Introduction: Anemia in the world increased during the Covid-19 pandemic; uninterrupted treatment decreases its prevalence: Objective: to determine the relationship between access to treatment and prevalence of anemia before and during the pandemic in children under 5 years of age in the province of Angaraes - Peru. Method: relational research, correlational, cross-sectional design, using data from the Ministry of Health His Report and SIEN through a registration form validated by experts. For access to treatment the population was 771 and 903 children, for prevalence (3651, 3284), (3202 and 2754) children; normality was ruled out by kolmogorof Smirnov, Spearman's Rho and Mann-Whitney U (95% CI) were applied. Results: Before the pandemic, 46.7% accessed treatment without interruption, 19.5% with one month of interruption and 8.2% six months; during the pandemic it increased to 27.2% without interruption, 23.3% with one month of interruption and 19.5% six months; conditioning an increase in prevalence of 4.5% between 2020 and 2021; the mean prevalence before was 35% (95% C.I.: 31.2% - 38.5%); the mean prevalence before the pandemic was 35% (95% C.I.: 31.2% - 38.5%). C 95%: 31.2% - 38.8%) and during was 40.6% (C.I 95%: 36.6% - 44.2%); with an error of 0.005 there is a relationship between access to treatment and prevalence, the Rho Spearman value 0.115 indicates a low relationship; with a p value of 0.000 there is a difference in prevalence before and after. Conclusion: There is a low intensity relationship between access to treatment and prevalence of anemia, the latter being higher during the pandemic.

By German Inga Huayllani, Lida Ines Carhuas Peña, Raul Ureta Jurado, Tarcila Hermelinda Cruz Sanchez, Guido Flores Marín, Sonıa Amandy Sınche Charca, Oscar Wilfredo Diaz Gamboa

Introduction: Perceived social support plays a crucial role in students' university experience, influencing their emotional well-being, academic adaptation, and success in university.
Objective: To determine whether perceived social support is associated with psychological distress in a sample of Peruvian university students.
Methods: Quantitative, non-experimental, correlational, cross-sectional study. The sample consisted of 220 students of both sexes who were administered the Multidimensional Scale of Perceived Social Support and the Psychological Distress Scale, both instruments with adequate psychometric properties. Data were processed using SPSS version 25, and the Spearman's rho correlation coefficient was used to identify the potential relationship between study variables.
Results: It was found that 30% of students perceived a high level of social support. Additionally, it was identified that the psychological distress level of 35% of students was regular. Furthermore, it was determined that psychological distress was inversely and significantly correlated with the perceived social support variable (rho= -0.526; p<0.05) and the family (rho= -0.575; p <0.05), friends (rho= -0.501; p <0.05), and others (rho= -0.518; p<0.05) dimensions.
Conclusions: Perceived social support is inversely and significantly related to psychological distress in a sample of Peruvian university students. Therefore, it is recommended to strengthen social support networks and promote an inclusive environment that encourages open communication and access to mental health resources.

By Edwin Gustavo Estrada-Araoz , Lesy Berly León-Hancco, Basilide Avilés-Puma, Efraín Humberto Yupanqui-Pino, Guido Raúl Larico-Uchamaco

Introduction: In Mexico the prevalence of childhood obesity has experienced an alarming increase; it was reported that 9.7% of children under 5 years of age were suffering from overweight or obesity. This situation was exacerbated in the northern region of the country with a prevalence of 13.2%. Within this context, Parenting Style has been identified as a determinant factor in children's eating behavior, directly influencing their Body Mass Index. Aim: To understand the relationship between Parenting Styles (General and by type of Parenting Style), Body Mass Index, and Physical Activity of preschoolers. Methodology: A cross-sectional, descriptive, and correlational study involved 664 individuals, comprising 332 mother/child dyads, aged between 3 and 5 years. Variables were measured using the Parenting Styles and Dimensions Questionnaire (PSDQ) and the Physical Activity Questionnaire for Parents of Preschool Children, with descriptive and correlational statistics being conducted. Results: A positive and significant correlation was found between the Democratic Parenteral Parenting Style with the minutes that preschoolers dedicated to performing mild physical activities (rs = .136, p<0.05) and moderate physical activities (rs = .172, p<0.01). ). Permissive and authoritarian parenting styles did not show significant relationships with minutes of physical activity. Discussion: Despite the lack of correlation between the general Parenting Style and BMI, this finding underscores the complexity of factors shaping children's physical activity, suggesting the need for multifaceted strategies that include parental education, improvements in infrastructure, and public policies to promote a healthy lifestyle among children.

By Milton Carlos Guevara Valtier, María de los Ángeles Paz Morales, Silvia Guadalupe Soltero Rivera , Cynthia Berenice Rueda-Sánchez, Roger Quintana-Lagunas, Diana Cristina Navarro Rodríguez

Introduction: there are different methods to estimate the percentage of fat mass, among them are anthropometry and bioimpedance.
Objective: this study seeks to demonstrate the degree of agreement of the percentage of fat mass estimated with bioelectrical impedance versus skin folds in a healthy adult population.
Methods: agreement study; made up of 44 students from the Adventist University of Chile. The percentage of fat mass obtained by anthropometry was estimated by the Siri formula (density estimated by the Durnin and Womersley equation) based on the bicipital, tricipital, subscapular and suprailiac folds, in triplicate; while for impedancemetry the Seca mBCA 525 equipment was used. The intraclass compensation coefficient (ICC) and Bland-Altman graph were applied, with R-Studio.
Results: 65.91% had an age between 18-22 years, the 52.27% were women, 65.91% with normal nutritional status and with 26.63±10.97% fat mass. An ICC=0.84 (95% CI: 0.72-0.91) was found. Women and obese people had the lowest ICCs. The values are within the limits -11.39 - +9.68 of the Bland-Altman graph.
Conclusions: There is an acceptable level of agreement in the percentage of fat mass with the Siri formula versus bioimpedanciometry.

By Felipe Manzo-Sepúlveda, Mildred Rodriguez-Sanhueza, Antonella Cares-Muñoz, Miguel Ángel López-Espinoza

Introducción.
Las escuelas profesionales de Estomatología deben generar y garantizar el aprendizaje y el desarrollo de habilidades clínicas en los estudiantes, para lograr un adecuado perfil del egresado, este reto implica la necesidad de conocer los estilos de aprendizaje que poseen los estudiantes para generar estrategias y mejorar el aprendizaje
Objetivo: El presente estudio pretende analizar la importancia de los Estilos de aprendizaje en el desarrollo de habilidades clínicas de los estudiantes de Odontología de una universidad privada del Cusco.
Metodología: Se llevó a cabo un estudio descriptivo y transversal, la población estuvo conformada por 215 estudiantes del séptimo, octavo y noveno semestre del área de clínicas de la escuela de Estomatología, con una muestra de 139 estudiantes, se utilizó la técnica de la encuesta y como instrumento el cuestionario para las variables en estudio, así mismo el procesado de datos mediante el software SPSS, v. 26.
Resultados: se conoce que el estilo de aprendizaje de los estudiantes en el 70.5% tienen un alto manejo de sus estilos de aprendizaje, predominando en el nivel alto, el 41.7% en el estilo reflexivo, 67.6% en el teórico y pragmático en 56.1%, lo que implica que de acuerdo a su vivencia educativa es que su estilo predomina; además de la importancia de los Estilos de aprendizaje en el desarrollo de capacidades clínicas.
Conclusión: las habilidades clínicas se asocian de manera significativa al estilo de aprendizaje que poseen los estudiantes.

By Giovanna Gutiérrez-Gayoso, Edgardo Guillermo Rivera Medina

Introduction: to achieve the health of infants and increase their quality of life, the health of legal guardians and educators is of particular importance; their beliefs and behaviors; and the ability, knowledge and will to acquire and provide the infant with healthy ways and styles of life.
Objective: determine the effectiveness of the “Healthy Smile” Program in terms of knowledge about oral health of legal representatives and educators, as well as the role of educators of preschool infants.
Methods: a quasi-experimental before-after research was carried out where the sample was 86 legal guardians and 9 preschool educators from the “La Demajagua-Atanagildo Cajigal” towns in the period 2021-2023.
Results: the pre-university level of instruction predominated (68; 71,579 %) and a regular level of knowledge (73; 76,842 %) before the implementation of the program; the same being modified to good (77; 81,053 %) with a tendency to fair (18; 18,947 %). The educators significantly increased (8; 88,88 %) the reasons for preventing diseases related to the stomatognathic apparatus to maintain good oral hygiene; the results of the student T test showed statistically significant differences in knowledge of caries (X1=3,22; X2=3,80) and about children’s oral health (X1=1,55; X2=3,44).
Conclusions: the “Healthy Smile” program was effective in positively modifying the level of knowledge about oral health of legal representatives and educators, as well as in the role assumed by them with respect to the health of the infants in their care.

By Rosa María Montano-Silva, Yoneisy Abraham-Millán, Aliana Peña-Méndez, Yuliet Pérez-Cruz, Ernestina Navarro-González, Luis Enrique Ricardo-Díaz

Introduction: The pathogenic variant c.35delG of the GJB2 gene is the most frequently observed in all populations, associated with nonsyndromic autosomal recessive prelingual prelingual sensorineural deafness, since 2001 is available in the National Network of Medical Genetics the study of this mutation.
Objective: to describe the presence of the pathogenic variant c.35delG of the GJB2 gene associated with nonsyndromic prelingual deafness, with evidence of autosomal recessive inheritance.
Methods: A descriptive cross-sectional study was carried out on 379 cases registered with isolated prelingual hearing loss between 2001 and 2023; for the identification of the c.35delG mutation, the polymerase chain reaction technique was used, with enzymatic digestion, and its genotype and frequency were described.
Results: The pathogenic variant c.35delG of the GJB2 gene was found in 121 of those studied (31.91%), 59 in homozygosis and 62 in heterozygosis. The allele frequency found among the positive cases was 0.743.
Conclusion: the pathogenic variant c.35delG in individuals with nonsyndromic prelingual deafness of possible autosomal recessive inheritance is found in a high proportion.

By Estela Morales Peralta, Mercedes Arceo Alvarez, Yuledmi Perdomo Chacón, Manuel Gómez Martínez, Teresa Collazo Mesa

Introduction: In higher education, the integration of graphic organizers in teaching can enhance the understanding and retention of content, thereby contributing to the academic development of students. Objective: Analyze the impact of the implementation of unconventional digital graphic organizers on the generation of meaningful learning in first-semester students at the Central University of Ecuador. Methods: 156 first-semester students participated in the "Leadership" course in the Civil Engineering program at Central University of Ecuador. The research was longitudinal and observational with a pre-experimental design. Pre and post-tests were conducted addressing the impact of digital graphic organizers on meaningful learning. Results: An increase in the usage of less common digital graphic organizers is revealed, showing a strong correlation with meaningful learning analyzed through the correlation coefficient. The Chi-square test supports that graphic organizers positively influence meaningful learning. Conclusions: The importance of adapting methodological strategies to university students is emphasized, acknowledging that success depends not only on these strategies but also on the creativity and flexibility of teaching. The inclusion of unconventional digital graphic organizers in teaching significantly benefits the generation of meaningful learning, suggesting that these structured visual tools are valuable for enhancing understanding. This knowledge will drive educators to design interventions that maximize learning.

By Guerrero-Gallardo, Héctor Iván, Ximena Patricia León Quinapallo

Introduction: Malnutrition is a state of nutritional imbalance that results from insufficient intake of nutrients to meet normal physiological needs. The causes, inadequate food intake in quantity and quality required to meet the needs of the body during growth and psychomotor development, childhood malnutrition, which affects children under 5 years of age worldwide, associated with social and economic determinants in the most countries in the region. In Ecuador it affects 27.2% of children under 2 years of age, this is the result of inadequate or insufficient nutrition.
Objectives: Determine the number of infants who are suffering from child malnutrition under 3 to 5 years of age E.G.B. Republic of Colombia, from the Saquisilí canton.
Methods: A cross-sectional, quantitative design study with descriptive scope was carried out. Three instruments were used, the first instrument was the WHO growth curve, structured by percentiles, the second was the survey directed at parents, and the third instrument was a questionnaire to assess development-learning.
Results: The results obtained in this research describe that 90% exclusively maintained breast milk during the first six months of life, being a protective factor for the children's immune system. In the final results obtained from the research, mild malnutrition is reflected. In 36.7% of children, and a significant 20% of these children suffer from moderate malnutrition, which can indirectly affect their learning development.
Conclusions: In this sense, child malnutrition can be reduced by improving levels of maternal education and government policies to promote income redistribution, since the highest percentage of malnourished children belongs to the lowest poverty quintile.

By Johana Mishel Sanchez Sinchiguano, Miriam Ivonne Fernández Nieto

Introduction: Resilience in the population allows to develop coping skills in situations that put their health well-being at risk, and during the pandemic it has been shown that the population can adapt and face this situation without altering their health well-being, therefore, their research objective is to determine resilience and its relationship with nursing care in a vulnerable population during the COVID-19 pandemic, Methods: It is a quantitative, descriptive and cross-sectional study, with a population of 1343 participants who developed a sociodemographic questionnaire and the Connor-Davidson resilience scale, Results In their results, 13(1%) of the inhabitants have a low resilience, 413 (30.8%) a medium resilience and 917 (68.2%) a high resilience, Conclusions: In conclusion, strategies regarding the mental health of the inhabitants have been promoted to improve their coping skills.

By Rosa Perez-Siguas, Hernan Matta- Solis, Eduardo Matta-Solis, Victoria Tacas-Yarcuri, Hernan Matta-Perez, Alejandro Cruzata-Martinez, Eva Ventura-Hernandez

Introduction: Mental disorders are one of the problems caused by the coronavirus pandemic in the general population, so the objective of the study is to determine depression, anxiety and stress due to the COVID-19 pandemic in residents who go to a community health facility in North Lima, Methods: It is a quantitative, descriptive-cross-sectional study, with a total population of 140 people attending a community health facility, who answered a questionnaire on sociodemographic aspects and the scale of depression, anxiety and stress, Results In their results, we can observe that 51.4% (n=72) of the participants have moderate depression, 45% (n=63) moderate anxiety and 42.1% (n=59) moderate stress, Conclusions: In conclusion, actions aimed at the mental health of the general population due to the COVID-19 pandemic must be reinforced, improved or implemented in a comprehensive manner

By Brian Meneses-Claudio, Juan Saberbein-Muñoz, Maria Salinas-Cruz, Teresa Quesada-Aramburu, Elias Mejia-Mejia, Francis Díaz-Flores, Enrique Lee Huamaní, Melissa Yauri-Machaca

The purpose of this research was to determine the difficulties caused by the confinement due to the pandemic caused by COVID-19 in "initial 2" (preschool) students of the Cañar parish, Ecuador. The study involved students residing in this community, who by means of questionnaires to their representatives allowed to know first-hand the main difficulties during the confinement. For this purpose, a quantitative research approach with a descriptive scope was developed; the data were collected using a randomized method, which consisted of using a Google form to administer a survey in which it was possible to evidence, among other things, the inequality of conditions that affect educational effectiveness, especially the lack of adequate spaces for learning. In addition, variations in the academic routines of students, with a significant percentage lacking an established routine, suggesting deficiencies in the management of activities by teachers. Lack of interaction with peers and teachers affected motivation and enjoyment of learning. In addition, confinement had an impact on fine motor skills and the learning of letters and numbers, and the problems of access to virtual classes showed the need for improvements in the technological infrastructure.

