Causes and consequences of chromosome segregation errors in the mouse preimplantation embryo

La division cellulaire est un processus biologique universel nécessaire à la reproduction, au développement, à la survie cellulaire ainsi qu’à la réparation des tissus. Une ségrégation chromosomique exacte pendant la mitose est essentielle pour une répartition égale des chromosomes répliqués entre les cellules filles. Des erreurs dans la ségrégation des chromosomes mènent à une condition appelée aneuploïdie, définie par un nombre inadéquat de chromosomes dans une cellule. L’aneuploïdie est associée à une altération de la santé cellulaire, la tumorigénèse, des malformations congénitales et l'infertilité. Contre toute attente, les embryons préimplantatoires de mammifères, dont les humains, consistent souvent en un mélange de cellules euploïdes et de cellules aneuploïdes. Ce mosaïcisme est inexorablement causé par des erreurs dans la ségrégation des chromosomes au cours des divisions mitotiques suivant la fécondation et est associé à un potentiel de développement réduit lors des traitements de fertilité. Malgré sa découverte il y a 25 ans, les mécanismes qui sous-tendent l’apparition de l'aneuploïdie mosaïque dans les embryons préimplantatoires sont toujours méconnus. Pour explorer les causes et les conséquences des erreurs de ségrégation chromosomique, des approches d'imagerie de fine pointe ont été utilisées sur des embryons préimplantatoires murins. L'analyse de la dynamique de la ségrégation des chromosomes via l’imagerie de cellules vivantes a permis d’identifier les chromosomes retardataires, lors de l’anaphase, comme la forme la plus répandue des erreurs de ségrégation. Ces chromosomes retardataires entraînent fréquemment une encapsulation de chromosome unique dans une structure appelée micronoyau. D'autres expériences d'imagerie par immunofluorescence sur des cellules vivantes ou fixées ont révélé que les chromosomes des micronoyaux subissent des dommages importants à l'ADN et sont mal répartis de manière récurrente lors des divisions cellulaires subséquentes dans la phase préimplantatoire. D’autres approches ont aussi permis d’examiner l'efficacité du mécanisme de contrôle de l’assemblage du fuseau mitotique, (SAC pour Spindle Assembly Checkpoint). Les résultats obtenus attestent que le SAC fonctionne, cependant la signalisation liée au SAC n’est pas efficace et ne permet pas de différer l'anaphase, malgré la présence de chromosomes retardataires et ce indépendamment de la taille des cellules. Les résultats présentés révèlent aussi qu’une inhibition partielle d’une cible du SAC, le complexe de promotion de l'anaphase (APC/C), cause une mitose prolongée et une réduction des erreurs de ségrégation. En outre, les études présentées démontrent que la fonction déficiente du SAC pendant le développement préimplantatoire est la cause principale d’une forte incidence de chromosomes retardataires qui entraînent une mauvaise ségrégation chromosomique répétée et qui causent une aneuploïdie mosaïque dans l’embryon. De plus, ce travail fournit la preuve que la modulation pharmacologique de la signalisation SAC-APC/C permet d’éviter les erreurs de ségrégation des chromosomes dans les embryons précoces. En conclusion, ces résultats apportent de nouvelles perspectives sur les causes et la nature des erreurs de ségrégation chromosomique dans les embryons. De plus, ce travail apporte de nouvelles explications mécanistiques sur l'apparition du mosaïcisme dans les embryons ce qui aura des implications importantes dans la détection et la prévention thérapeutique potentielle de l'aneuploïdie mosaïque dans les embryons préimplantatoires.Cell division is a universal biological process necessary for reproduction, development, cell survival and the maintenance and repair of tissues. Accurate chromosome segregation during mitosis is essential to ensure replicated chromosomes are partitioned equally into daughter cells. Errors in chromosome segregation often result in cells with abnormal numbers of chromosomes, a condition termed aneuploidy, which is associated with impaired cellular health, tumorigenesis, congenital defects and infertility. Counterintuitively, preimplantation embryos from many mammalian species, including humans, often consist of a mixture euploid and aneuploid cells. Such mosaic aneuploidy in embryos is inexorably caused by errors in chromosome segregation during mitotic divisions following fertilization and has been associated with reduced developmental potential in fertility treatments. However, ever since its discovery 25 years ago, how and why mosaic aneuploidy arises in the preimplantation embryo has remained elusive. To explore the causes and consequences of embryonic chromosome segregation errors, advanced imaging approaches were employed in the mouse preimplantation embryo. Live cell imaging analysis of chromosome segregation dynamics identified lagging anaphase chromosomes as the most prevalent form of chromosome mis-segregation in embryos. Lagging chromosomes frequently result in the encapsulation of single chromosomes into micronuclei, which occur in embryos in vitro and in vivo. Further live imaging and immunofluorescence experiments revealed chromosomes within micronuclei are subject to extensive DNA damage and centromeric identity loss, failing to assemble functional kinetochores and being recurrently mis-segregated during ensuing cell divisions in preimplantation development. To uncover the underlying causes for the increased propensity for chromosome mis-segregation in embryos, live imaging and loss-of-function approaches were used to examine the effectiveness of the mitotic safeguard mechanism, the Spindle Assembly Checkpoint (SAC). These studies demonstrated that the SAC normally functions to prevent segregation errors during preimplantation development but SAC signaling at misaligned chromosomes fails to delay anaphase. Moreover, SAC failure in embryos is most evident during mid-preimplantation development, independent of cell size. Partial inhibition of SAC target, the Anaphase Promoting Complex (APC/C), extended mitosis and reduced chromosome segregation errors in embryos. These studies have uncovered deficient SAC function during preimplantation development as a major cause for the high incidence of lagging chromosomes in embryos, which result in repeated mis-segregation of single chromosomes in a manner that necessarily causes mosaic aneuploidy. Additionally, this work provides proof-of-principle demonstration that pharmacological modulation of SAC-APC/C signalling can avert chromosome segregation errors in the early embryo. Altogether, these findings present new insights into the causes and nature of chromosome mis-segregation in embryos, providing novel mechanistic explanations for the occurrence of mosaicism that will have substantial implications for the detection and potential therapeutic prevention of aneuploidy in preimplantation embryos

