to these recommendations. This article introduces a novel technique for modeling recommended LPs, including not only an evaluation of path utility, but also a quantitative measure of student adherence thereto using process mining, and more precisely, log skeletons. Following an event abstraction process regarding real student-recorded activity, a scoping process is employed to retain the trajectories that adhere to the prescribed LP. The method based on process mining is translated into practice by considering an online university mathematics course. Results confirm the applicability of the method and, in this case, reveal that adhering to the suggested path correlates positively with final grades. Few students strictly follow the prescribed LP, although the vast majority support it. The method can be easily applied to overcome several challenges associated with enhancing academic performance from the learning analytics perspective.

Abstract Background Lyme disease continues to expand in Canada and the USA and no single intervention is likely to curb the epidemic. Methods We propose a platform to quantitatively assess the effectiveness of a subset of Ixodes scapularis tick management approaches. The platform allows us to assess the impact of different control treatments, conducted either individually (single interventions) or in combination (combined efforts), with varying timings and durations. Interventions include three low environmental toxicity measures in differing combinations, namely reductions in white-tailed deer (Odocoileus virginianus) populations, broadcast area-application of the entomopathogenic fungus Metarhizium anisopliae, and fipronil-based rodent-targeted bait boxes. To assess the impact of these control efforts, we calibrated a process-based mathematical model to data collected from residential properties in the town of Redding, southwestern Connecticut, where an integrated tick management program to reduce I.xodes scapularis nymphs was conducted from 2013 through 2016. We estimated parameters mechanistically for each of the three treatments, simulated multiple combinations and timings of interventions, and computed the resulting percent reduction of the nymphal peak and of the area under the phenology curve. Results Simulation outputs suggest that the three-treatment combination and the bait boxes–deer reduction combination had the overall highest impacts on suppressing I. scapularis nymphs. All (single or combined) interventions were more efficacious when implemented for a higher number of years. When implemented for at least 4 years, most interventions (except the single application of the entomopathogenic fungus) were predicted to strongly reduce the nymphal peak compared with the no intervention scenario. Finally, we determined the optimal period to apply the entomopathogenic fungus in residential yards, depending on the number of applications. Conclusions Computer simulation is a powerful tool to identify the optimal deployment of individual and combined tick management approaches, which can synergistically contribute to short-to-long-term, costeffective, and sustainable control of tick-borne diseases in integrated tick management (ITM) interventions. Graphical Abstract

Abstract Background To better understand the influence of habitat on the genetic content of bacteria, with a focus on members of Candidate Phyla Radiation (CPR) bacteria, we studied the effects of transitioning from soil via seepage waters to groundwater on genomic composition of ultra-small Parcubacteria, the dominating CPR class in seepage waters, using genome resolved metagenomics. Results Bacterial metagenome-assembled genomes (MAGs), (318 total, 32 of Parcubacteria) were generated from seepage waters and compared directly to groundwater counterparts. The estimated average genome sizes of members of major phyla Proteobacteria, Bacteroidota and Cand. Patescibacteria (Candidate Phyla Radiation – CPR bacteria) were significantly higher in soil-seepage water as compared to their groundwater counterparts. Seepage water Parcubacteria (Paceibacteria) exhibited 1.18-fold greater mean genome size and 2-fold lower mean proportion of pseudogenes than those in groundwater. Bacteroidota and Proteobacteria also showed a similar trend of reduced genomes in groundwater compared to seepage. While exploring gene loss and adaptive gains in closely related CPR lineages in groundwater, we identified a membrane protein, and a lipoglycopeptide resistance gene unique to a seepage Parcubacterium genome. A nitrite reductase gene was also identified and was unique to the groundwater Parcubacteria genomes, likely acquired from other planktonic microbes via horizontal gene transfer. Conclusions Overall, our data suggest that bacteria in seepage waters, including ultra-small Parcubacteria, have significantly larger genomes and higher metabolic enrichment than their groundwater counterparts, highlighting possible genome streamlining of the latter in response to habitat selection in an oligotrophic environment.