By Juan Carlos Solano Chuma, Claudio Sebastián Montero Jácome

Introduction: The World Health Organisation (WHO) stresses the fundamental importance of exclusive breastfeeding. This approach helps prevent diseases that cause infant mortality, while decreasing the risk of breast and ovarian cancer, diabetes, and heart disease and hypertension in women.
Objective: To analyse the importance of maternal nutrition by studying the components of milk in order to prevent pathologies in the short term.
Methodology: A systematic search was carried out by reviewing the literature in scientific databases such as Pubmed, Elsevier, Springer, Scopus, Scielo published in the last 5 years, considering significant contributions in the areas of paediatrics and neonatology, as well as theoretical approaches, with the aim of reflecting the controversies that arise around avoidable pathologies in exclusive breastfeeding.
Results: Breastfeeding provides essential nutrients and immunological components that strengthen infant health and protect against disease by offering benefits such as protection against infectious diseases and allergies, and promotes optimal cognitive development. Although breastmilk substitutes have improved, they cannot match its unique benefits.
Conclusion: Exclusive breastfeeding for the first six months is critical to the health of the newborn, providing essential nutrients and strengthening the immune system. Although breast substitutes have advanced, they cannot match the benefits of breastfeeding. The importance of promoting breastfeeding to improve infant health and prevent disease is emphasized.

By Luis Humberto Vásquez Cortez; Andrea Cristina Cortez Espinoza, Jhoselyn Elizabeth Novillo Yánez, Adriana Isabel Rodríguez Basantes

Introduction: clinical simulation as a teaching-learning tool has experienced a significant evolution in recent years in terms of the methodologies it has implemented to achieve learning results in different areas of health professions. Interdisciplinary clinical simulation is the recommendation of the experts.
Objectives: implement a simulated clinical service for the learning of intermediate cycle students of Health careers at the Faculty of Health and Social Sciences of a private university in Santiago de Chile in the year 2022.
Method: 408 students a private university in Santiago de Chile, a student satisfaction survey was applied regarding the learning experience in the interdisciplinary simulation center.
Conclusions: the students who participated in the activity valued the experience positively and considered it valuable for their professional training.

By Julia Zuñiga Espinoza, Cristian Lermanda Peña, Ignacio Astudillo Ganora

Introduction: During confinement many of the families have foreseen a situation that compromises the relationship of their members, where communication within the home will play an important role in the emotional balance in the family, to the objective of the study is to determine the family functionality in women victims of family violence in times of COVID-19 in areas of Lima, Methods: It is a is quantitative, its methodology is descriptive, not experimental, cross-sectional, with a total population is made up of 794 women participants from areas of Lima, who answered a questionnaire on sociodemographic aspects and the scale FACES IV., Results: In the results we can observe in the dimension family communication that, 737 (87%) of the women victims of family violence have very low communication with the other family members, 31 (6%) have a low family communication, 9 (2.9%) have a moderate family communication, 13 (3.9%) have a high family communication and 4 (0.2%) have very high family communication., Conclusions: It is concluded that health services should be taken into account, where health professionals can identify situations of risk of violence within the home and that can prevent it.

By Lucia Asencios-Trujillo, Lida Asencios-Trujillo, Carlos La Rosa-Longobardi, Djamila Gallegos-Espinoza, Livia Piñas-Rivera, Rosa Perez-Siguas

Background: The crucial role of nurses within the global healthcare system is undeniable, especially considering the high demand and significant stress that characterizes their professional field. From an administrative and human resource management perspective in healthcare, the importance of emotional well-being, along with emotional intelligence and self-efficacy, has emerged as a primary focus of interest in recent research, particularly highlighted in the Peruvian nursing scenario. Objective: This study aimed to understand the relationship between self-efficacy, emotional intelligence, and work engagement among Peruvian nurses, and how these factors might influence the quality of care provided and staff retention in the healthcare sector. Methods: A quantitative analysis was conducted, based on structured surveys that measured levels of self-efficacy, emotional intelligence, and work engagement. The participants were registered nurses in Peru, and the sample was stratified according to different regions and levels of experience. Results: The findings confirmed a positive relationship between self-efficacy and work engagement, corroborating previous research. Furthermore, the positive association between emotional intelligence and work engagement in this professional group was validated. It was evidenced that nurses with higher emotional intelligence and self-efficacy tend to have a greater work engagement, positively affecting the quality of care and their retention in the healthcare sector. Conclusions: Emotional intelligence and self-efficacy are fundamental for the work engagement of Peruvian nurses. These factors not only impact the academic realm but also have essential practical significance in the healthcare sector. The promotion and training in these areas could be crucial to ensure quality care and the emotional well-being of nursing staff.

By Amanda Cabana-Mamani, Silvia Ccalachua, Wilter C. Morales-García, Maribel Paredes-Saavedra, Mardel Morales-García

Introduction: In older adults, lifestyle plays a key role in adaptation to cope with the coronavirus pandemic during isolation and quarantine at home, so its research objective is to determine the lifestyle during the pandemic of COVID - 19 in older adults’ regular basic education teachers in a district of North Lima.
Methods: It is a quantitative, descriptive, non-experimental cross-sectional study, with a total population of 176 adults over 60 years of age, who answered a questionnaire of sociodemographic data and the lifestyle instrument.
Results: The results show the lifestyle of older adults, where 38 (21.6%) have a lifestyle in a danger zone, 21 (11.9%) have a low lifestyle, 89 (50.6%) have an adequate lifestyle and 28 (15.9%) have a fantastic lifestyle.
Conclusions: In conclusion, strategies should be sought or developed to improve both physical and eating activities in older adults regular basic education teachers at home.

By Livia Piñas-Rivera, Lucia Asencios-Trujillo, Lida Asencios-Trujillo, Rosa Perez-Siguas, Carlos La Rosa-Longobardi, Djamila Gallegos-Espinoza

Introduction: Nursing students are a population vulnerable to mental health problems, especially burnout syndrome. Trait emotional intelligence appears as a protective factor against these risks. The psycho-emotional effects of returning to in-person academic activities post-COVID-19 confinement have not been described.
Objective: Describe the relationship of trait Emotional Intelligence with academic burnout in Nursing students after returning to in-person academic activities post-confinement at a Chilean university.
Methods: Quantitative-correlational, cross-sectional, non-experimental, non-probabilistic study. 213 surveys were administered to measure trait emotional intelligence and academic burnout in the post-confinement period. Differences in means were reported through post-hoc analysis with Games Howell statistics, and correlations were performed with the Rho Spearman coefficient.
Results: There was a high percentile in trait emotional intelligence (58%) of the sample, and a mild prevalence of academic burnout (92.1%). Statistically significant correlations (p<0.000) were observed between several factors. The Well-being factor was presented negatively with two dimensions of burnout; while the Emotionality factor was shown to be a risk for increased emotional exhaustion and depersonalization, but positively associated with personal fulfillment.
Conclusions: There is a relationship between variables, two factors of trait emotional intelligence were associated with burnout. Universities and academics must act as promoters of emotional intelligence in order to reduce burnout. More research and caution is required when automatically concluding that higher levels of emotional intelligence are always better in any circumstance.

By Rodrigo-Alejandro Ardiles-Irarrázabal, Pablo Pérez-Díaz, Juan-Carlos Pérez-González, Miguel Valencia-Contrera, Paula Gatica Mercado

Introduction: Satisfaction with life plays a crucial role in students' academic and personal experience as it can influence their academic performance, emotional well-being, and adaptation to the higher education environment.
Objective: To determine whether resilience, perceived social support, and self-esteem predict satisfaction with life in Peruvian pre-service teacher education students.
Methods: A quantitative, observational, analytical, predictive, and cross-sectional study was conducted. The sample consisted of 215 students of both sexes who were administered the Connor-Davidson Resilience Scale Short Form, the Social Support Perception Scale, the Rosenberg Self-esteem Scale, and the Satisfaction with Life Scale, instruments with adequate psychometric properties. Regarding statistical methods, Pearson correlation coefficient was used, followed by multiple linear regression analysis.
Results: Multiple regression analysis showed a good fit for the model (F=78.319; p<0.05), indicating that resilience (β=0.103; p<0.05), perceived social support (β=0.268; p<0.05), and self-esteem (β=0.274; p<0.05) explained 52% of the total variance of the satisfaction with life variable.
Conclusions: Resilience, perceived social support, and self-esteem predict satisfaction with life in Peruvian pre-service teacher education students. Therefore, it is recommended to foster an institutional culture that values and promotes students' emotional well-being, providing psychological and emotional support resources and services.

By Edwin Gustavo Estrada-Araoz, Guido Raúl Larico-Uchamaco, Jair Emerson Ferreyros-Yucra, Silvia María Revilla-Mendoza, José Octavio Ruiz-Tejada

Introduction: Type 2 Diabetes mellitus is a chronic, multifactorial disease, characterized by an alteration in carbohydrate metabolism. Objective: Determine self-care in patients with Type II Diabetes Mellitus to prevent complications such as diabetic foot. Methodology: Quantitative, descriptive quasi-experimental study that includes a total of 20 adults from the Guaytacama parish of the city of Latacunga-Cotopaxi-Ecuador, for data collection a survey validated by experts in the area and with a reliability index was used. Cronbach's Alpha 0.9, inclusion and exclusion criteria were applied and data tabulation was carried out using the SPSS statistical tool. Results: At the beginning of the survey, it was determined that the patients had deficient knowledge about their disease and the care that it entails; after the intervention of the health personnel, the patients have clear information about self-care. Conclusion: Diabetes mellitus is a disease that in the long term can cause disability, which is why the role of health personnel is fundamental in addressing education, since this helps to promote self-care, in order to avoid complications that can cause disability, and consequently psychological problems that worsen the quality of life of patients.

By María Belén Espíndola Lara, Angel Rafael Borja Cabrera, Cinthya Anabel Ortiz Martínez, Diana Nathalie Navarrete Tinajero, Alba Maribel Viteri López, Fanny Paola Egas Medina, Anthony Steeven Vilca Ruiz

Introduction: Post-COVID-19 syndrome or long COVID is a condition characterized by symptoms that persist after the disease's infection. Objective: To compare clinical, physical, and psychological outcomes among individuals with post COVID-19 syndrome with different levels of functional status after hospitalization for COVID-19. Methods: An observational, analytical, cross-sectional and with a quantitative approach with 75 individuals with post COVID-19 syndrome after hospitalization. Individuals underwent assessment of pulmonary function, six-minute walk test (6MWT), 1-minute sit and stand test (STS1), hand grip strength (HGS) and one repetition maximum test (1RM), Hospital Anxiety and Depression Scale (HADS), Short-Form Healthy Survey (SF-36) and Post-COVID Functional Scale (PCFS). Individuals were separated according to PCFS into two groups: low (LFL) and high (HFL) functional limitation (PCFS 1-2 and PCFS 3-4, respectively). Data regarding anthropometric and clinical characteristics, hospitalization history, and occupational activity were also collected. Results: Individuals post COVID-19 syndrome with HFL presented worse score in the SF-36 in the functional capacity (p=0,01); pain (p=0,01), social aspects (p=0,01) and these individuals had a higher need for ICU admission (p=0,03) and prolonged hospitalization stays (p=0,04) compared to those with LFL. Conclusion: Individuals with post COVID-19 syndrome that reported HFL exhibit poorer quality of life concerning the domains of functional capacity, pain, and social aspects when compared to those with LFL. Additionally, HFL individuals had a higher need for ICU admission and prolonged hospitalization stays.

By Walter Sepúlveda-Loyola, Aline Gil Panont, Jordana Cordeiro Maluf, Vanessa Suziane Probst, Lorena Oliveira Bezerra, Lauanda da Rocha Rodrigues, Alejandro Álvarez-Bustos, Juan José Valenzuela- Fuenzalida

The object of this study is to integrate Hazard and Operability (HAZOP) analysis and Fuzzy Logic to improve risk assessment in the Liquefied Petroleum Gas (LPG) filling industry. the research introduces a new approach to resolve the uncertainties and imprecise information inherent in traditional risk evaluation methods. Using HAZOP, a qualitative analysis conducted by the experts of industry identifies potential process deviations and hazards, categorized by impact type such as fire, explosion, and environmental damage. Fuzzy Logic, quantifies these risks by evaluating the likelihood and consequences of accidents using linguistic variables like "high," "medium," and "low." The simulation of different parameters considers various scenarios, including the interplay of consequence severity, event frequency, and detection capability on overall risk using model fuzzy-Hazop. The results provide more precision and actionable risk assessments, showing the potential of the combination of Hazop and fuzzy logic for safety measurement in the LPG filling process. The study concludes HAZOP with fuzzy logic evaluates risks in uncertain conditions, offering an alternative for clearer, decision-making in risk-based design processes.

By Oubellouch Hicham, Soulhi Aziz

Introduction: mortality from oropharyngeal cancer ranked tenth among cancer types in Cuba in 2020 and 2021.
Objective: to implement an educational intervention on oral cancer in high-risk patients between 35-59 years old.
Method: an educational intervention with a quasi-experimental design, before-after type, was carried out in consulting room 19, La Demajagua, Isla de la Juventud between April-September 2023. The population was 126 patients, the sample being made up of 80 at high risk of oral cancer. Theoretical, empirical and mathematical-statistical methods were used and the variables were used: risk to predict oral cancer, risk factors, oral hygiene, teaching aids and level of knowledge about oral cancer, oral hygiene, risk factors and oral self-examination.
Results: the risk of suffering from oral cancer was high in 63 % of the patients between 35-59 years old in the study office. Before the intervention, bad knowledge predominated, representing 48,7 % of the sample, managing to raise it to good after the intervention by 96,3 % . The Wilcoxon test demonstrated highly significant differences.
Conclusions: the main risk factors were: poor oral hygiene, smoking, consumption of hot or spicy foods and stress. The use of the website contributed to raising knowledge about oral cancer, the main risk factors associated with its appearance and oral self-examination, allowing the transformation of modes of action and the evaluation of the educational intervention implemented in high-risk patients between 35 and 35 years old as satisfactory.

By Yoneisy Abraham-Millán, Rosa María Montano-Silva, Yanelilian Padín-Gámez, Douglas Crispin-Rodríguez, Lauren Danitza Leyva-Manso, Ana Maura Ortiz-Figueroa

Introduction: Gini coefficient (Gini index or Gini ratio) is a parameter that is normally used in economy to measure the income distribution in a country or in the whole wide world, but it can be used to measure any kind of distribution. In the present study it is exposed an innovative proposal of application of the Gini coefficient to Heart Rate Variability (HRV) like a psychophysiological indicator of mental stress.
Objective: To assess the application of the Gini coefficient as a psychophysiological indicator of mental stress.
Methods: A non-observational crossover study, carried out in the biomedical laboratory of the Medical University of Santiago de Cuba. The involved participants are 13 healthy individuals (age 19 ± 1.5 years). Heart rate was continuously recorded at rest (5 minutes) and during a mental stress (5 minutes). Linear and nonlinear methods of heart rate variability were assessed, and 2 new indicators (Sequential and Non-Sequential Gini) were calculated and proposed to measure HRV differences between states.
Results: When comparing rest and mental stress conditions, a sensible decrease of the traditional indicators of the HRV was founded (p<0,05), an increase of the heart rate (p=0,004) and of the Sequential Gini (p=0,004) and Non-Sequential Gini (p=0,04).
Conclusions: The results suggest that temporary inequality of the RR intervals analyzed from the Gini coefficient could be an adequate indicator of sympathetic activity present during the mental stress.

By Miguel Enrique Sanchez-Hechavarria, Ramon Carrazana-Escalona, Sergio Cortina-Reyna, Victor Ernesto González-Velázquez, Elys María Pedraza-Rodríguez, Adán Andreu-Heredia, Erislandis López-Galán

Introduction: Falls affect the functionality, quality of life and socio-familial relationships of older adults. Perceived social support and fear of falling because of a fall are important factors for falls syndrome and its prevention. Objective: To determine the association between previous falls and perceived social support with fear of falling in older adults. Methods: Analytic, cross-sectional and correlational study. The sample consisted of 250 participants. The instruments used were a Sociodemographic Data Form, the International Falls Efficacy Scale and the Multidimensional Scale of Perceived Social Support. A univariate linear regression analysis was performed to determine the relationship between fear of falling and Perceived Social Support in participants with a history of falls. Results: A significant association was found between fear of falling and ASP (p = 0.006), the dimension of perceived family support (p = 0.003) and the dimension of perceived social support from friends (p = 0.031). In the predictive analysis, previous falls and perceived support from friends were found to predict fear of falling (F [2, 248] = 17.22; p<.001; R2=.122). Conclusion: Fear of falling was found to be dependent on previous falls and perception of support by friends, so nursing interventions to reduce fear of falling in MAPs should focus on these variables.
Keywords: Fall Accidents; Social support; Elderly; Fear.