Ablación precoz o diferida de la taquicardia ventricular en pacientes con cardiopatía isquémica y desfibrilador automático implantable

[ES] La ablación con catéter de la taquicardia ventricular (TV) reduce la carga de la misma en pacientes con desfibrilador automático implantable (DAI). No obstante, el momento adecuado de la ablación y sus efectos clínicos y pronósticos continúan siendo objeto de debate. El objetivo del estudio será comparar los resultados de la ablación precoz de TV (realizada antes de la implantación del DAI) y la ablación diferida de TV (después de ≥3 descargas del DAI) en pacientes con arritmias potencialmente mortales con indicación del DAI en prevención secundaria.[EN] Catheter ablation for ventricular tachycardia (VT) reduces the recurrence of VT in patients with implantable cardioverter-defibrillators (ICDs).Nevertheless, the appropriate timing of VT ablation and its effects on prognosis remain a matter of debate. In patients with life-threatening arrhythmias necessitating ICD implantation, we compared outcomes of preventive VT ablation (undertaken before ICD implantation) and deferred ablation (after ≥3 ICD shocks for VT)

ESTRUCTURA ESPACIO‐TEMPORAL DE LA DIVERSIDAD TAXONÓMICA Y FUNCIONAL DE COLIBRÍES EN LA RESERVA DE LA BIOSFERA EL TRIUNFO, CHIAPAS, MÉXICO