Chronic kidney disease (CKD) has severe consequences on the quality and expectancy of life and is considered a major health problem worldwide. This is, especially relevant in pediatric patients, as they have unique characteristics and a mortality rate 30 times higher (in advanced stages) than healthy people. This review aims to define the minimum components for the diagnostic approach and monitoring of CKD in the pediatric population from primary health care to promote comprehensive care and adequate risk management. For this purpose, we performed a systematic review of the literature with a panel of experts. Based on the evidence, to optimize the definition, diagnosis, and timely treatment of CKD in the pediatric population, we formulated 21 recommendations. These were approved by the research team and peer-reviewed by clinical experts. They will facilitate the definition of the diagnostic approach for CKD in the pediatric population in primary health-care settings, allowing for timely treatment intervention, comprehensive care, and monitoring of this disease.

In portfolio theory, the investment portfolio optimization problem is one of those problems whose complexity grows exponentially with the number of assets. By backtesting classical and quantum computing algorithms, we can get a sense of how these algorithms might perform in the real world. This work establishes a methodology for backtesting classical and quantum algorithms in equivalent conditions, and uses it to explore four quantum and three classical computing algorithms for portfolio optimization and compares the results. Running 10 000 experiments on equivalent conditions we find that quantum can match or slightly outperform classical results, showing a better escalability trend. To the best of our knowledge, this is the first work that performs a systematic backtesting comparison of classical and quantum portfolio optimization algorithms. In this work, we also analyze in more detail the variational quantum eigensolver algorithm, applied to solve the portfolio optimization problem, running on simulators and real quantum computers from IBM. The benefits and drawbacks of backtesting are discussed, as well as some of the challenges involved in using real quantum computers of more than 100 qubits. Results show quantum algorithms can be competitive with classical ones, with the advantage of being able to handle a large number of assets in a reasonable time on a future larger quantum computer.

Introducción: En el trasplante renal de donante vivo, la percepción de la situación de enfermedad y la vivencia personal influyen de forma significativa en la adaptación emocional y el afrontamiento de la persona. Objetivo: Conocer el significado que atribuyen las personas con trasplante renal de donante vivo a su enfermedad y a su tratamiento, y detectar si existen cambios antes y después trasplante. Material y Método: Estudio cualitativo fenomenológico. Participaron 7 personas con enfermedad renal que recibieron un trasplante renal de donante vivo preventivo. Se obtuvieron los datos mediante entrevistas semiestructuradas y observación cualitativa. Resultados: Del análisis temático de las entrevistas emergieron tres temas: sin sentimiento de enfermedad (no se sentían enfermos ni a nivel físico ni psicológico); sin necesidad de trasplantarse (la enfermedad no les alteró su vida, pero confiaron en los profesionales y aceptaron la cirugía); y trasplantarse para mantener el mismo modo de vida (para evitar la diálisis y recuperar actividades). Conclusiones: El significado de la enfermedad y del trasplante renal cambian según la etapa (pre o post trasplante) en la que esté el paciente: la identificación de la enfermedad está relacionada con la presencia de sintomatología, con la sintomatología física y con las rutinas de toma de medicación diarias y visitas de seguimiento; y el trasplante renal, significa evitar la diálisis, hacer la misma vida, superar un reto y recuperar la condición física.

A prototype of a hydrodynamic cavitation reactor was evaluated to determine the effectiveness of this system on the percentage decrease of cephalexin concentration present in an aqueous solution prepared with ultrapure water. The process variables or factors were pH [5 and 9], number of holes in the cavitation plate [5 and 7] and reaction time (30 min and 60 min). The results indicate that the percentage removal of Cephalexin (CFX) and total organic carbon (TOC) depends on the variables studied and the interaction between them. The highest yields were achieved at pH 5, 5 holes in the cavitation plate and 60 min of reaction reaching values of 24.16 % for CFX and 16.8 % for TOC. It was determined that, for the lowest number of holes in the cavitation plate and acid pH, the phenomenon that guides the process is the hydrodynamic cavitation, when increasing the number of holes and therefore decreasing the intensity of cavitation, the pH becomes more relevant and has incidence on the performance of the analyzed process. On the other hand, it was determined that, also in reaction times of 30 min, removal values very close to the maximum values obtained are achieved. The process can be intensified by the simultaneous application of other advanced oxidation processes to increase the effectiveness.