By Luís Carlos Cortez González, Josué Francisco Vázquez López, Alejandro Morales Jinez, Diana Berenice Cortes Montelongo, Tirso Duran Badillo

Introduction: The Health-related quality of life considerably influences the well-being of the person, although when a disease occurs, this well-being tends to decrease and that this modifies the lifestyle of the person, therefore, the objective of the study is to determine the Health-related quality of life in relation to health in hypertensive regular basic education teachers who come to a cardiology clinic in North Lima, Methods: It is a quantitative, descriptive-cross-sectional study, with a total population of 124 hypertensive regular basic education teachers, Results: In their results, we can observe that 13.7% (n=17) have a very low Health-related quality of life in relation to their health, 26.6% (n=33) low Health-related quality of life, 9.7% (n=12) average Health-related quality of life, 43.5% (n=54) high Health-related quality of life and 6.5%(n=8) very high Health-related quality of life, Conclusions: In conclusion, evaluations should be carried out in the health of the population, for the detection of risk factors and hypertension in an early stage.

By Carlos La Rosa-Longobardi, Lucia Asencios-Trujillo, Lida Asencios-Trujillo, Djamila Gallegos-Espinoza, Livia Piñas-Rivera, Hernan Matta- Solis

Introduction: Patient identification is a key component of Patient Safety goals. In the context of gender identity (GI) regulations, the adaptation of identification protocols is required for compliant implementation. The objective was to identify challenges and tensions in patient identification as a safety goal and its intersection with the current gender identity legislation in Argentina.
Methods: A qualitative approach was used to collect data from seven healthcare institutions with patient admissions, selected based on their different profiles in terms of sector (public/private), patient safety accreditation process, and type of care (specialized/general). Grounded theory was employed to identify common institutional patterns.
Results: Three institutional situations were identified: 1. Contradiction: where compliance with GI regulations is perceived to undermine secure patient identification; 2. Potential convergence: although GI regulations are not fully implemented in patient identification, institutions deploy informal strategies to comply with them; 3. Convergence: institutions that have made changes to records and systems in line with GI. All institutions acknowledge the need for training in the care of transgender, transvestite, and non-binary patients.
Conclusions: Strengthening institutional policies based on safety goals and adherence to gender identity legislation is necessary. Organizational changes are essential, and training is needed to address the care of transgender, transvestite, and non-binary patients effectively.

By Silvia Gabriela Pérez, Ermelinda Salinas, Silvio Saravia, Valeria Cros Báez, Viviana de los Ángeles Galarza, Victoria Sánchez Antelo

This article focuses on the study of cognitive impairment in the elderly. The general objective focuses on the analysis of three variables present in the selected articles which are cognitive impairment and quality of life, which explores the perceptions associated with the well-being and satisfaction of older adults, understanding the dynamics of personal achievement, social relationships, autonomy, and quality of life that impact on the conditions of integral health within the context of integral well-being. A second variable of mood alterations and comorbid pathologies, where it was identified that depression and anxiety are pathologies that cause emotional alterations in older adults and interfere in the development of symptoms associated with pathological comorbidities, and the third variable is lifestyle and neurocognition includes protective elements associated with physical activity, nutrition and socialization processes that promote active and healthy aging. The methodology is of quantitative design with a bibliometric approach under the context of a systematic literature review. Taking into account, the prism methodology that responds to the approach of Boolean equations that were used to perform the analysis and categorization of the documents using variables. Finally, it is concluded the need to make cognitive and behavioral changes in the elderly through a differentiated evaluation for each patient, thus minimizing the effects in the social, family, economic, affective, and emotional spheres

By Nubia Hernández-Flórez, Elisama Beltrán de la Rosa, Olena Klimenko, Maria José Orozco Santander, Francis Araque-Barboza, Johana Vásquez-Torres

Introduction: In the educational context, workload entails various responsibilities, from planning and conducting classes to participating in extracurricular activities. This array of tasks can affect teachers, both in their performance and in their physical and mental well-being.

Objective: To determine if workload is related to the psychological capital of Peruvian basic education teachers.

Methods: A quantitative, non-experimental, cross-sectional correlational study was conducted. The sample consisted of 183 teachers who were administered the Workload Scale and the Psychological Capital Questionnaire, instruments with adequate metric properties.

Results: Preliminarily, it was determined that 39.3% of teachers perceived their workload to be high. Similarly, 52.5% of teachers also rated their psychological capital as high. Additionally, a correlation coefficient of -0.539 (p<0.05) was found between both variables.

Conclusions: There is an inverse and significant relationship between workload and the psychological capital of elementary school teachers. Therefore, it is recommended that educational authorities establish institutional policies that promote a balanced workload-resource ratio for teachers. This may include adequate allocation of resources and materials, as well as a review of assessment and work planning practices. Furthermore, implementing psychological support programs, time management, and stress management is suggested to ensure teachers' well-being.

By Edwin Gustavo Estrada-Araoz, Néstor Antonio Gallegos-Ramos, Yolanda Paredes-Valverde , Rosel Quispe-Herrera

Introduction: Management requirements are parameters that have been established by international organizations such as the International Organization for Standardization (ISO), which allow clinical laboratories to implement the necessary requirements to achieve the long-awaited quality, through adequate compliance with each one of these parameters.
Objective: To evaluate the degree of compliance with the management requirements of the services provided by the private clinical laboratories of the Ambato Canton. Methods: An observational, descriptive, cross-sectional study with a qualitative approach was designed, through the application of evaluation instruments, surveys with multiple choice questions, 80 interviews were carried out with the directors of private clinical laboratories with current operating permits, different levels of operation, in the Ambato Canton. Results: It was evident that the majority of laboratories meet some of these requirements, however, a minority percentage did not meet them in their entirety. Through a comparative analysis, it was established that 77.90% of the universe studied did have the management requirements implemented, 9.27% partially coupled them or were in the process of implementation, 10.80% did not comply with them and finally 2.03% consider them not applicable in relation to the 15 indicators evaluated. Conclusions: It was determined that, in a high percentage of private clinical laboratories in the Ambato Canton, the quality management requirements of the services provided are implemented, however, a smaller percentage of laboratories do not put these requirements into practice in their establishments.

By Edison A. Galárraga-Perez, Alejandra E. Moreira-Ramos, Johanna J. Chasi-Tisalema

Introduction: The relationship within the family is very important in adolescence, since it will allow them to develop skills and behaviors that improve their resilience, so the research objective is to determine resilience and nursing intervention in adolescents of an educational institution in a vulnerable area of Lima, Methods: It is a quantitative, descriptive and cross-sectional study, with a population of 571 adolescents who answered a questionnaire of sociodemographic aspects and the Conno-Davidson resilience scale, Results In their results, 157 (27.5%) of the adolescents have low resilience, 301 (52.7%) medium resilience and 113 (19.8%) high resilience, Conclusions: In conclusion, intervention in the family should be taken into account in order to identify factors that put the adolescent at risk in his early development.

By Rosa Perez-Siguas, Hernan Matta-Solis, Victoria Tacas-Yarcuri, Hernan Matta-Perez, Alejandro Cruzata-Martinez, Eva Ventura-Hernandez, Olga Valderrama-Rios

Introduction: Diabetes and arterial hypertension are increasing in adults, where calf circumference and waist circumference are two clinical epidemiological markers poorly studied for predicting cardiometabolic risk. Objective: To characterize four phenotypical models in the Chilean adult population based on muscleness and fatness using both calf circumference and waist circumference outcomes. Methodology: An epidemiological observational cross-sectional representative study based on the Chilean National Health Survey 2016-17, where four phenotypes groups were analyzed; Low skeletal muscle mass and high-waist circumference (Lsmm-Hwc, n=140), low skeletal muscle mass and low waist circumference (Lsmm-Lwc, n=242), high skeletal muscle mass and high waist circumference (Hsmm-Hwc, n=1076), and high skeletal muscle mass and low waist circumference (Hsmm-Lwc, n=1358). These groups described information about diabetes, hypertension prevalence, including other risk factors. Results: The reference group Hsmm-Lwc group showed lower fasting plasma glucose (FPG) vs. Hsmm-Hwc (90.4 [95%CI] [89.0; 91.8] vs. 111.7 [109.1; 114.3]), and vs. Lsmm-Hwc (90.4 [89.0; 91.8] vs. 118.3 [107.2; 129.4] mg/dL, both P<0.0001). Lower levels (i.e., appropriate) of FPG (R2 4.8%), glycated hemoglobin (R2 2.6%), systolic BP (R2 19.0%), and diastolic BP (R2 2.5%) were significantly associated (all, P<0.0001) with the Reference group Hsmm-Lwc. Conclusion: A high muscleness and low fatness phenotype is present in those who are younger adults, is associated with better glucose/blood pressure control, and reports low cardiovascular risk factors for diabetes and hypertension in Chilean adults.

By Cristian Alvarez, Christian Campos-Jara, Francisco Guede-Rojas, Claudia Marchant, Héctor Márquez, Lorena Martínez-Ulloa, Igor Cigarroa, Jaime Vásquez-Gómez, Carmen Luz Muñoz-Mendoza, Cristian Caparros-Manosalva, Pedro Delgado-Floody

Introduction: Psychological distress is one of the events that compromise the mental health of University professors in a situation that puts their physical and mental well-being at risk, therefore, the objective of the research is to determine psychological distress in University professors that are of a University Institution in North Lima.
Methods: It is a quantitative, descriptive, non-experimental cross-sectional study, with a total population of 147 participating health professionals, who responded to a questionnaire of sociodemographic data and the depression, anxiety, and stress scale (DASS-21).
Results: The results show that in health professionals, 61 (41.5%) present high psychological distress, 44 (29.9%) medium psychological distress and 42 (28.6%) low psychological distress.
Conclusions: It is concluded that strategies should be sought to improve the mental health of health professionals, who are in the first line of care for COVID-19 patients and this should be increased in mental health services that allow attending to professionals who are at a higher risk of psychological distress.

By Carlos La Rosa-Longobardi, Lucia Asencios-Trujillo, Hernan Matta-Solis, Lida Asencios-Trujillo, Djamila Gallegos-Espinoza, Livia Piñas-Rivera

University Social Responsibility (USR) is a new university management policy that redesigns the way in which extension and social projection are being carried out to face the academic and administrative impacts of all university processes. The purpose of the article was to analyze the process of management and implementation of RSU in Latin America, through a systematic review, using the PRISMA methodology. The reviewed databases were: Scopus, Scielo, EBSCO, Web of Science. Twenty articles were selected, of which 70% are related to RSU management and 30% to implementation. It is concluded that in Latin America the management and implementation of the RSU is in an initial process because it has not yet been consolidated as a university management system. Likewise, there are no public policies that promote RS in higher education, the same ones that have a welfare, reductionist approach, with little support and little socialization.

By Denisse Vanessa García Chacchi, Marysela Ladera-Castañeda, Miguel Ángel Atoche Pacherres, Cristian Gumercindo Medina Sotelo, Yhedina Dunia Sánchez-Huamán, César Augusto Atoche Pacherres

Software Defined Networking (SDN) is an infrastructure platform for delivering simplified and compliant services with flexible services. These are the means of centralized maintenance and adaptive functions. SDN is affected by various contention flows and causes network performance issues. In this case, we need to provide efficient solutions to handle conflicting flows with better priority and actions. In this paper, we propose a DeepQ Residue method for analyzing normal and conflicting flow scenarios in the load balancing phase. During simulation, an open SDN network is generated using TensorFlow. We use a Hybrid Support Vector machine with an improved decision tree method to predict accuracy and performance. In this case, we analyze threads from 1000 to 100000 in increments of 10000 threads in each iteration. Here, we train a deep belief network with a decision-free feature for environmental simulation. Based on the simulation results, the accuracy of our proposed method reaches 97%, and we compare the results with the results of various existing methods. Our proposed algorithm provides a high-performance SDN application with different conflicting load-balanced flows.

By B. Ananth

A research was developed and its main purpose was to corroborate the effect of the EDU-TB Program to enhance learning about TB prevention in the IRE of the Central University of Ecuador, 2023. Applied research was considered and a longitudinal study was carried out which allowed the evaluation of the variables before and after the implementation of the EDU-TB Program. With a quantitative approach to research. The population was made up of 136 IRE. When comparing the results obtained by both the control and experimental groups, it is evident that the learning levels of those who received the content increased. This could be verified with the application of test and also through statistical processing. Verification of the study hypotheses. The implemented research met the objectives set by demonstrating the effectiveness of the educational program, designed for interaction with students who are pursuing their specialization in nursing. Two important contributions are made, firstly an instrument to evaluate knowledge about TB prevention, which was correctly validated, making it reliable material. The second contribution is made up of the EDU-TB Program, which was effective and fulfilled its purposes.

By Viviana Magdalena Tapia Puga, Luis Alberto Núñez Lira, Yolvi Ocaña Fernandez, Boris Fernando Sánchez Moreno, Luis Israel Tapia Puga

Introduction: chronic kidney disease (CKD) is a progressive alteration that can lead to renal replacement therapy (hemodialysis, HD). This situation has an impact on the quality of life and is affected by the patient's sociodemographic factors, Objective: determine the relationship between sociodemographic factors and quality of life in hemodialysis patients, Methods: cross-sectional analytical study in a population of 92 patients with a diagnosis of CKD in stage V, with HD treatment. Biomedical data were collected with a dialysis record. Quality of life was estimated with the KDQOL-36 scale. Their scores were compared according to two or more groups with Mann-Whitney U tests, or Kruskal-Wallis, respectively. Spearman's correlation coefficient was used for ordinal variables. R-Studio was applied, Results: education is statistically related to “symptoms/problems” (p=0.0176), “effects of kidney disease” (p=0.0054), and “burden of kidney disease” (p=0.0200), with a tendency to observe higher scores in university studies; while economic income was the same with these last two factors (rho=0.24 and rho=0.23, respectively). Furthermore, the “symptoms/problems” score was statistically higher in men than women (74.3 versus 64.1; p=0.00417) and in the case of the “physical component” summary, patients treated in a center public hospital presented statistically higher scores compared to patients treated in private centers (38.1 versus 32.0; p=0.00607), Conclusions: there are aspects of quality of life that are linked to sociodemographic factors that health professionals can consider to focus efforts of the health team and improve this important variable.

By Edith Rivas Riveros, Miguel Ángel López Espinoza

Introduction: Empathy is one of the qualities that health professionals must possess, which allows them to improve their relationship with the patient and in turn the care to be performed, so the objective of the study is to determine empathy in Professor of an Educational Institution in Metropolitan Lima, Methods: It is a quantitative, descriptive-cross-sectional study with a population of 102 Professor who developed a questionnaire of sociodemographic aspects and the Jefferson Medical Empathy Scale., Results: In their results, we observed that 26.5% (n=27) have a low level of empathy, 25.5% (n=26) moderate low level, 24.5% (n=25) moderate high level and 23.5% (n=24) high level of empathy., Conclusions: In conclusion, training in nurses should be improved, since it will allow quality and humanized care in the patient.

By Djamila Gallegos-Espinoza, Lucia Asencios-Trujillo, Livia Piñas-Rivera, Lida Asencios-Trujillo, Carlos La Rosa-Longobardi, Rosa Perez-Siguas

Introduction: Nursing research is a scientific process that supports the practice of care by improving and generating new knowledge for incorporation into practice. However, it is limited by factors that affect the development of the research function, such as indicators that hinder the work of researchers and their investigative competencies.
Objective: To determine the indicators associated with scientific production and competencies in clinical nurses at a specialized institute. Method: This was a non-experimental study with a quantitative, descriptive, correlational, and cross-sectional approach. The population consisted of a total of 248 nurses working in a specialized institute. Two instruments were used: the Scale of Indicators Associated with Scientific Production and the Instrument of Research Competencies. Results: Regarding the indicators associated with scientific production, the highest scored dimension was preparation for research production (Me=3.00, RI=1.00), and the lowest scored dimension was teamwork and network formation (Me=0.00, RI=1.00). In the variable of scientific production competencies, the lowest scored dimension was dissemination (Me=20.00, RI=8.50). Conclusions: It is evident that the nursing professional's production is limited by factors supporting research. Moreover, scientific production can be boosted by identifying its relationship with the competencies required to conduct research in health institutions.