RESUMEN ∙ La diversidad taxonómica y funcional de las comunidades de aves está determinada por la distribución espacio‐temporal y la densidad de las poblaciones de las especies que las integran. La diversidad puede variar según el gradiente de elevación, en general al aumentar la elevación se reduce la riqueza de especies, como es el caso en algunas comunidades de colibríes (Trochilidae). En este estudio se evaluó la distribución, la densidad, la diversidad taxonómica y funcional de tres comunidades de colibríes en diferentes elevaciones y temporadas en la Reserva de la Biosfera El Triunfo, Chiapas, México. Establecimos transectos en tres elevaciones (300 a 2500 m s.n.m.), los cuales se recorrieron durante tres temporadas (secas, lluvias y post‐lluvias) de 2015 a 2016. Asimismo, obtuvimos datos morfométricos de las especies para analizar rasgos funcionales (i.e., masa corporal, longitud y curvatura del pico) y evaluar la diversidad funcional de las comunidades. Los resultados indican que la mayor diversidad de colibríes ocurrió en la elevación media, y no hubo variación significativa de la diversidad entre temporadas. De acuerdo a los rasgos funcionales medidos, solo la masa corporal mostró diferencias con la altura, siendo mayor en elevaciones altas. Los valores de la diversidad funcional obtenidos fueron similares entre elevaciones, pero la divergencia fue mayor en la elevación baja, y la especialización fue mayor en elevaciones media y baja. Esto indica una diferenciación de nichos en la elevación baja y un efecto ambiental en la elevación alta, lo que estructuraría las comunidades de colibríes en nuestro sitio de estudio.Abstract ∙ Spatio‐temporal structure of the taxonomic and functional diversity of hummingbirds at the biosphere reserve El Triunfo, Chiapas, Mexico The taxonomic and functional diversity of bird communities is determined by the spatio‐temporal distribution and population density of their constitutive species. Diversity can change along environmental gradients and one of these patterns shows that as the elevation increases bird richness is reduced, as has been observed in some communities of hummingbirds. We evaluated the distribution, taxonomic and functional structure of three hummingbird (Trochilidae) communities at El Triunfo Biosphere Reserve, Chiapas, Mexico. We established transects where we performed counts at three elevations (300 to 2500 m a.s.l.) and during three seasons (dry, rainy, and post‐rainy) from 2015 to 2016. We also obtained morphometric data from the species to analyze functional traits (i.e., body mass, length, and curvature of the bill) and functional diversity. The results indicate that the highest species diversity of hummingbirds occurred at intermediate elevation, and that there was no significant variation in diversity among seasons. Out of the functional traits measured only body mass showed differences, being higher at high elevations. Functional diversity values were similar across elevations, but the divergence was higher at low elevations, and the degree of specialization was higher at medium and low elevations. This suggests a differentiation of niches at low elevations and an environmental filtering effect at high elevation, which structure hummingbird communities at our study site

Valoración de la Ecología de Aprendizaje Autorregulado Virtualizada para la Didáctica de las Ciencias de la Naturaleza durante la crisis COVID-19

University teaching-learning models are being affected by the crisis caused by COVID-19. To address this unleashed crisis, a virtualized self-regulated learning ecology proposal was urgently designed in the subject of Natural Sciences and its Didactics I, of the Degree in Primary Education Teacher, during the confinement of 2020. In this article it is described this learning ecology: the materials produced, the designed environments and the use of teaching-learning strategies based on self-regulated learning, both in virtual teaching and in student tutoring. The objective of this study is to analyze the ecology of self-regulated learning through the students’ appreciation regarding their motivation towards the subject, their opinion on the quality of the materials and on the evaluation, the students’ perception of the teacher’s motivation towards the subject and with respect to the workload of the subject, as well as the general satisfaction of the teaching work. The information was collected using the Student Opinion Questionnaire on the quality of teaching carried out by the University of Burgos. All the items were well valued, so the experience can lay the foundations for the implementation of learning ecologies that can be extrapolated to other university degrees and contexts other than the one implemented here.Los modelos de enseñanza-aprendizaje universitarios están siendo afectados por la crisis originada por la COVID-19. Para atender a esta crisis desencadenada se diseñó de urgencia una propuesta de ecología de aprendizaje autorregulado virtualizada durante el confinamiento de 2020 en la asignatura de Ciencias de la Naturaleza y su Didáctica I del Grado en Maestro de Educación Primaria. En este artículo se describe esta ecología de aprendizaje: los materiales elaborados, los contextos diseñados y la utilización de estrategias de enseñanza-aprendizaje basadas en el aprendizaje autorregulado, tanto durante la docencia virtual como durante la tutorización del alumnado. El objetivo de este estudio es analizar la ecología de aprendizaje autorregulado a través de la apreciación del alumnado con respecto a su motivación hacia la asignatura, su opinión sobre la calidad de los materiales y sobre la evaluación, la percepción del alumnado de la motivación del profesorado hacia la asignatura y respecto a la carga de trabajo de la asignatura, así como la satisfacción general de la labor docente. La información se recabó utilizando el Cuestionario de opinión del alumnado sobre la calidad de la docencia realizado por la Universidad de Burgos. Todos los ítems fueron bien valorados, por lo que la experiencia puede sentar las bases para la implementación de ecologías de aprendizaje que puedan extrapolarse a otras titulaciones universitarias y contextos diferentes al aquí implementado.Universitat de València | Ref. UV-SFPIE_ PID20-135000