Wastewater-based epidemiology (WBE) aims to understand a population’s consumption habits, exposure to chemicals, and the prevalence of specific diseases or pathogens. This is achieved by the chemical or biological/genomic determination of biomarkers (e.g., excreted metabolic products), which are in urban wastewater generated by that population. WBE has been mostly linked to the determination of small molecules of human origin using liquid-chromatography mass spectrometry (LC-MS). In this Perspective, we provide a state-of-the-art and critical evaluation of further developments in the information achieved by determining small molecules as well as the most promising analytical techniques to enlarge the information obtained. By simultaneously monitoring small and large molecules we can comprehensively trace the population’s health by their consumption of prescribed pharmaceuticals and illegal drugs, as well as by the amount of excreted macromolecule biomarkers such as peptides and proteins. Moreover, species-specific protein sequences allow us to monitor animal populations reflecting farming and slaughterhouse activities (poultry, pigs…) or pest occurrences (rats). To this end, the capability of proteomic studies using high-resolution tandem mass spectrometry is highlighted and compared in the context of other advances in the broader field of high-resolution mass spectrometry (HRMS).

Las políticas públicas pueden interpretarse como el resultado de la toma de decisiones de los Gobiernos, que se construye a partir de las preferencias, expresadas en el Parlamento mediante discursos políticos. Objetivos: identificar cuáles son las preferencias y objetivos introducidas en la agenda de los Gobiernos autonómicos para profundizar en el papel que estos juegan dentro de la gobernanza del sistema de educación superior. Metodología: a través del análisis documental de los discursos de investidura de cuatro casos autonómicos españoles (Andalucía, Cataluña, Galicia y Madrid), se identifican las preferencias gubernamentales en educación superior e investigación y desarrollo entre 1980 y 2021. Asimismo, se describe la diversidad territorial y el cambio de la gobernanza del sistema de educación superior a lo largo del tiempo. Resultados: se han identificado variaciones territoriales en la gobernanza del sistema de educación superior, así como diferencias en la conexión entre las materias de educación superior e investigación y desarrollo. Conclusiones: la gobernanza del sistema de educación superior ha transitado hacia la autorregulación y supervisión estatal, aunque dicha tendencia dista de ser general, dado que se establecen estrategias diferenciadas en el nivel autonómico, algunas de ellas compatibles con formas tradicionales de planificación racional y control del sistema de educación superior.

Introduction Since its beginning in the 1970s in Wisconsin, Assertive Community Treatment (ACT), has been adopted by numerous hospitals worldwide. It improves outcomes for people who are most at-risk of psychiatric hospitalization. The main goal is to provide a global attention with a focus on promoting maximum autonomy and facilitating integration into society. In 2012, the Health Care Complex of Zamora, Spain, adopted this pioneering approach to Mental Health. The main efforts were focused on creating a community network for individuals with severe mental disorders. It embraced a biopsychosocial model of intervention aimed at facilitating patient recovery, giving them tools to create a new life project based on their own autonomy. Objectives The primary objective of this study was to assess the progress of the Assertive Community Treatment (ACT) since its introduction at the Health Care Complex of Zamora, with a specific focus on analyzing the number of hospitalizations as the dependent variable. Methods A quantitative analysis about psychiatry number of hospitalizations was conducted using the database of the Zamora’s Psychiatry Hospitalization Unit. SPSS Statistics for Windows was used to calculate statistical values related to number of hospitalization. The dataset covers de period from 2010 to 2017. Results The implementation of ACT has resulted in a significant reduction in hospitalizations reaching up to 75% in the Psychiatry Service of Zamora. It has been revealed a decrease from 17107 hospitalizations registered in 2011 to a total reduction to 4869 stances in 2013. A consistent trend in the reduction of hospitalizations has been observed (figure 1).A restructuration of the Hospitalization Unit was performed in order to implement de community model and reduce hospitalizations. Removal of more than 50% of the beds was developed.Besides, there has been implemented a community subunit with the objective of regaining their autonomy after a psychiatric exacerbation. Image: Conclusions Getting hospitalized in a Psychiatry Unit can have many different socio-laboral consequences. The ACT model has demonstrated a significative reduction in hospitalizations and it has evolved into a support network dedicated the integration of individuals that are usually left behind by society. Moreover, it presents itself as a positive cost-benefit intervention.ACT allows us to envision a future with fewer hospitalization and greater integration of mental health patients into modern society. It is important to emphasize that the city of Zamora possesses unique characteristics that have facilitated the adaptation of this model. Not only are the rental prices for housing usually affordable, but the city’s small size, which easy walking, allows for easy access to Community Mental Health resources and services. Disclosure of Interest None Declared