By Jackeline Djana Legua García, Alicia Karina Pando Berrocal, Mónica Elisa Meneses-La-Riva, Wilter C. Morales-García, María Teresa Cabanillas-Chavez, Mardel Morales-García

Introduction. Plan E in the Medicine Career is designed so that developer learning prevails with a broad and active participation of the student in their training. As of the 2022 academic year, the Cuban students who began the Clinical Propedeutics and Medical Semiology subject did so in this new study plan.
Aim. To determine the results of the promotion in the Clinical Propedeutics subject of Plan E of the Medicine career.
Methods. An observational, exploratory, retrospective and cross-sectional study was carried out, based on the analysis of the promotion report of 3rd year medical students in the Clinical Propedeutics and Medical Semiology subject, at the "Miguel Enríquez" Faculty of Medical Sciences, corresponding to the course academic 2022-2023.
Results. The average final grade obtained was 4.2 points. 242 evaluations were carried out, 35% obtained a Good evaluation, 13% were classified as Excellent. In the first partial, 74.6% passed and in the final exam it increased to 84%. After the extraordinary exam, 48% of the students obtained a grade of Good, with 100% passing.
Conclusions. The results show that a 100% promotion of the students in the Clinical Propedeutics and Medical Semiology subject with the new plan E, and the quality of the grades obtained improves as the evaluative cuts are made.

By Lisbel Garzón Cutiño, Daisy María Wainshtok Tomás, Ana Claribel Herrera Wainshtok, Libertad Engracia Valdés Izquierdo

Introduction: Quality of life is very important in relation to health, since it addresses functions that allow Teachers to maintain a healthy life, so the research objective is to determine the quality of life in relation to health in Teachers with chronic diseases residing in a vulnerable area of North Lima.
Methods: It is a quantitative, descriptive-cross-sectional and non-experimental study. With a total population of 152 Teachers with chronic diseases, who answered a questionnaire of sociodemographic aspects and the questionnaire of quality of life in relation to health.
Results: In the results it can be observed that 18 (n = 11.8%) have a low quality of life, 26 (n = 17.1%) average quality of life, 58 (n = 38.2%) high quality of life and 50 (n = 32.9%) a very high quality of life.
Conclusions: It is concluded that strategies that increase the promotion and prevention of noncommunicable diseases should be taken into account.

By Carlos La Rosa-Longobardi, Lucia Asencios-Trujillo, Hernan Matta-Solis, Lida Asencios-Trujillo, Djamila Gallegos-Espinoza, Livia Piñas-Rivera

Introduction: this article was conducted in the field of polymerase chain reaction (PCR) test safety, where it is essential to understand the contribution and impact of risk analysis methods to improve test safety medical diagnosis at the institutional level. In this context, the current study focuses on failure modes and effects analysis (FMEA) applied to the Perkin-Elmer/Cetus deoxyribonucleic acid (DNA) thermocycler.
Objective: the objective of this study is to provide practitioners with a comprehensive overview of the application of FMEA to improve the operational safety of Perkin-Elmer/Cetus DNA thermocyclers used in medical diagnostics in ataxic patients.
Methods: to carry out this study, a methodology based on an exhaustive review of the scientific literature available in academic databases and relevant sources was used. Previous studies on FMEA analysis of DNA thermocyclers in common and expanded forms were collected and analyzed.
Results: the results obtained demonstrated that FMEA is an effective tool to identify and evaluate possible failure modes of Perkin-Elmer/Cetus DNA thermal cyclers. Several defects were identified and their consequences, causes and classification based on their severity and frequency were determined. Likewise, corrective actions are proposed to reduce the identified risks.
Conclusions: early identification of possible failure modes and implementation of corrective actions can reduce risk and guarantee the quality of the diagnoses carried out and therefore improve operational safety.

By Julio Cesar Pino Tarragó, Leider Inocencio Saraiba Núñez, Maira Rosario Moreno Pino, Yorley Arbella Feliciano

Deep learning is a bunch of calculations in AI that endeavor to learn in numerous levels, comparing to various degrees of deliberation. It regularly utilizes counterfeit brain organizations. The levels in these learned factual models compare to unmistakable degrees of ideas, where more significant level ideas are characterized from lower-level ones, and a similar lower level ideas can assist with characterizing numerous more elevated level ideas. As of late, an AI (ML) region called profound learning arose in the PC vision field and turned out to be exceptionally famous in many fields. It began from an occasion in late 2018, when a profound learning approach in light of a convolutional brain organization (CNN) won a mind-boggling triumph in the most popular overall com management rivalry, ImageNet Characterization. From that point forward, scientists in many fields, including clinical picture examination, have begun effectively partaking in the dangerously developing field of profound learning. In this section, profound learning procedures and their applications to clinical picture examination are studied. This study outlined 1) standard ML procedures in the PC vision field, 2) what has changed in ML when the presentation of profound learning, 3) ML models in profound learning, and 4) uses of profound figuring out how to clinical picture examination. Indeed, even before the term existed, profound learning, in particular picture input ML, was applied to an assortment of clinical picture examination issues, including harm and non-harm characterization, harm type grouping, harm or organ division, and sore location.

By RADHA R, RADHA N, SWATHIKA R, POONGAVANAM N,, MISHMALA SUSHITH

Introduction: Dysarthria assessment tools should be tailored to the speech characteristics and impairments. Currently, there are many different tools in clinical practice, mainly perceptual and motor. However, this speech impairment is associated with loss of functionality, limitations in activities of daily living, and restriction in social and occupational participation. This research compares the assessment procedures of several speech assessment tools commonly used in clinical practice for individuals with dysarthria in Chile and worldwide. Methods: A cross-sectional documentary analysis was conducted on various speech assessment tools for individuals with dysarthria. A purposive sampling was used based on the research conducted by Altaher et al. Results: The content analysis shows that all tools have procedures for assessing speech subsystems and non-speech tasks. However, the assessment of the functional characteristics of speech, mainly considering intelligibility, is scarcely addressed. Some tools incorporate tasks that assess different aspects of speech, highlighting that this complementary information can be relevant to the diagnostic process. Conclusions: There is a lack of a standardized speech assessment and the need to incorporate tasks that allow for functional assessment to understand the performance of subsystems and the needs of individuals and their interlocutors to set baselines.

By Marcela Sanhueza-Garrido, Virginia García-Flores, Carlos Rojas-Zepeda, Jaime Crisosto-Alarcón

Introduction: Cleft lip and palate is the most prevalent craniofacial congenital defect worldwide. It consists of a labial or palatal cleft, even a combination of both. It is currently known that cleft lip and palate have multifactorial causes, which include both genetic and environmental factors, which influence the first trimester of pregnancy. Objective: To describe environmental factors in patients with cleft lip and palate treated at the William Soler Pediatric Hospital, in the period between 2021 and 2022. Methodological design: Descriptive, cross-sectional and retrospective study in patients with a diagnosis of cleft lip and palate. The sample was characterized taking into account sex, type of fissure, maternal toxic habits, exposure to radiation, mechanical injuries and environmental toxins, drug consumption, as well as acute and chronic maternal diseases. Data collected during interrogation and physical examination were used. Results: isolated palatal clefts represented 50.5%. 13.7% of mothers smoked during the first trimester of pregnancy, while 10.5% consumed alcohol. High blood pressure (25%) was the most common maternal chronic disease while 41% were diagnosed with vaginal moniliasis. Conclusions: Isolated cleft palate and considerable tobacco and alcohol consumption among pregnant women predominated. Among the chronic diseases, there was a predominance of high blood pressure, the most frequent infectious diseases were vaginal moniliasis and urinary tract infections, and there was a high frequency of the consumption of clotrimazole and oral contraceptives.

By Julio Valcarcel Llerandi, Estela Morales Peralta, María del Carmen Fernández González, Amparo Pérez Borrego

Introduction: the pedagogical model as a scientific result of educational research, understood as a representation of essential elements of the training process or some of its parts. Objective: to validate a model for the formation of the professional competence "Management of patient safety in intensive care" in the Bachelor's degree in Nursing. Method: A study was carried out at the Baracoa Medical Sciences Branch, belonging to the Guantánamo University of Medical Sciences from 2016-2018, methods such as methodological triangulation were used through the criteria of 20 experts by the Green method. Results: The consensus general of the experts was "strongly in agreement" for the foundations that support the training model of professional competence "Management of patient safety in intensive care" in the Nursing Bachelor's degree and its quality. Conclusions: the training model of professional competence "Management of patient safety in intensive care" is accepted as valid and feasible for its implementation in practice, it constitutes a novel and relevant contribution for the transformation of the training process in the career of Nursing, from the Emergency Nursing subject in the fourth year, which promotes the relationship between the systematization of skills and the development of innovation capacity in students to guarantee patient safety.

By Reudis Durán Rodríguez, Raúl Hernández Heredia, Irayma Cazull Imbert, Rosilé Obret Orphee

Introduction: Older adults go through a series of physiological changes, making the loss of physical, psychological and cognitive functions common in this population, mostly causing dependence to perform activities in basic daily life. This condition makes older adults fragile and prone to have any type of fall leading to disability, increase the number of hospitalizations and even death, therefore, the execution of exercises is the best prevention tool.
Objective: To determine the effect of nursing intervention on the deterioration of physical mobility in older adults.
Methods: Quantitative approach, quasi-experimental design with correlational scope. The population consisted of 70 older adults, the sample was chosen by inclusion and exclusion criteria, data collection was by the Barthel index and the battery (SPPB); subsequently, data tabulation was performed using the SPSS statistical program. The research was framed within the bioethical aspects established in the Helsinki declaration.
Results: Older adults prone to frailty are women, who improved their condition from frail to pre-frail, by means of the Otago exercise program.
Conclusions: Nursing interventions is of utmost importance as care plans can be designed, ensuring a better quality of life.

By Daniela Alejandra Romero Mejía, Valeria Isabel Espín López

Introduction: Old age is a stage of life that begins at the age of 65, a natural physiological process that all human beings go through. Negative stereotypes affect older adults, impacting their physical and emotional well-being and influencing the attitudes of younger generations.
Objective: to evaluate the perception that young adults in a community have towards old age.
Methods: research with a quantitative approach, non-experimental transversal design of descriptive scope, the sample was of 133 people between 20 and 39 years old, residents of the Ambatillo parish, La Esperanza neighborhood, the negative stereotypes towards old age questionnaire (CENVE) was applied, the results were tabulated in the SPSS statistical program and the bioethical aspects indicated in the Helsinki declaration were respected.
Results: Young adults showed positive stereotypes 57.1% and negative stereotypes 42.9%. The health, personal character and social motivation dimensions of the questionnaire emphasized a positive perception in the respondents. A 76.7% of the sample mentioned that they had not heard of stereotypes towards old age.
Conclusion: Women showed a more positive inclination than men, age, marital status and level of education also influenced the perception of old age. Finally, we could assert that people with negative stereotypes have limited information since a significant percentage mentioned that they had not heard about stereotypes towards old age.

By Katherine Alexandra Brito Torres, Valeria Isabel Espín López

Introduction: Hospital-acquired pressure ulcers (HAPU) represent a significant public health challenge. Understanding their main characteristics and related factors is essential for effective prevention. This article aims to analyse the main characteristics of HAPUs in four high-complexity hospital centres in Chile.
Methods: Secondary, analytical observational study. The sample (n=1000) included paediatric and adult patients. The study variables were the presence of HAPU, age, sex, dermatitis, risk of HAPU, change of position, pressure relief surface, immobilisation and speed of onset. Measurement of variables included physical examination and chart review. Descriptive statistics and multivariate logistic regression models were performed, accepting 95%CI, p<0.05.
Results: A crude prevalence of 18.7% was estimated. Most patients with HAPU were male (56.1%), aged 18-59 years (39.6%) and 60-80 years (39.0%). On average, ten days elapsed from patient admission to the development of HAPU The most common stage was stage I (50%), and the sacral region was the most frequent site of occurrence (30.1%). The factor with the strongest association with having HAPU was having a high ulceration risk classification (OR 2.6, 95%CI1.5-4.4).
Conclusions: This is the first study in Chile that showed the characterization of HAPU in a relevant sample of hospitalized patients. The relevant representative aspects for monitoring and preventing HAPU as its prevalence, location and factors associated with its appearance.

By Naldy Febré-Vergara, Katherine Mondaca-Gómez, Denisse Cartagena-Ramos, Paula Méndez-Celis, Viviana Muñoz-Cáceres, Macarena Chepo-Chepo

Background: The first reported case of COVID in all of India was in Thrissur, Kerala. Kerala was one among the states which had high recovery rate, low death rate and slow progression which was recognized internationally in managing and controlling the COVID-19 pandemic. For efficient control of transmission of COVID 19, mask wearing was considered as primary and popular measure. Wearing mask everytime can cause discomfort and prolonged mask usage can lead to many health impacts. Mask wearing can be made comfortable and convenient, if the discomforts and health impacts of wearing mask are worked on in future.
Objective: To study perceptions and behavioural traits related to mask usage in general population of Kerala, India.
Methods: An online cross sectional study was conducted in Kerala among 291 adults aged 20 to 60 years with a validated questionnaire. Data was analysed with Pearson’s Chi square and Odds ratio.
Results: Majority of the participants were self-motivated, though 90% of participants reported mild discomforts, yet more than 80% were inclined to proper mask wearing practice. Among the participants, 77% washed and reused masks, more than 49% changed their face touching behavior, 67 % were inspired by family and friends in wearing mask. Older participants (greater than 40 years) had higher knowledge level of mask use (98%) and wearing masks outdoors (92.8%), lesser preference for N95 mask and double mask compared to younger participants.
Conclusion: Study reinforces hypothesis of mask use efficacy in controlling and reducing pandemic spread. Community perceptions and behavioural traits study can enhance planning and implementation of public health programs.

By Anupama Krishnan, Shahnaz Fathima A, Praveen V, Bargale Sushant Sukumar, Shashirekha H K, Harshal Tare, Neha Gadgil, Akshar Kulkarni

Introduction: the identification of risk and protective factors for quality of life allows the development of interventions to improve the quality of life of caregivers of older adults.
Objective: determine the relationship between stress, overload and spirituality with the quality of life of caregivers of older adults.
Methods: cross-sectional and analytical study in 97 caregivers of older adults. The Perceived Stress Scale, Zarit test, Spirituality Questionnaire and Whoqol Breff questionnaire were applied. Descriptive and inferential statistical tests were applied.
Results: no statistical significance was observed of overload, stress and spirituality on global quality of life (F [3, 93] = 2.19, p = 0.094). Overload is a risk factor for physical quality of life (p=0.002), stress is a risk factor (p<0.001) and spirituality is a protective factor (p<0.001) for psychological quality of life, stress is a risk factor for social quality of life (p=0.023) and spirituality is a risk factor for environmental quality of life (p=0.002).
Conclusions: the design of interventions to improve the quality of life of caregivers must consider addressing stress and overload since they are factors that affect the dimensions of quality of life. Spirituality is a protective factor for psychological and environmental quality of life, so it is important to encourage its practice in caregivers.