Morphology and molecular systematic of marine gregarines (Apicomplexa) from Southwestern Atlantic spionid polychaetes

Gregarines are a common group of parasites that infect the intestines of marine invertebrates, and particularly polychaetes. Here, we describe for the first time four gregarine species that inhabit the intestines of three spionid species: Dipolydora cf. flava, Spio quadrisetosa and Boccardia proboscidea from the Patagonian coast, Argentina, using light and scanning electron microscopy and molecular phylogenetic analyses of small subunit (SSU) rDNA sequences. Even though the spionid species thrive in the same environments, our results showed a high host specificity of the gregarine species. Selenidium cf. axiferens and Polyrhabdina aff. polydorae were both identified from the intestine of D. cf. flava. The new species, Polyrhabdina madrynense sp. n. and Selenidium patagonica sp. n., were described from the intestines of S. quadrisetosa and the invasive species B. proboscidea, respectively. All specimens of D. cf. flava and S. quadrisetosa were infected by gregarines (P?=?100%), recording the highest mean intensity values of infection (MI?=?80; 60 respectively), in contrast to B. proboscidea (P?=?60%; MI?=?38). We associated this finding with the recent invasion of this host. It is expected that in the future, an increase of its population density might favour a rising intensity of this gregarine infection

La relación entre la falta de sueño, el ocio sedentario y el sobrepeso infantil

En esta investigación se estudio, a través del path analysis, la relación entre los hábitos de ocio sedentario, sueño y el índice de Masa Corporal (IMC). Participó una muestra de 72 alumnos, 41 chicas y 31 chicos, de cuarto de primaria con una edad comprendida entre los 9 y los 10 años y medio. Para ello se realizó una entrevista individual en la que se preguntaba a los niños los programas que veían cada uno de los días de la semana y los juegos con los que jugaban con la consola y el ordenador. Los resultados pusieron de manifiesto que los niños que duermen menos emplean más tiempo realizando alguna forma de ocio sedentario y que esto se relaciona a su vez con un IMC más elevado. Se discuten las implicaciones sobre el estudio del estilo de vida y sobrepeso infantil.The objective of this research was to analyse the relations between short sleeping, sedentary leisure and childhood overweight using the path analysis. The sample consisted of 72 participants aged 9 to 10 and half years, 41 girls and 31 boys. One individual interview was used in order to evaluate these variables. The results pointed out that participants with short sleeping spent more time watching TV and playing videogames o using computer and in the same way this type of leisure is related with a higher Body Mass Index. The implications on the study of childhood lifestyle and overweight are discussed

Impact of patatin-like phospholipase domain-containing 3 gene polymorphism (rs738409) on severity of liver disease in HIV/hepatitis C virus-coinfected patients

Objective: To analyze the association between patatin-like phospholipase domain-containing 3 gene (PNPLA3) rs738409 polymorphism and severity of liver disease in HIV/hepatitis C virus-coinfected patients. Methods: We performed a cross-sectional study of 215 patients who underwent a liver biopsy. PNPLA3 rs738409 polymorphism was genotyped using GoldenGate assay. The outcome variables were as follows: advanced fibrosis (F ≥3 and FIB-4 ≥3.25), rapid fibrosis progression (FPR ≥0.10 fibrosis units/year), severe activity grade (A≥3), and steatosis (fatty hepatocytes ≥10%). The genetic association analysis was carried out according to an additive genetic model through logistic regressions adjusted by the most significant covariables. Results: Overall, 21.4% had F at least 3, 8.9% had FIB-4 at least 3.25, 11.4% had A at least 3, 60.6% had steatosis, and 32.5% had FPR at least 0.10. For each rs738409 G allele, we found an increased frequency of patients with advanced fibrosis (F at least 3) (0% CC, 18.5% CG, and 25.2% GG; P = 0.049) and FIB-4 at least 3.25 (0% CC, 3.8% CG, and 13.2% GG; P = 0.016). Furthermore, for each rs738409 G allele, the odds of having F at least 3 increased 2.15 times (95% confidence interval=1.07; 4.35; P = 0.029) and having FIB-4 at least 3.25 increased 8.77 times (95% of confidence interval = 1.11; 69.0; P = 0.039). Note that rs738409 G allele carriers tended to higher likelihood of having FPR at least 0.10, but statistical significance was not reached (P = 0.054). Finally, we did not find any association for A at least 3 and liver steatosis. Conclusion: PNPLA3 rs738409 polymorphism was associated with the severity of liver fibrosis in patients coinfected with HIV and hepatitis C virus, suggesting that this polymorphism might also play a significant role in the progression of hepatic fibrosis in this group of patients.This work has been supported by grants given by Fondo de Investigación de Sanidad en España (FIS) (Spanish Health Founds for Research) (grant numbers PI11/01556, PI14/01094, PI11/00245, PI14CIII/00011), and ‘Fundación para la Investigación y la Prevención del Sida en España’ (FIPSE) (grant number 361020/10). This work has been (partially) funded by the RD12/0017/0024 and RD12/0017/0004 projects as part of the Plan Nacional R+D+I and cofinanced by ISCIII – Subdirección General de Evaluación y el Fondo Europeo de Desarrollo Regional (FEDER). ‘Instituto de Salud Carlos III’ (grant numbers CD12/00442, CD13/00013 and RD12/0017/0024, respectively). This work has been (partially) funded by the RD12/0017 project as part of the Plan Nacional R+D+I and cofinanced by ISCIII – Subdirección General de Evaluación y el Fondo Europeo de Desarrollo Regional (FEDER).S