Listeriosis is a disease caused by L. monocytogenes, a relevant microorganism as a causative agent of foodborne diseases - FBD. This study aimed to evaluate the distribution of Listeria spp., and L. monocytogenes in different production areas in two small plants (A and B) and two micro-food processing plants (C and D) producing meat derivatives, located in different cities of Colombia. The methodology implemented was i. The analysis of sampling points is based on a harmonised tool. ii. Four samplings in each production plant between 2019 and 2020. iii. Isolation and identification of microorganisms through conventional microbiology, a semi-automated system, molecular serotyping and clonal characterisation by ERIC-PCR. L. monocytogenes frequency in the production plants belonging to the study ranged between 5.9 and 28.6 %; for Listeria spp., plants A and D had isolated, plant A had the highest proportion, while for L. monocytogenes geno-serotypes found were: 1/2a, 1/2c, 4a-4c, 4b, 4d - 4e, with geno-serotype 4b as the most frequent. Furthermore, possible persistent isolates were detected in plant C as the feasible sources of contamination, based on failures in flow management, raw material contaminated with L. monocytogenes, lack of standardised cooking processes and transfer of the microorganism through equipment and surfaces. Finally, in three of the four production plants assayed, L. monocytogenes or Listeria spp. were present in the packaging area in some of the samples taken during the study, which calls for increased and frequent monitoring, as well as constant technical support for the control of L. monocytogenes in micro and small-scale production plants.

Abstract Objective To improve susceptibility profiles of nosocomial bacteria, identifying the difference between infectious complications in patients undergoing endoscopic flexible ureterolithotomy (fURS) with negative urine culture (UC) that received extended antibiotic prophylaxis (EP) compared with standard antibiotic prophylaxis (SP). Methodology This is a retrospective, observational, analytical cohort study, comparing infectious complications between patients undergoing fURS with negative UC who received EP versus SP. We include patients with susccessfull fURS,

Objectives. Atypical hemolytic uremic syndrome (aHUS) is a rare complement-mediated kidney disease with genetic predisposition and represents up to 10% of pediatric hemolytic uremic syndrome (HUS) cases. Few studies have evaluated aHUS in Latin American population. We studied a Colombian pediatric cohort to delineate disease presentation and outcomes. Methods. A multicenter cohort of 27 Colombian children with aHUS were included. Patients were grouped by age at onset. Clinical features were compared using analysis of variance (ANOVA) and Fisher exact tests. Renal biopsy was performed on 6 patients who were suspected of having other renal diseases before aHUS diagnosis. Results. Most patients were male (70%). The onset of aHUS occurred frequently before age 4 years (60%) and followed gastroenteritis as the main triggering event (52%). Age groups showed comparable clinical presentation, disease severity, treatment, and outcomes. Pulmonary involvement (67%) was the main extrarenal manifestation, particularly in the 1 to 7 age group ( P = .01). Renal biopsies were as follows: 3 had membranoproliferative glomerulonephritis (MPGN) type I, one MPGN type III, one C3-glomerulonephritis, and one rapidly progressive GN. Genetic screening was available in 6 patients and identified 2x CFHR5 , 2xMCP , 1x ADAMTS13/THBD , and 1x DGKE mutations. A total of 15 relapses were seen, of which 8 (72%) occurred in the 1 to 7 age group. The renal outcome was not significantly different regardless of age group. Conclusion. In our cohort, we observed a relatively high frequency of extrarenal involvement at first presentation represented by pulmonary manifestations. The renal prognosis at initial presentation was worse than in previous reports.