By Berenice Elizabeth Donjuan Díaz, Tirso Duran-Badillo, Jesús Alejandro Guerra Ordoñez, Juana María Ruiz Cerino

Introduction: The lifestyles of university students are essential, as they impact their physical and mental well-being, as well as academic success.
Objective: To analyze the lifestyles of students majoring in Administration, Accounting, and Law at a private university in the Peruvian Amazon.
Methods: A quantitative, non-experimental, cross-sectional descriptive study was conducted. A total of 285 students participated and were administered the Lifestyle Profile (PEPS-I), an instrument with adequate metric properties. Descriptive statistical methods were applied to categorize the variable and dimensions according to cut-off points. Similarly, the non-parametric Chi-Square test was used to determine whether lifestyles were significantly associated with the proposed sociodemographic and employment-related variables.
Results: It was found that 40.7% of the students had a less healthy lifestyle, 32.3% had a healthy lifestyle, and 27% had an unhealthy lifestyle. Likewise, the dimensions of nutrition, exercise, and health responsibility were also rated as unhealthy, while the dimensions of stress management, interpersonal support, and self-actualization were rated as healthy. Furthermore, it was found that lifestyles were associated with some sociodemographic variables, such as gender and socioeconomic level.
Conclusions: The students were characterized by having a less healthy lifestyle. Based on the results found, it is imperative that universities implement health education programs focused on promoting healthy lifestyle habits.

By Sara Agripina Ttito-Vilca, Edwin Gustavo Estrada-Araoz, Maribel Mamani-Roque

Introduction: Knowledge about arterial hypertension in future nursing professionals is essential since these future healthcare professionals will play a crucial role in promoting health and caring for hypertensive patients in the future.
Objective: To assess the level of knowledge about arterial hypertension in students of the nursing program at a public university.
Method: The research was quantitative, non-experimental, descriptive, and cross-sectional. A total of 188 students participated, to whom the Hypertension Knowledge Questionnaire was administered, an instrument with adequate metric properties.
Results: 38.8% of students had a moderate level of knowledge about hypertension, 31.4% had a high level, and 29.8% had a low level. Similarly, knowledge about general aspects and risk factors was at a moderate level, but knowledge about preventive measures was low. Additionally, the year of study was significantly associated with the level of knowledge about hypertension (p <0.05).
Conclusions: The overall level of knowledge among students about hypertension is moderate. These findings emphasize the importance of strengthening education and awareness about hypertension prevention among nursing students.

By Edwin Gustavo Estrada-Araoz, Maribel Mamani-Roque

Introducción: El trastorno del espectro autista (TEA) es caracterizado principalmente por déficit en la comunicación e interacción social, siendo una barrera para estas personas relacionarse con su medio social y/o familiar. Entre las terapias más conocidas se destacan la terapia farmacológica, - que consistente en medicamentos antipsicóticos-, y la terapia conductiva conductual (TCC), ambas utilizadas para disminuir las conductas desadaptativas.
Objetivo: Analizar la efectividad de las terapias complementarias en la comunicación de niños con (TEA).
Metodología: Estudio de revisión narrativa, se realizó una búsqueda de literatura en base a las terapias complementarias más utilizados para el TEA: “terapia asistida con animales” (TAA) y “musicoterapia”. La búsqueda se realizó en SCOPUS, EBSCO y PUBMED. Se encontraron un total de 228 artículos, de los cuales 8 estudios (n de los 8 estudios = 569) cumplieron con los criterios de búsqueda.
Resultados: se encontraron cinco estudios de musicoterapia (n de los 5 estudios = 481) y tres estudios de TAA (n de los 3 estudios = 88). La musicoterapia y la TAA son las terapias más frecuentemente mencionadas en la literatura, siendo la TAA la que ha reportado mayores resultados en el aumento de habilidades sociales y comunicación no verbal en niños con TEA bajo una perspectiva cualitativa por parte del clínico y de los cuidadores de niños con TEA.
Conclusión: De los ocho estudios que se analizaron, cinco de ellos reportaron beneficios significativos bajo un criterio cualitativo clínico y por parte de las familias del usuario que estaba participando de estas terapias. Tres de los estudios de musicoterapia no evidenciaron cambios en la comunicación de los usuarios, mientras que uno destaca la relación usuario-terapeuta como factor determinante en el éxito o fracaso de la terapia.

By Javiera Etchegaray-Montecinos, Scarlet Moreno-Sanhueza, Catalina Cea-Salgado, Karen Navarrete-Araneda, Cristian Álvarez, Arturo Flores

Introduction: The perception of the level of adherence to hypertensive treatment in adults refers to the extent to which patients follow medical indications and take their medications as prescribed by health professionals.
Objective: To analyze adherence to antihypertensive treatment in adults by means of a quali-quantitative study during the months of May and June in order to create strategies aimed at preventing short-term complications in primary health care.
Methods: The study carried out adopted a mixed quali-quantitative, phenomenological, cross-sectional, cross-sectional approach during the months of May and June of the present year, with a population of 26 people with census sampling using semi-structured interviews, informed consent and the Morisky-Green questionnaire.
Results: According to the study carried out, most of the people suffering from arterial hypertension are female, married, between 30 and 60 years of age, and most of them are engaged in domestic chores. Both men and women with this pathology, according to the surveys, do not adapt to follow the pharmacological treatment; however, they do not abandon it because they know the importance of having a better quality of life.
Conclusion: The analysis of the present study was based on adherence to antihypertensive treatment in adults at the Martínez Health Center in which the suggested strategy is to educate the population more about the importance of adherence to antihypertensive treatment.

By Evelyn Cristina Chicaiza-Almachi, Ana Pamela Pachucho-Flores

Introduction: Education in the 21st century has undergone a profound transformation thanks to technological advances. In this context, augmented reality (AR) has emerged as an innovative pedagogical tool that promises to revolutionize the way students acquire knowledge and skills.
Objective: Establish the impact of augmented reality on the learning of health sciences students at a private university in Lima.
Methods: It is a quantitative, descriptive, non-experimental, cross-sectional study, whose sample was 74 health sciences students from a private university in Lima. The survey technique was used and the instrument was the questionnaire.
Results: The use of AR was located at an intermediate level with 43.24% (32), in learning, a medium level was recorded in 40.54% (30) of the participants; The same trend occurred in the dimensions of both variables.
Conclusions: It was determined that AR has a significant impact on the learning process of health sciences students at a private university in Lima, demonstrated through the Chi-square analysis, p-value = 0.023 < 0.05.

By Elvira García-Huamantumba, Camilo Fermín García-Huamantumba, Leonardo Velarde Dávila, Jhonny Henry Piñán García, Pedro Getulio Villavicencio Guardia, Nérida del Carmen Pastrana Díaz, Guadalupe Ramírez Reyes, Gelacio Pozo Pino, David Julio Martel Zevallos, Lida Days Beraun Quiñones

Introduction: cardiovascular health in the elderly constitutes a line of research of great value for the improvement of health services in primary health care.
Objective: to identify cardiovascular risk in older adults at the Policlínico Universitario "5 de septiembre", Consolación del Sur, in the period 2019-2022.
Methods: observational, analytical, transversal study. A sample of 176 patients was selected by simple random sampling. One-factor analysis of variance, Student's t-test and Mann Whitney U test were used as inferential statistical tests, as well as the Kaplan-Meier curve to predict event-free evolution.
Results: 36,4 % of the adults were aged 80 to 89 years and 72,7 % had a moderate cardiovascular risk. A significant statistical association (p<0,001) was identified between age, sex, blood pressure, weight, height, waist circumference, waist-to-hip ratio and waist-to-height ratio and cardiovascular risk. The presence of sedentary lifestyle, left ventricular hypertrophy, atrial fibrillation, family history of diabetes mellitus and ischemic heart disease, being a smoker and consuming alcohol were associated with increased cardiovascular risk (p<0,001). Follow-up up to 18 months identified the presence of cardiovascular events in 27,3 %.
Conclusions: in older adults a moderate cardiovascular risk was identified, determined by the sum of clinical-humoral factors, habits and lifestyles, and genetic factors, with the presence of early cardiovascular events in those at higher cardiovascular risk.

By Denis Ariel Pérez Álvarez; Adrián Alejandro Vitón-Castillo, Iván Bustinzuriaga-Marto, Francisca Díaz-Pita, Aymeé María Díaz Esquivel

Background: sleep disorder can be considered as a relevant factor in patients with cardiovascular risk.
Objective: the main objective of this study is to associate sleep disorder as a determining factor for the decrease or increase in cardiovascular risk in the adult population.
Methods: transversal analytical study based on secondary records obtained from the database of the third National Health Survey from 2016-2017, with a total of 6,233 respondents aged 15 years and over, through a random and complex selection (stratified and multistage by conglomerates). Data from the Epworth Scale and cardiovascular risk classification were used. Binary logistic regression was applied with the R 3.2.2 “svy” package.
Results: a statistically significant association was found between high cardiovascular risk and Epworth scores between 11-21 points (compared with 0-10 points) adjusted for sex and age (ß= 0.63; p=0.002).
Conclusion: there is observational evidence that allows associating the sleep disorder with a higher risk of developing and / or dying from cardiovascular disease in the Chilean adult population.

By Karla Aravena-Baquedano, Marlene Garcés-Baeza, Leidy García-Sanabria, Miguel Ángel López-Espinoza

Introduction: The family is deeply affected by the appearance of type 2 diabetes (T2D), and throughout the chronic process, the changes that this disease can trigger in the family nucleus make it prone to family dysfunction; Furthermore, depressive symptoms have a high incidence among people with T2D, so these variables could be correlated.
Methods: A quantitative, correlational, cross-sectional, and prospective study was carried out with a sample of 160 individuals with T2D. The Beck Depression Inventory II (BDI-II) was used to assess depressive symptoms, and the Family Functioning Assessment Instrument was used to assess family functioning. Inferential statistics such as C-Cramer and Rho-Spearman were applied.
Results: Significant relationships were identified between sex, socioeconomic level and prepandial glucose levels with family functionality. Likewise, a significant relationship was observed between socioeconomic level and depressive symptoms; A significant and negative relationship was also found between family functionality and depressive symptoms in individuals with T2D.
Conclusions: Nursing and health sciences must consider not only clinical aspects, but also social and family factors when addressing the mental health of people with T2D.

By Kevin Julian Aya Roa, José Manuel Herrera-Paredes, Carlos Alberto Núñez-Colin, María Mercedes Moreno-González, Carlos Oscar Lepez, Adriana Hernández-Bustos

Introducción: El asma es una enfermedad crónica por lo cual es imprescindible adherirse a un buen tratamiento y seguir las recomendaciones de manera adecuada, Objetivo: determinar la efectividad de recomendar consumir frutas y verduras (FV) sobre la reducción de crisis asmáticas, incluido puntajes del cuestionario de control de asma (ACQ) e interleucina-6 (IL-6), Métodos: La búsqueda se realizó en las bases de datos electrónicas: Pubmed, Web of Science, Scopus y Cochrane Library. Fueron incluidos estudios que aplicaron al menos una intervención o recomendación de consumo de FV en pacientes con asma, inflamaciones en las vías respiratorias y otros problemas asociados. Dos revisores independientes evaluaron los estudios seleccionados y midieron riesgo de sesgo. Se resumió la información relevante y se combinó con metaanálisis de efecto aleatorio (DerSimonian-Laird). Se aplicó RevMan 5.4. Por último, se evaluó el grado de recomendación con GRADE-pro, Resultados: Fueron identificados tres ensayos clínicos aleatorios (ECA) que suman 197 sujetos. Se logró observar una disminución de síntomas asmáticos según el ACQ, pero no estadísticamente significativo (-0,20; IC 95%: -0,59; 0,19). Además, interleucina-6 tampoco presentó significancia 0,20 (IC 95%: -0,06; 0,46). La naturaleza del diseño de los estudios meta-analizados permite puntuar un grado de recomendación alto y moderado, respectivamente. Los hallazgos en general sugieren que la ingesta de FV pueden generar cambios favorables en el asma y en su prevención. Sin embargo, este estudio no consiguió demostrarlo estadísticamente, Conclusión: Es necesario que se realicen más ECA para aumentar la potencia de la evidencia y actualizar la información disponible.

By Emilie Thomann-López, Moisés González-Ramírez, Gastón Morales-Quiroga, Carolina Pérez-Sánchez, Miguel Ángel López-Espinoza

Bullying, cyberbullying and virtual intimidation in adolescents is a problem with relevant aspects to be investigated, since in recent years it has been increasing, taking into account that during adolescence acceptance among peers is essential for their social development, that is why this population is prone to suffer rejection, harassment and all kinds of cyber violence. The purpose of this work is to know research on the variables associated with bullying, cyberbullying and virtual intimidation in adolescents. For this, the articles that have been published between 2011 and 2021 in Spanish, English in the following bases have been reviewed: Pro Quest, EBSCO Host, Scopus and Eric.

By Fernando Joel Rosario Quiroz, Kriss Melody Calla Vásquez, Freddy Antonio Ochoa Tataje, Jesús Yolanda Morí Holguín, Marilyn Villanueva-Batallanos

Introduction: Hypertension is one of the diseases that puts at risk the quality of life of the person making him vulnerable to presenting another disease, therefore, the objective of research is to determine the quality of life in hypertensive university professors and the intervention of nursing during pandemic of COVID-19 in a health facility in North Lima.
Methods: It is a quantitative, descriptive-cross-sectional study, with a total population of 265 hypertensive university professors, who responded to a questionnaire of sociodemographic data and the SF-36 questionnaire.
Results: In their results, it was observed that 16(6%) of hypertensive university professors have a low quality of life 93 (35.1%) average quality of life, 76 (28.7% high quality of life and 80 (30.2%) a very high quality of life.
Conclusions: In conclusion, strategies should be sought that allow the guidance of the person with hypertension on the possible risks of their disease and how to prevent it.

By Djamila Gallegos-Espinoza, Carlos La Rosa-Longobardi, Hernan Matta-Solis, Lucia Asencios-Trujillo, Livia Piñas-Rivera, Lida Asencios-Trujillo

Introduction: The COVID-19 pandemic led to mandatory virtual education; as vaccination progressed, a return to in-person learning was implemented with biosecurity strategies in place.
Objective: To analyze health measures and actions implemented in the educational context during the COVID-19 pandemic for prevention, preparedness, and response to future international public health emergencies.
Methods: A systematic review was conducted following PRISMA 2020 guidelines. Data were collected from Scopus, Science Direct, and Google Scholar databases, with inclusion and exclusion criteria reducing the initial 341 articles to 12 for analysis.
Results: Three key strategies for addressing future pandemics in educational settings are highlighted. Prevention focuses on measures like social distancing, mask-wearing, and rigorous hygiene to ensure the safety of students and staff. Preparedness involves ongoing training, clear protocols, and available resources. Response includes socioemotional support for students and teachers, continuous assessments, and necessary adjustments.
Conclusions: This study provides a solid foundation for developing prevention, preparedness, and response strategies in the educational context in the face of potential COVID-19 resurgences and other public health emergencies. By implementing these measures, educational institutions will be better prepared to ensure continuity of education and protect the health of students and staff in a world facing unknown challenges.

By Richar Jacobo Posso-Pacheco, Carmen Mercedes Zambrano-Aguilar, Rodolfo Martín Cornejo-Urbina, Sinchi Yachac Chimba-Santillán, Nube Marina Chimbay-Vallejo

This research delves into the transformative potential of Brain-Computer Interfaces (BCIs) in the domains of education and healthcare. The study explores their applications for cognitive disorder diagnosis and their integration into educational environments, highlighting the multidisciplinary collaboration and technological advancements driving BCI research. Objective: The primary objective is to assess the impact of BCIs on cognitive disorder diagnosis and their potential integration into educational settings. Methodology: A qualitative systematic review of scientific articles published in English and Spanish between 2010 and 2022 was conducted. A total of 84 articles were evaluated, with 68 meeting the selection criteria, focusing on BCI as the object of study associated with cognitive functions. Results: The study reveals the pivotal role of EEG technology in BCI development, particularly in diagnosing cognitive disorders such as ADHD. It highlights the applications of BCIs in cognitive training and their promising potential in enhancing education and healthcare. Interdisciplinary collaboration is identified as a driving force, fostering innovation in BCI systems. Conclusion: This research underscores that BCIs represent not only technological innovation but also a paradigm shift in how cognitive disorders are diagnosed and managed. Their integration into educational settings holds promise for tailored interventions, improving learning experiences and socialization. BCIs empower individuals with disabilities, granting them greater independence and access to various technological tools. The study's findings have profound implications for educational strategies and the overall quality of life for individuals with cognitive disorders, offering a brighter future where BCIs redefine possibilities and enhance the human experience.
Keywords: Brain-Computer Interfaces (BCIs); Cognitive Functions; Electroencephalogram (EEG); Educational Technology; Neurological Disorders.