Mx1, OAS1 and OAS2 polymorphisms are associated with the severity of liver disease in HIV/HCV-coinfected patients: A cross-sectional study

The mechanisms involved in the chronic hepatitis C progression are incompletely understood. The aim was to analyze the association between 2'5'oligoadenylate synthetase 1,2 and 3 (OAS1-3) and myxovirus resistance proteins 1 (Mx1) polymorphisms and severity of liver disease in human immunodeficiency virus (HIV)/hepatitis C virus (HCV) coinfected patients. We performed a cross-sectional study in 219 patients that underwent a liver biopsy. DNA genotyping for Mx1 (rs469390), OAS1 (rs2285934), OAS2 (rs1293762) and OAS3 (rs2010604) was performed by using GoldenGate assay. The outcome variables ion liver biopsy were: (i) significant fibrosis (F ≥ 2); (ii) moderate activity grade (A ≥ 2). Additive model of inheritance for genetic association test was used. The likelihood of having significant fibrosis (F ≥ 2) was lower in patients carrying OAS2 rs1293762 A allele [adjusted odds ratio (aOR) = 0.51; p = 0.040]. Besides, the likelihood of having moderate activity grade (A ≥ 2) was higher in patients carrying Mx1 rs464397 C allele (aOR = 1.63; p = 0.028) and Mx1 rs469390 G allele (aOR = 1.97; p = 0.005), while it was lower in patients carrying OAS1 rs2285934 A allele (aOR = 0.64; p = 0.039) and OAS2 rs1293762 A allele (aOR = 0.41; p = 0.009). In conclusion, Mx1 and OAS1-2 polymorphisms were associated with the severity of liver disease in HIV/HCV-coinfected patients, suggesting a significant role in the progression of hepatic fibrosis.This work has been supported by grants given by Fondo de Investigación de Sanidad en España (FIS) [Spanish Health Founds for Research] [grant numbers PI14/01094, PI14CIII/00011] and Red Española de Investigación en SIDA (RIS) [AIDS Research Network] [grant numbers RD16CIII/0002/0002RD16 and RD16/0025/0017]. This work has been (partially) funded by the RD12/0017 project as part of the Plan Nacional R + D + I and cofinanced by ISCIII- Subdirección General de Evaluación y el Fondo Europeo de Desarrollo Regional (FEDER). J.B. is an investigator from the Programa de Intensificación de la Actividad Investigadora en el Sistema Nacional de Salud (I3SNS). M.G.A., D.P.T. and M.A.J.S. are supported by “Instituto de Salud Carlos III” [grant numbers CD12/00442, CM12/00043, CD13/00013, respectively]. The authors thank the Spanish National Genotyping Center (CeGen) for providing SNP genotyping services (http://www.cegen.org).S

Clinical practice guideline for psychooncologic diagnosis and treatment of primary caregivers of cancer patients

Introducción: Los cuidadores primarios representan un papel crucial en la atención de los pacientes con cáncer, lo que comúnmente representan tareas complejas de cuidado. Los cuidadores de los pacientes pueden experimentar diversas afectaciones físicas y psicológicas, así como un funcionamiento social deficiente.Objetivo: Proporcionar a los servicios de psicooncología un algoritmo con los elementos suficientes que faciliten el diagnóstico y tratamiento psicosocial de cuidadores primarios de pacientes con cáncer. Método: Se realizó una búsqueda de la literatura en PsycInfo, LatinIndex y Medline en el período de 2005-2014.Resultados: El presente algoritmo se divide en dos momentos clave: 1). Evaluación y 2). Tratamiento del cuidador primario. Los instrumentos más empleados para ansiedad y depresión son: CES-D, BDI, IDARE, HADS y POMS. Para carga el ECCZ y CRA; las intervenciones psico-educativa, capacitación y orientación terapéutica presentan efectos benéficos para esta población.Conclusiones: El algoritmo ofrece un proceso de toma de decisiones para el diagnóstico y tratamiento psicooncológico del cuidador primario informal.Introduction: The primary caregivers play a crucial role in the care of cancer patients, which commonly represent complex care tasks. Caregivers of patients may experience various physical and psychological effects, and poor social functioning.Objective: To provide at psychooncology services of an algorithm with sufficient elements for diagnosis and psychosocial treatment of primary caregivers of patients with cancer elements. Method: A literature search in PsycInfo, Medline LatinIndex in the period of 2005 to 2014.Results: This algorithm is divided into two key points: 1) Evaluation and 2) Treatment of primary caregiver. More used instruments are CES-D, BDI, IDARE, HADS and POMS. For Burden ECCZ and CRA; the psycho-educational interventions, training and therapeutic orientation have beneficial effects for this population.Conclusions: The algorithm provides a process of decision making for the diagnosis and psychooncologic treatment of the primary caregiver

Influence of Satisfaction, Expectations and Perception of Performance on University Dropout during the Pandemic

[Resumen] El abandono universitario es un área de investigación creciente debido a las diversas consecuencias negativas que puede acarrear. Se trata de un fenómeno complejo en el que intervienen múltiples variables, entre ellas factores emocionales-motivacionales. Algunas de estas variables, como la satisfacción con la educación superior y las expectativas de la titulación, son especialmente relevantes entre los estudiantes de primer curso, y más aún en un contexto de virtualidad forzada, como ha sido el caso de la crisis del COVID-19. El objetivo de este estudio es analizar la relación entre las variables emocionales-motivacionales y la intención de abandono entre un grupo de estudiantes, así como evaluar la percepción de su rendimiento académico durante la pandemia. La muestra del estudio estuvo formada por 513 estudiantes de primer y segundo curso de diferentes titulaciones de Ciencias Sociales y Ciencias de la Salud de dos universidades públicas españolas. Se utilizó un cuestionario ad hoc para medir la intención de abandono y su relación con una serie de variables. Se realizaron análisis descriptivos y modelización en árbol de decisión. Los resultados revelan que las variables predictoras más significativas para explicar la intención de abandono son la satisfacción con la elección de la titulación, las expectativas y el aprendizaje de conocimientos relevantes para su futuro profesional. También se encontró que la percepción de los estudiantes de que su rendimiento académico había disminuido durante el COVID-19 era uno de los predictores del abandono.[Abstract] University dropout is a growing area of research owing to the diverse negative consequences it can entail. It is a complex phenomenon involving multiple variables, including emotional-motivational factors. Some of these variables, such as satisfaction with higher education and expectations of the degree, are especially relevant among first-year students, and even more so in a context of forced virtualization, as has been the case during the COVID-19 crisis. The aim of this study is to analyse the relationship between emotional-motivational variables and dropout intention among a group of students, and to assess their perception of their academic performance during the pandemic. The sample for the study comprised 513 first- and second-year students from different Social Sciences and Health Sciences degrees at two Spanish public universities. An ad hoc questionnaire was used to measure dropout intention and its relationship with a series of variables. Descriptive analyses and decision tree modelling were performed. The results reveal that the most significant predictor variables to explain dropout intention are satisfaction with degree choice, expectations, and learning knowledge that is relevant to their professional future. Students’ perception that their academic performance had decreased during COVID-19 was also found to be one of the predictors of dropout