By Jhonny Richard Rodriguez-Barboza, Flor de María Sánchez-Aguirre, Gliria Susana Méndez-Ilizarbe, Ricardo-Edmundo Ruiz-Villavicencio, Giovana Edith Ruiz-Villavicencio, Carmen Gisela Ramos-Ventura

Introduction: Alcohol and tobacco, present in society for centuries, represent serious risks during pregnancy. Alcohol can cause serious fetal disorders, such as FASD, while tobacco is linked to low birth weight and breathing problems. Both increase the probability of premature birth and neonatal complications, requiring preventive actions and urgent treatment. Objective: To determine neonatal complications in pregnant women with alcohol and tobacco addiction. Methodology: It is a literature review of the literature between 2019 and 2024. Academic databases such as Sciencie Direct, Google Scholar, SciELO, PubMed and Boolean operators were used to broaden the search. The PRISMA method is used to assess the quality of the studies. Results: The initial information search revealed a total set of 1532 articles, of which 60 met the eligibility criteria. Of these, 46 were not relevant, leaving a total of 15 records that contributed to the fulfillment of the study objectives and were used to carry out the meta-analysis. Conclusion: The consumption of alcohol and tobacco during pregnancy causes several neonatal complications, among them we can mention premature birth, low birth weight, among others.

By Nelly Tannia Montaguano Plaza, Evelin Fernanda Velasco Acurio

Introduction: the literature states the importance of self-regulation and gender in school contexts. Therefore, it is necessary to review the published evidence on how the two variables interact.
Objective: to describe research that addresses the variables gender and self-regulation in school contexts.
Methods: a review was carried out using the PRISMA method, searching three databases, Scopus, Web of Science (WOS), and Scielo in July 2023, considering studies in early childhood, primary and secondary school contexts.
Results: Nineteen out of 94 articles identified were analyzed. All of these are quantitative and mostly explanatory. The reported results indicate that female students showed higher levels of self-regulation than male students There are clear differences in results across cultures, and gender is used as a predictor and moderator of self-regulation and other variables. On the language used to refer to gender, 17 publications were found that use terms referring to biological rather than gender differences.
Conclusions: The results show the importance of the gender variable on self-regulation when used as a predictor and moderating variable. The need to take care with the language used to refer to gender and to justify the reasons for collecting data on this variable is evident, for the respective interpretations of the studies.

By Carolina Contreras-Saavedra, Fabiola Sáez-Delgado, Carla Contreras-Saavedra, Javier Mella-Norambuena, Yaranay López-Angulo

Introduction:
Breast cancer is the leading cause of mortality in women in the Americas Region, with 491,000 annual cases and approximately 106,391 deaths. In Ecuador, in 2020, there were 38.2 cases per 100,000 inhabitants, with a mortality rate of 10.9 per 100,000 individuals, emphasizing the importance of early detection and access to effective treatments to reduce the morbimortality associated with this pathology.
Methodology: A systematic review of 58,922 scientific articles was conducted, from which, applying inclusion and exclusion criteria, 36 publications were selected from databases such as PubMed, BVS, SCOPE, Web of Science, Google Scholar, and health websites of the six representative countries under study: the United States, Canada, Mexico, Uruguay, Brazil, and Ecuador. The collected data measured the impact and characteristics of breast cancer detection programs in relation to the reduction of mortality.
Results: Fifty percent of selected countries have active breast cancer detection programs, 33% (equivalent to 2 nations) had protocols and clinical guidelines for prevention, and only one South American country was in the initial stage of implementing a sustainable pilot plan.
Conclusion: In the Americas Region, it is crucial for governments to implement organized and accessible programs, ensuring universal access to the diagnosis and treatment of breast cancer. Ecuador must join this initiative, promoting prevention and public health through pragmatic policies to reduce mortality from breast cancer.
Keywords: screening programs, breast cancer, original article, healthcare system, health promotion, disease prevention.

By Carolina Campoverde Loor, Ricardo Recalde-Navarrete

Introduction: the World Health Organization stated that cardiovascular diseases cause the death of 17.9 million people annually. The Spanish Society of Arteriosclerosis recommended complete lipid analysis including total cholesterol, HDL cholesterol, triglycerides, LDL cholesterol, apolipoprotein B and lipoprotein (a) for cardiovascular risk.
Objective: to conduct a review article on lipidomics and its integral approach in the analysis of the lipid profile, with emphasis on its relationship with cardiovascular risk, by searching and synthesizing relevant and updated scientific literatura.
Methods: the search was carried out in the databases PubMed, Science Direct, Scopus and in the Google Schoolar search engine, following the PRISMA guidelines, the PICO question was posed, studies from the last 5 years and in English language were included.
Results: A total of 5827 documents were obtained and 11 articles were included in the analysis of results. Six articles were used to determine the relationship between non-HDL cholesterol, LDL cholesterol, apolipoprotein B and remaining cholesterol with cardiovascular risk, three for the relationship between lipoprotein (a) and cardiovascular risk and two were used in relation to ethnicity and formulas to determine lipoproteins.
Conclusions: apolipoprotein B over non-HDL cholesterol and LDL cholesterol is the best lipid biomarker, lipoprotein (a) is recommended to be measured once in life and it is advisable to measure LDL cholesterol directly. Introduction: the World Health Organization stated that cardiovascular diseases cause the death of 17.9 million people annually. The Spanish Society of Arteriosclerosis recommended complete lipid analysis including total cholesterol, HDL cholesterol, triglycerides, LDL cholesterol, apolipoprotein B and lipoprotein (a) for cardiovascular risk.
Objective: to conduct a review article on lipidomics and its integral approach in the analysis of the lipid profile, with emphasis on its relationship with cardiovascular risk, by searching and synthesizing relevant and updated scientific literatura.
Methods: the search was carried out in the databases PubMed, Science Direct, Scopus and in the Google Schoolar search engine, following the PRISMA guidelines, the PICO question was posed, studies from the last 5 years and in English language were included.
Results: A total of 5827 documents were obtained and 11 articles were included in the analysis of results. Six articles were used to determine the relationship between non-HDL cholesterol, LDL cholesterol, apolipoprotein B and remaining cholesterol with cardiovascular risk, three for the relationship between lipoprotein (a) and cardiovascular risk and two were used in relation to ethnicity and formulas to determine lipoproteins.
Conclusions: apolipoprotein B over non-HDL cholesterol and LDL cholesterol is the best lipid biomarker, lipoprotein (a) is recommended to be measured once in life and it is advisable to measure LDL cholesterol directly.

By Karen Nicole Punina Lindo, Álvaro Sebastián Ron Mora

Since the SARS-Cov-2 pandemic, e-Health has become an alternative for patient care; however, few studies have shown the treatment results of this tool in the elderly. The aim of this study was to analyze the results of telemedicine treatment in the elderly. A systematic review was carried out according to the formulation of the question, literature search, selection of eligibility criteria, selection of articles, evaluation of the methodological quality of the studies, synthesis and levels of evidence. The PubMed, CINAHL and Science Direct databases were used. The search strategy was constructed according to the combination of MeSH descriptors, CINAHL Subjects, keywords, Boolean operators AND and OR. Experimental studies between 2017 and 2022 were included. All references were exported to the EndNote manager. Methodological quality was analyzed using the Mixed Method Appraisal Tools (MMAT) checklist. The deductive thematic analysis of the data was based on the Model for Assessment of Telemedicine Applications (MAST). Of a total of 2,628 articles identified, 15 duplicates were eliminated and 10 included. Telephone follow-up is a clinically effective tool that was evidenced by psychosocial changes in the elderly.

By Elizabeth Martínez, Fernanda Rivera, Katiuska Reynaldos-Grandón, Felipe Díaz, María Elisa León, Naldy Febré, Ricardo Arcêncio, Denisse Cartagena-Ramos

Introduction: Polycystic Ovary Syndrome (PCOS) is a gynecological endocrine pathology characterized by affecting the quality of life of women of reproductive age, due to the variety of signs and symptoms that manifest, there are treatment options such as the use of complementary medicine and alternative therapies.
Objective: To determine the use of complementary medicine and alternative therapies in Polycystic Ovary Syndrome.
Methods: Systematic review with reflexive critical analysis of publications from 2019 to 2020, in English and Spanish. The question was elaborated using the PICO strategy. Keywords extracted in Health Sciences Descriptors (DeCs) were used. The search was performed in Scopus, PubMed, Semantic Scholar and Google Scholar databases. The PRISMA flowchart was used as a search strategy. The bibliographic sources were organized and interpreted by means of documentary analysis and synthesis.
Results: The methods used in complementary medicine are acupuncture, auriculotherapy, kinesiology, Chinese medicine enema and electrical stimulation. On the contrary, in alternative therapies are yoga, moxibustion, naturopathy and phytotherapy. In addition, as pharmacological method vitamin D, metformin and iron or folic acid.
Conclusions: Complementary medicine is the most used as a method of treatment of Polycystic Ovary Syndrome, specifically the most prevalent is acupuncture as it decreases the symptomatology, induces ovulation, allows improving the menstrual cycle, fertility and increases self-esteem in patients.

By Yadira Nathaly Chicaiza Quilligana, Ana Lucia Jiménez Peralta

Oral health is fundamental in the quality of life of human beings and older adults tend to neglect it. The objective of the study was to describe oral health in older adults of the Gerontological Center "Los Rosales" in Ecuador. It was a descriptive, observational, prospective, descriptive and cross-sectional research. Surveys were conducted with 40 older adults. This study revealed crucial perceptions about the understandings and behaviors related to oral health among older adults in the Gerontology Center of "Los Rosales" sector. The results indicate unanimity in the importance attributed to oral health, with 100% of the participants recognizing its impact on quality of life. However, there is a notable discrepancy between this assessment and effective dental care practices: a low percentage of annual dental visits, together with a tendency towards self-medication and the use of home remedies for discomfort. In addition, the majority of respondents have removable prostheses and highlight nutrition as a crucial factor in dental care, but there are gaps in knowledge and application of proper denture cleaning practices. It is concluded that there is a significant gap between the perception of the importance of oral health and concrete actions for its care and prevention in the older adult population. The practices adopted do not always reflect knowledge of the subject, which underscores the need for educational interventions and access to dental services

By Amalia Fernanda Vera Veloz, Aurelia María Cleonares Borbor

Introduction: Escherichia coli is one of the most investigated bacteria due to the diversity of impacts on human health; it can sometimes form new resistant strains through conjugation processes, becoming a real public health problem.
Objective: To evaluate the relationship between prolonged use of psychotropic drugs and increased antimicrobial resistance in Escherichia coli strains.
Methods: A comprehensive literature review was conducted using different databases of scientific importance; including 35 theses, research articles and reviews published in Spanish and English, from 2019 to 2023.
Results: Studies of patients under psychotropic treatment with tricyclic antidepressants and selective serotonin reuptake inhibitors for more than 3 months were analyzed; proving the appearance of dysbiosis in the intestinal microbiota.
Conclusion: The appearance of dysbiosis in the intestinal microbiota of patients under treatment with psychotropic drugs such as tricyclic antidepressants and selective serotonin reuptake inhibitors, causes a reduction in beneficial bacteria and favors the necessary environment for an increase in pathogenic gram-negative bacteria with resistant mutated strains, specifically Escherichia coli.

By Dayanara Tifane Zambrano Zambrano, Lourdes Gioconda Tabares Rosero

Introduction: urinary tract infection (UTI) is common in pregnant women due to different anatomical, hormonal and functional changes. The incidence of UTI in pregnant women is 5% to 10%. This study collected information related to etiological agents, predisposing factors for UTI, mechanisms and antibiotic resistance by etiological agents in pregnant women.
Methods: a bibliographic review was carried out in databases in Pubmed, Scopus, Scielo, Elsevier and Google Google Scholar. In which, through the prism method, scientific articles and documents containing updated information published during the period 2018-2023 were selected and included.
Results: a thorough search was carried out in different databases and 19 articles were selected, in which it was identified that the most frequent etiological agent was Escherichia coli, followed by Klebsiella pneumoniae. The antibiotic with the greatest resistance by the etiological agents was ampicillin and the main mechanism of resistance in uropathogens was the production of βLEE mainly in Escherichia coli.
Conclusions: urinary tract infection is frequent in pregnant women, and resistance to antibiotics has currently been increasing, so it is important to constantly update the pattern of susceptibility and resistance to antibiotics in pregnant women for antibiotic treatment and prevention feto-maternal safety.

By Jenifer Maribel Santo Guanoluisa, Álvaro Sebastián Ron Mora

Introduction: Over the past four decades, hospitals have faced transformations in funding and management to address growing healthcare demands. The implementation of evidence-based practices, such as the Registered Nurses' Association of Ontario (RNAO) clinical guidelines and the Best Practice Spotlight Organisations (BPSO®) programme, is crucial to improve the quality of care. The collaboration between the RNAO and the Ministry of Health (MINSAL) in Chile highlights the importance of innovation and excellence in healthcare. The aim of this article is to describe the relevance of RNAO guidelines, barriers to their implementation and the role of nursing through a narrative review of the literature. Development: Implementation of BPSO® has demonstrated substantial improvements, including significant increases in patient risk identification and management. However, implementation of the RNAO Good Practice Guidelines (GBP) faces challenges, such as political, organisational and professional barriers. Implementation science is crucial to address these by designing strategies that drive evidence-based quality of care. Conclusion: In summary, the implementation of evidence-based practices, such as the RNAO GBP, represents an organisational change supported by programmes such as BPSO® that have improved care. It is essential to identify barriers, especially in nursing, in order to overcome obstacles and ensure the active participation of professionals in the continuous improvement of the quality of health care.

By Javier Rojas-Avila, Katiuska Lídice Reynaldos-Grandón

The COVID-19 pandemic has had a significant impact on the Kitu Kara indigenous communities of Pichincha, Ecuador. This disease, which mainly affects the lungs but can also damage other organs, has had negative consequences in these communities. The objective of this study was to investigate the situation of education and prevention of COVID-19 in these vulnerable communities. To carry out the research, an exhaustive search for information was conducted in Google, as well as in databases such as SciELO, PubMed, LILACS and various repositories. The information selected followed the criteria established by the PRISMA flowchart, including documents from the period 2020-2022, such as original articles, systematic reviews, case studies and editorials. Forty documents were identified that addressed the situation of indigenous peoples in the face of the pandemic. The results obtained revealed that the pandemic has highlighted the vulnerability of these populations, who not only face precarious living conditions, but are also more susceptible to the impacts of crises. It was concluded that, in most aspects, the situation of indigenous peoples is considerably worse than that of other people with similar characteristics, such as educational level, age, geographic location (rural or urban), type of work and family structure. This suggests the existence of barriers that affect them in a differentiated and excluding manner, as they are a vulnerable group due to lack of information and education, which has led to an increase in COVID-19 cases due to lack of knowledge in these indigenous communities

By Roberto Enrique Alvarado Chacón, Elizabeth Germania Vilema Vizuete, Guadalupe Eduviges Cuello Freire, Valeria Kasandra Guevara Guamán

Amebiasis is an intestinal infection prevalent throughout the world, with the population of underdeveloped and tropical countries being the most affected. The disease is caused by the genus Entamoeba, Entamoeba histolytica is considered the only pathogenic species for humans, affecting the intestine, lung, brain and liver with the formation of abscesses. The data on the prevalence and incidence of amebiasis are considered to be overestimated, because traditionally the epidemiology of the disease has been studied by direct observation by microscopy, a technique that does not facilitate the differentiation of E. histolytica from other morphologically similar and non-pathogenic amoebas. To identify the real rate of amebiasis infection, techniques and methods have been implemented that moderately increase the diagnostic specificity of amebiasis, such as concentration techniques (Faust and Ritchie), stains, cultures and blood tests; these methods have not been able to resolve this problem public health problem. With the arrival of technology, laboratories have managed to implement techniques that identify microorganisms at a molecular level using techniques such as: Polymerase chain reaction (PCR) or Loop-mediated isothermal amplification (LAMP), whose specificity rate is close to 100%, which they are considered novel techniques whose objective is to update the diagnostic process of amebiasis.

By Kevin Adrián Garcés Curay, Elena Johanna Pérez Laborde

The fundamental importance of the analytes lies in their role as primary biomarkers to identify possible conditions that may arise during the gestation process. Objective: To analytes the importance of determining uric acid, cholesterol and triglycerides in pregnant women. Methodology: The article was a literature review that focused on the synthesis and analysis of scientific articles related to the topic in question. The PRISMA method was used to search for information, which consisted of an exhaustive and systematic search for relevant data using appropriate search terms and strategies. Results: Thirteen articles were screened and selected for analysis, of which six were excluded because they focused on pregnant women, but with different analytes. From the standards, 7 articles were identified that met the methodology and were included in the article development analysis. Conclusions: The research evidenced that the evaluation of uric acid, cholesterol and triglyceride levels are a first source in preclinical diagnosis, however, among the most common pathologies such as preeclampsia there are approximately 66 predictive parameters being this an important part of prenatal care to promote a healthy pregnancy.

By Ana Lizbeth Guadalupe-Carrasco, Martha Cecilia Ramos-Ramírez

Preventive dentistry focuses on the analysis of bacterial plaque and the promotion of proper hygiene and eating habits. This makes it possible to work on the prevention of possible dental diseases. Therefore, it is essential to apply various methods that encourage people's interest in their oral hygiene, including the control of bacterial plaque, the application of appropriate toothbrushing techniques and regular dental checkups. The objective of this study was to compare the plaque index pre and post prophylaxis using chlorhexidine by means of a literature review. The methodology used included the analysis of 20 scientific articles through a documentary review and the development of a content matrix. The findings suggest that Chlorhexidine, an antiseptic, is effective in reducing oral biofilm and controlling periodontal diseases by inhibiting bacterial plaque. However, other alternatives with similar functions have also been identified, such as mouthwashes based on chamomile and sodium bicarbonate. It is concluded that Chlorhexidine is an antiseptic that is responsible for reducing oral biofilm and controlling periodontal diseases by inhibiting bacterial plaque and combating bacteria present in oral tissues. It is also used before surgical interventions for better cleaning; however, if these mouthwashes are not administered in the correct doses, side effects such as taste impairment and dental discoloration may occur

By Grijalva Palacios Miryan Margarita, Ponce Reyes Nathalie Stefy, Tacuri Eras Helen Dayana, Flores Aupaz Jhean Pierre

Introduction: care in intensive care units (ICU) is complex, requiring the collaboration of a multidisciplinary health team. Despite the existence of protocols, gaps in care persist. The FAST HUG mnemonic, a checklist to remember key aspects in the care of critically ill patients, has demonstrated effectiveness in reducing variability and improving compliance with care standards. Methods: a systematic review of the literature was carried out following the PRISMA guideline for answer the question about the benefits of the FAST HUG mnemonic in ICU patients. Databases such as PubMed were searched for articles in English, Spanish and Portuguese published between 2019-2023. The selection was made by reviewing titles, abstracts and complete reading applying the criteria. Results: a total of 16 articles were included in the review. It was found that the FAST HUG mnemonic has had various modifications such as FAST HUGS BID and FAST HUGS COVID to suit specific needs. Its implementation as a routine checklist in intensive care units improves the quality of care for critically ill patients, preventing possible complications. However, adequate training of health personnel is required, given that several studies revealed insufficient knowledge about its correct use in nursing personnel. Conclusions: there is growing support for the potential benefits of the FAST HUG mnemonic in care. of critically ill patients, but with significant variability in its application and knowledge among health professionals.

By Karla Acosta, Evelin Velasco

Introduction: Renal failure is a disease in which the kidneys present a decrease in glomerular filtration, so they are not able to eliminate water and wastes from the blood correctly. It is classified into two types; acute kidney injury (AKI) and chronic kidney disease in which the latter has generated a greater impact in terms of mortality.
Objective: To relate Cystatin C levels and the severity of renal damage in patients with renal failure.
Methods: A descriptive and observational research was carried out with a non-experimental design and a descriptive and exploratory level of research, to develop this research the PRISMA methodology was used, where the main sources used for its development are detailed.
Results: this research describes the generalities about cystatin C, analytical methods, interferences, stability, and the stages of analysis of this biomarker, the same that was classified into pre-analysis, analysis and post-analysis of the test exposing in each of them the most important points involved.
Conclusions: Cystatin C turns out to be a biomarker with a higher accuracy and sensitivity compared to other tests, in terms of clinical utility this test allows early detection of renal failure, and in patients suffering from this disease helps to determine the stage in which they are in this way allows to obtain a better diagnosis and prognosis regarding this condition.

By Alexandra Estefania Chugcho Aguagallo, Álvaro Paul Moina Veloz

Introducción: Las técnicas quirúrgicas mínimamente invasivas (TMI) han revolucionado el campo de la cirugía, ofreciendo importantes beneficios sobre la cirugía abierta tradicional. Esta revisión narrativa examina la evolución histórica, los avances actuales y las perspectivas de MIS, centrándose en su impacto en los resultados de los pacientes, la capacitación quirúrgica y los sistemas de atención médica.

Objetivo: Proporcionar una descripción general completa de los avances en TMI, destacando las innovaciones tecnológicas, los cambios en la práctica clínica y la evolución de la educación quirúrgica. La revisión también tiene como objetivo discutir los desafíos y las direcciones futuras de TMI.

Métodos: La revisión incluyó 24 artículos publicados entre 2004 y 2023. Los criterios de inclusión fueron la relevancia para el desarrollo y el impacto de TMI, con exclusión de artículos que no estuvieran en inglés y no relacionados. Los datos se sintetizaron para delinear la progresión, el estado actual y las tendencias futuras en TMI.

Resultados: Los hallazgos clave incluyen avances significativos en tecnologías quirúrgicas como la robótica y las imágenes mejoradas, la expansión de MIS en varias especialidades y mejores resultados para los pacientes, como tiempos de recuperación reducidos y tasas de complicaciones más bajas. Los desafíos identificados incluyen la pronunciada curva de aprendizaje para los cirujanos y las disparidades en el acceso global a TMI. Las tendencias futuras indican un movimiento hacia la integración de la IA, enfoques quirúrgicos personalizados y un mayor refinamiento de los sistemas robóticos.

Conclusiones: las TMI representan un cambio de paradigma en la práctica quirúrgica, caracterizado por la innovación tecnológica y la mejora de la atención al paciente. A pesar de los desafíos, su futuro es prometedor y se espera que los avances continuos remodelen aún más los procedimientos quirúrgicos.

By Andrea Patricia Pérez Ayme, Josseline María Caiza Suárez , Martin Mateo Paredes Ortega , Daniel Samuel Gualoto Gualoto, Juan Carlos Santillán Lima, Adriana Elizabeth Rivera Campoverde, Alfredo Augusto Rivera Ticona, Jonathan Steven Coello Vergara, Gerzon David Martínez Serrano

Introduction: Monkeypox, or monkeypox, is a zoonosis endemic in the rural jungle areas of central and western Africa, in humans the first occurrence was in 1970 in the Democratic Republic of Congo. It is caused by a virus belonging to the genus Orthopoxvirus of the Poxviridae family.
Objective: To determine the causes and predisposing factors to the outbreak of monkeypox, transmission routes, clinical manifestations, evolution, complications, diagnosis, therapeutic management, prevention and control of infection.
Material and methods: A systematic review was carried out in the Medscape, Pubmed, Science Direct and Scielo databases. Thirty-one papers were used.
Results: Monkeypox was discovered in 1958 in the city of Copenhagen, capital of Denmark, in monkeys used for research. In 1970, the first case of monkeypox in humans was reported in a child in the Democratic Republic of Congo. Once the diagnostic suspicion is determined, sampling is indicated to confirm infection by nucleic acid amplification test (NAAT) or real-time PCR. PCR is the definitive diagnostic test, can be alone or followed by restriction fragment length polymorphism (RFLP) analysis or sequencing, has high sensitivity and specificity; and a rapid turnaround time of about one day or less. Monkeypox is usually mild and most people recover without treatment.
Conclusions: So far in Ecuador 421 cases of monkeypox have been reported, so it is important that public health officials and health care personnel receive training on the risk of the disease, recognition, treatment and isolation of cases. It is important that the country has sufficient PCR tests in public facilities for the confirmation of cases and as a method of prevention, citizens should maintain the biosecurity measures announced by the MSP.

By Esmeralda Maricela Estrada Zamora, Verónica Gabriela Salinas Velastegui, María Belén Trujillo Chávez, Byron Josue Coronel Miranda, Liner Oswaldo Chango Moposita

Introduction: The interplay between surgery, internal medicine, and anesthesia is fundamental to the comprehensive care of patients, particularly in complex clinical scenarios. Understanding the dynamics of these interactions is crucial for improving patient outcomes and advancing healthcare practices.

Objective: To review the existing literature on the collaboration between surgery, internal medicine, and anesthesia, identifying key areas of synergy, challenges, technological impacts, and future directions for research and practice.

Methods: An extensive literature search was conducted across multiple databases, including PubMed and Google Scholar, using a combination of keywords related to surgery, internal medicine, anesthesia, patient care, and interdisciplinary collaboration. 22 relevant articles were selected based on predefined inclusion and exclusion criteria, with a focus on those that explored the integration and outcomes of these medical disciplines. Data were synthesized through thematic analysis.

Results: The review highlights the significance of interdisciplinary collaboration in optimizing patient care, the role of technological advancements in bridging gaps between disciplines, and the ethical and patient-centered considerations that underpin successful integration. Education and training emerge as critical components for fostering effective collaboration.

Conclusions: Effective interdisciplinary collaboration between surgery, internal medicine, and anesthesia is pivotal for enhancing patient outcomes. Future research should focus on addressing identified gaps, particularly in the integration of technology and the development of ethical guidelines for complex patient care.

By María Auxiliadora Calero Zea, Alexis Andrei Granados Flores, Daniel Ismael Astudillo Pinos, Geovanna Paola Jaramillo Calderón, Alfredo Augusto Rivera Ticona, Génesis Karolina Huilca Villalba, Emily Melissa Armijo Ibarra, Andrés Bryan Vergara Bohórquez, Francisco José Terán Villacres

The effectiveness of calcium hydroxide as an antiseptic agent in endodontics has recently gained relevance, being crucial to ensure optimal results in endodontic treatments. The aim of the study was to interpret the use of calcium hydroxide as an intra-endodontic medication by means of a literature review. A narrative review of the updated literature was performed, with the aim of describing the effects of CaOH and exposing the different clinical procedures in which it is used, as well as the results of its application in endodontic therapy. Clinical trials, meta-analyses and original and published articles from 2018 to 2023, in English or Spanish, were included. It was found that calcium hydroxide plays a key role in endodontics due to its dissociation into calcium and hydroxyl ions, which contributes to its antimicrobial and biological efficacy. Its clinical application is extensive, including preventive endodontics, direct and indirect pulp capping, pulp curettage and pulpotomies, especially in teeth with incomplete apical development. The mechanism behind its antimicrobial action lies in the diffusion of calcium ions and the increase in pH, which limit the rate and enhance the antimicrobial effect in root canals. It was concluded that, for an effective endodontic treatment, it is necessary to eliminate all microorganisms from the root canal. In addition, the microorganism such as E. faecalis has a high resistance to endodontic treatment, which is due to its ability to penetrate into the dentinal tubules, tolerate high alkalinity, and form biofilms

By María Belén Muñoz Padilla, Verónica Alicia Vega Martínez, Camila Alejandra Villafuerte Moya

Introduction: every person has a work activity to satisfy their basic needs, acquire what they want and contribute productively to society. However, in any job there are certain circumstances, conditions and risk factors to which said worker is exposed; That is, accidents and illnesses may occur that affect your physical or psychological well-being, making it necessary to activate prevention in work environments.
Objective: establish the importance of the elements involved in occupational health and safety programs. Method: a bibliographic review was carried out in the Scopus, Web of Science and SciELO databases. 35 articles were analyzed and examined.
Results: the importance of occupational health and safety programs for the well-being of workers was evident.
Conclusion: companies must develop, implement and constantly improve their framework of action in order to apply occupational health and safety programs in the risk management process

By Hugo Daniel Garcia Juarez, Alejandro Ticona Machaca, Delia Concepción Cahuana Pacco, Felix Alberto Caycho Valencia

The use of lasers in endodontics has revolutionized the dental field by offering a precise and less invasive option to treat pulp and periapical problems. This is why the importance of the diode laser in endodontics is recognized in order to potentiate the irrigation of the root canal system. The aim of this study was to interpret, by means of a systematic literature review, the use of the diode laser to enhance root canal irrigation in endodontics. Through a systematic review, 18 original articles related to the aforementioned topic were analyzed, which were obtained from the electronic search of the following databases: Springer, BioMed Central, Multidisciplinary Digital Publishing Institute, PubMed, Wiley Online Library. In addition. It was obtained as results that it is possible to reach areas such as lateral or accessory canals that may be inaccessible for traditional irrigation techniques, eliminating dentin debris, smear layer and other residues; however, despite its advantages it should be considered that the application of the diode laser should not replace conventional treatment, but should be considered as a possible complementary treatment. It is concluded that the application of the diode laser in endodontic therapy improves the efficiency of root canal system disinfection

By Miryan Margarita Grijalva Palacios, Nathalie Stefy Ponce Reyes , Naomi Leonela Vásquez Guerra, Alejandra Daniela Chávez Arteaga

INTRODUCTION: Physical activity, especially high-impact activity, generates an increase in total testosterone levels in the athletes' bodies, this increase provides a gain in strength and muscle growth in a short period of time.
METHODS: A narrative review was carried out with different search strategies in PubMed, Elsevier, Academic Google, Scielo, 22 research articles and reviews published in Spanish and English were included, from 2019 to 2023.
RESULTS: Of the studies reviewed, the majority provided key information on the association between elevated levels of total testosterone and physical growth in athletes.
CONCLUSION: Sport is essential to improve the quality of life of the individual, however, the obsession with developing spectacular muscles and increasing their strength has led athletes to consume anabolic androgenic steroids that dangerously raise testosterone levels, consequently, causing the damage to organs and systems, which could become a public health problem; therefore, consumption must be controlled medically. Low testosterone levels in men are associated with erectile dysfunction, in women with infections and vaginal dryness. Testosterone levels in trans women, despite wanting to suppress them through hormone therapy, remain high, giving them an additional advantage over the rest of the female gender.

By Yanira Monserrath Herrera Telenchana, Lourdes Gioconda Tabares Rosero

ABSTRACT

Introduction: Menopause exerts a marked influence on Insulin Resistance. The homeostatic model for assessing insulin resistance (HOMA-IR) is a proven effective and useful clinical tool. The aim of this study was to seek scientific information to understand the differences, underlying factors and relevant implications in the detection of this condition in two stages of women's life. Methods: A systematic review was performed in Google Scholar, Scopus and PubMed using key terms such as Insulin Resistance Assessment, HOMA Index, HOMA-IR, Premenopausal women, Postmenopausal women, Menopause and Comparative Study. The search was limited to English language articles published in the last five years, which were analyzed according to PRISMA methodology. Results: Eight studies were evaluated, 50% focused on postmenopausal women, 25% on premenopausal women and another 25% both stages. The studies showed a higher body mass index in postmenopausal women, associated with 34.2% of insulin resistance in this population. In all studies, HOMA-IR and Body Mass Index (BMI) were evaluated, and 87.5% included lipid profile. In addition, 12.5% suggested innovative metrics such as Triglyceride to Glucose Index (TGI) and Galactin-3 Binding Protein (Gal-3BP) as new biomarkers. Conclusion: Assessment of insulin resistance with HOMA-IR is common, but the results reveal remarkable variations among the stages analyzed. Recognizing hormonal and metabolic differences is essential to improve accuracy and guide preventive strategies in the management of IR.

By Carlos Fernando Yauli Flores, Ericka Jazmín Tubón Luisa

Introduction: Chronic kidney disease has developed in recent years and has become one of the top 10 leading causes of death worldwide. Patients undergoing dialysis require monitoring of hematological and biochemical parameters to detect the progression of the disease and assess the quality of treatment.

Objective: To evaluate the variation in different parameters of the hematological and biochemical profile in patients before and after dialysis.

Methods:  a comprehensive literature review was conducted with 24 scientific articles obtained from digital databases such as Google Scholar, SciELO, PubMed, Elsevier, related to chronic kidney disease and the measurement of hematological and biochemical parameters in patients during pre and post-dialysis.

Results: Most hematological parameters, such as red blood cells, hemoglobin, MCV, MCH, and platelets, significantly increase after treatment. On the other hand, both urea and creatinine decreased during post-dialysis measurements, although they did not decrease enough to reach normal values.

Conclusions: Dialysis produces positive changes in hematological profile parameters, as levels increase after treatment. It also helps eliminate toxins from the blood by demonstrating a decrease in urea and creatinine.

By Noelia Nataly Pérez Salazar, Lourdes Gioconda Tabares Rosero

Teaching processes through gamification for university students constitute a fundamental activity that allows the individual to enhance skills for the improvement of the activities used and the acquisition of satisfactory results, both in primary and secondary education as well as in secondary and higher education. Thus, this review article establishes an analytical look at the implementation of gamification as a technique that strengthens soft skills such as communication and creativity in university students; For this, a total of 20 articles are used that define the categories of analysis and also constitute an investigative vision on the effective strategies that allow the individual to apply competencies in academic spaces of the university and in professional practices. As a result, significant application processes are defined from gamification to increase creativity and communication as skills that will help the individual to develop capabilities and competencies in the areas of knowledge.

By Sonia Rivera-Valderrama, Luis Efren Rua Sánchez, Guadalupe Citlalli Alfaro Rodas, Jazmin Isabel García Guerra

The interpretation of the refusal to use contraceptive methods in university students is important because it helps to understand the beliefs, attitudes and behaviors regarding sexual and reproductive health in this demographic group, and also allows the identification of possible cultural, educational or access barriers that may be affecting decision making related to the use of contraceptives. The objective of this systematic review was to analyze the causes of refusal to use contraceptive methods in university students based on a systematic literature review. For the development of the research, a search of electronic documents was carried out in databases such as PubMed, Scopus, Medline and Embase. Fourteen scientific articles were selected by applying the PRISMA 2020 guidelines, using descriptors such as: ("level of knowledge about contraceptive methods" OR "refusal to use contraceptive methods") AND ("University students") and an evaluation of the quality of the articles based on the use of the STROBE guidelines. The results reflected that most studies agree that students are knowledgeable about contraceptive methods, but do not use contraceptives for the most part. The main causes of refusal are related to inappropriate sexual behaviors, alcohol and drug abuse, early age of sexual debut, gender stereotypes, religion, lack of family counseling, and misuse of contraceptives. Currently, the education and training of students is a key factor in the prevention of unwanted pregnancies and sexually transmitted diseases

By Barrera Loayza Shirley Katherine, Cabuco Lalaleo Andrea Nicol, Tarco Orozco Diego Joel

Introduction: Spinal muscular atrophy type 1 is the most severe form of spinal muscular atrophy. It affects newborns and manifests within the first months of life. It is a progressive disease that significantly impacts the quality of life and has a high childhood mortality rate.
Objective: This article aims to provide an update on the diagnosis and treatment of spinal muscular atrophy type 1.
Methods: A literature review was conducted on articles published in the last five years, utilizing databases such as PubMed, the Cochrane Library, and Web of Science. Clinical studies, systematic reviews, and meta-analyses related to the topic were selected.
Results: Recent advances in genetics have enabled a more precise diagnosis through the Survival Motor Neuron 1 genetic test, in addition to electrodiagnostic studies and, in some cases, muscle biopsy. These tests allow for accurate disease confirmation, which is essential for effective treatment. Regarding treatment, it includes the use of Nusinersen, Onasemnogene Abeparvovec, and Risdiplam. These medications have shown promising results in improving motor function and patient survival. Each of these treatments addresses the disease from different mechanisms, offering various options for managing spinal muscular atrophy type 1.
Conclusions: Although there is still no cure, advances in the diagnosis and treatment of spinal muscular atrophy type 1 provide hope. Early detection and emerging therapies are crucial in improving outcomes for patients.

By Gabriela Alexandra Solano Peña, Richard Gabriel Armendáriz Molina, Gabriela Alejandra Díaz Teran, Gabriela Fernanda Acurio Armas, Rosa Ximena Valencia Bautista, Maria Caridad Rodas Rivera, Tatiana Alexandra Aldas Palacios

Introduction: Covid-19 is a recently discovered disease, originating in Wuhan, China at the end of 2019, this virus being responsible for the current pandemic. Due to the spread of the virus, it is of interest to evaluate the available evidence on the role of micronutrient supplementation, Objective: characterize the effectiveness of supplemented micronutrients on inflammatory markers in Covid-19 patients, Methods: A systematic review of 3,053 studies was carried out through a search in electronic databases. Studies without variable results, without a comparison group and incomplete information were excluded, Results: Three of which proposed supplementation with vitamin C and D in critically ill patients with Covid-19 were found. Two clinical trials evaluate vitamin D supplementation, showing a decrease in the response variables (interleukin 6, ferritin and CRP), while the third evaluated vitamin C in relation to the admission of patients to the ICU, Conclusions: with little evidence found, it is not possible to affirm the idea that the micronutrients studied help reduce the concentration of inflammatory markers.

By Valentina Rail, Nicole Seguel, Laura Quezada, Miguel Ángel López-Espinoza

Sleep is an essential biological cycle that regulates the internal rhythms of the human being and contributes to maintaining homeostasis. During sleep, the glymphatic system, responsible for eliminating brain waste, is activated. Sleep deprivation or related disorders can slow down the elimination of beta-amyloid protein, increasing the risk of cognitive impairment, dementia and Alzheimer's disease. This study sought to interpret how alterations in the glymphatic system during sleep affect brain health. A literature review was conducted using document analysis techniques, analyzing scientific articles in the Virtual Health Library, Lilacs, PubMed and various indexed journals. Search strategies based on descriptors and Boolean operators were developed during the period from August to September 2023. As results, a connection between migraine and the glymphatic system is suggested, observing a decrease in the elimination of brain solutes and metabolites during prolonged periods of wakefulness. A bidirectional relationship has also been identified between post-traumatic headache and sleep disturbances following brain injury, possibly due to dysfunction of the glymphatic system, which limits the clearance of headache-related neuropeptides and contributes to its chronicity. Dysfunction of the glymphatic system is present in several neurological disorders, as well as decreased drainage of proinflammatory chemicals and cytokines in different conditions. It is concluded that these findings suggest that the glymphatic system could be considered as a diagnostic and therapeutic avenue for neurological diseases that were previously considered chronic or irreversible

By Viteri Rodríguez Juan Alberto, López Barrionuevo Carlos Gustavo, Arellano Oleas Yesenia Esthefanía, Aldemar Alejandro Monsalve Guamán

Introduction: Respiratory diseases are an important cause of morbidity and mortality in the general population, but it affects older adults, children and immunocompromised people to a greater extent, with viruses being responsible for 80% of these infections. Studies have shown that influenza virus and respiratory syncytial virus are the most commonly identified agents. Since 2019 with the beginning of the COVID-19 Pandemic, the world's population has undergone great changes, with thousands of infections, deaths and economic losses.
Methods: A systematic electronic search of articles published from 2018 to July 2023 was carried out in the databases PubMed, Springer Scielo, ELSEVIER, Google Scholar. Descriptive, retrospective, prospective, observational, meta-analysis, original articles were chosen, which provided statistical information, for their search keywords such as: COVID 1, co-infection, respiratory co-infection, SARS Cov-2 infection, influenza virus, respiratory syncytial virus.
Results: With the literature review, 552 articles were obtained, of which only 73 were chosen according to the eligibility criteria, excluding 52, with a total result of 21 scientific articles.
Conclusions: Although the incidence of COVID-19 remains high, the prevalence of respiratory viral co-infections is relatively low. Global infection control measures may have contributed to reducing the circulation of respiratory viruses. All these actions should be directed for the benefit of the vulnerable population and should be cost-effective for health systems.

By Vanessa Pérez, Ricardo Recalde-Navarrete

Postpartum depression is a mental condition of considerable severity that has a negative impact on the physical and psychological well-being of the mother. This pathology usually manifests itself after the first or second-week following childbirth and can persist or emerge up to one year after the event. However, it is important to note that approximately half of these episodes actually originate before birth. Postpartum depression is the most socially stigmatized maternal condition; despite this, on numerous occasions, this condition is underdiagnosed, and for many professionals, this disorder goes unnoticed. The aim of this study was to identify the risk factors associated with postpartum depression, in order to prevent and highlight the importance of its early detection. For this purpose, a literature review was carried out, analyzing databases such as PubMed and SciELO, among others, from which 15 relevant articles were selected, which were interpreted with the support of hermeneutics, in a retrospective and observational research. Among the most significant findings, it was identified that the most relevant risk factors include age, occupation (especially being homemakers), parity and social support. It was concluded that mothers affected by postpartum depression tend to experience thoughts of self-harm or harm towards the baby, affecting their quality of life and manifesting symptoms such as fatigue, irritability, persistent sadness and lack of sleep

By Mónica Gabriela Chachalo Sandoval, Marcela Estefanía Chalacan Castro, Paulette Baymar González Rojas, Karla Magaly Sánchez Sánchez

Biosafety is of great importance in all areas of health care, including endodontic procedures, since they represent a high risk of biological transmission of diseases such as AIDS and hepatitis, among others. The aim of the study was to interpret biosafety in endodontics by means of a literature review using PRISMA 2020 methodology. It was an observational, retrospective and descriptive study corresponding to the exploratory level, following the guidelines of the PRISMA 2020 methodology, combining the terms 'biosafety' and 'endodontics' in the PubMed and Google Scholar databases. The results highlighted the importance of biosafety in endodontic procedures and it was found that endodontics is used to treat different types of endodontic infections with high bacterial loads, so the correct use of biosafety barriers and protocols is necessary, since the area of dentistry has a high risk of biological contagion. It was also shown that biosafety comprises a set of rules, precautions and guidelines used in various scientific research and teaching activities to prevent risks or infections associated with exposure to agents that may be infectious or present significant biological, chemical or physical risks. It was concluded that endodontics and its procedures require strict compliance with biosafety protocols to ensure a high success rate and safeguard the health of the professional, the patient and the work team

By María Belén Muñoz Padilla, Verónica Alicia Vega Martínez, Camila Alejandra Villafuerte Moya

Introduction: The human immunodeficiency virus (HIV) is characterized by attacking TCD4 cells and macrophages; with the progression of the pathology, secondary infections can develop.
Objetive: to describe the theoretical foundations of the HIV epidemiological surveillance system in Ecuador.
Methods: research based on bibliographic review in different databases, Epidemiological Gazettes, SIVE-ALERTA Manuals and websites of Scientific Knowledge Organizations, the PICOT question was also implemented and 25 articles based on the PRISMA method were used.
Results: The surveillance procedure is based on universal surveillance with different diagnostic methods, notified through EPI INFO-SIGEPI databases registered with the Ministry of Public Health. The total number of infections in Ecuador in 2022 is 48,924, with a higher incidence in the province of Napo with 0.67 and new cases in the province of Guayas with 32.5%.
Conclusion: Information from different databases on the incidence, prevalence, morbidity, mortality and opportunistic infections of the HIV virus was synthesized.

By Jennyfer Paulina Tobar Andy, Francisco Xavier Poveda Paredes

Gestational diabetes mellitus is a pathology suffered by one in seven pregnant women worldwide, in which carbohydrate metabolism is altered, that is, glucose intolerance occurs. It is recognized for the first time in pregnancy since these adaptations occur with the objective of providing an adequate amount of glucose to the fetus for its development. They are related to risk factors such as age, diet, lack of physical activity, among others, and can cause fetal macrosomia, neonatal jaundice, and cardiorespiratory complications. In the mother, it is diagnosed through different blood glucose tests such as the oral glucose tolerance test, O'Sullivan test, however currently new biomarkers have been implemented for an early prognosis such as IL-27, a protein retinol transporter 4, maternal fetuin A, high sensitivity C-reactive protein and molecular biomarkers, but more studies are required so that these biochemical markers can be standardized by an organization.

By Andrea Belén Miranda Sánchez, Álvaro Paul Moina Veloz

Introduction: Insulin resistance or insulin resistance (IR) is defined by the reduction in the processes of insulin uptake, to stimulate the use of glucose in different tissues and to eliminate the production and output of hepatic glucose. On the other hand, currently there are different standard methods to evaluate IR, but these types of methods are highly expensive and their processing requires time.
Objective: The objective of the literature review was to analyze the triglyceride/HDL cholesterol ratio and the role of the laboratory as an indicator of insulin resistance.
Methods: To carry out the bibliographic review article, a documentary exploration method was used through a search for information in databases of journals such as Google Scholar, Pubmed, Scopus, Elsevier, SciELO and Medline.
Results: The articles analyzed provide relevant information on the TG/HDL-C ratio and the importance of the laboratory as an indicator to predict and evaluate insulin resistance. Relevant information was also found on dyslipidemias and the different methods used for evaluation of the IR.
Conclusion: The triglycerides/HDL-C ratio is of utmost importance in the early diagnosis of insulin resistance, since in the studies reviewed a high value of this ratio is consistent with IR.

By Kevin Alexis Solís Salinas, Edison Arturo Galárraga Pérez

The prevalence rate of periodontal diseases corresponding to nicotine consumption by means of traditional or electric cigarettes is critical and deserves the attention of dental professionals because tobacco consumption contributes to an aggravation of periodontal disease making dental treatments less successful and increasing the risk of complications. The objective of the study was to determine the prevalence of periodontal disease in relation to the consumption of conventional and electronic cigarettes in students of the Universidad Regional Autónoma de los Andes UNIANDES, Ibarra campus. A survey was carried out with the objective of analyzing the incidence of cigarette consumption, whether traditional or electronic, in students from third to sixth level of the Dentistry course of the Universidad Regional Autónoma de los Andes UNIANDES, Ibarra campus. In addition, articles extracted from PubMed were reviewed to contribute to the research on the consequences of the consumption of nicotine products. It was found that there was a higher rate of tobacco consumption in women, who opt for the use of traditional cigarettes, which is worrisome because despite knowing that it affects their oral health and have bleeding when brushing their teeth, they continue to consume nicotine products. It is concluded that the rate of consumption of nicotine products is high and despite the fact that the students already show warning signs such as bleeding when brushing their teeth, they continue with their habitual consumption

By Grace Alejandra Cabezas Cantos, Hillary Milena Oviedo Chávez, Aldier Vázquez Álvarez, Marcela Deyaneira Eguez Chalacan

Introduction: Septic disease is the immune imbalance in response to an infection capable of leading to multiorgan failure, worldwide there are an estimated 6 million deaths due to sepsis.
Objective: To propose a comprehensive approach for the timely and accurate diagnosis of sepsis, through the determination and correlation between blood culture and procalcitonin.
Methods: The present literature review considered a total of 35 articles selected through the PRISMA methodology.
Results: Blood culture continues to be the gold standard for septic disease in identifying the microorganism, but its low specificity has led to the implementation of automated methods such as the BioFire® Blood Culture Identification Panel 2 (BCID2). Biomarkers include procalcitonin (PCT), C-reactive protein (CRP), lactate dehydrogenase (LDH), interleukin-6 (IL-6), ferritin and D-dimer (DD).
Conclusions: The new automated methods have a shorter response time and both high levels of sensitivity and specificity. Similarly, it is important to measure PCT, CRP, IL-6 to guide the diagnosis, and to complement it with LDH associated with hypoperfusion, ferritin, severe sepsis and D-dimer with a picture of disseminated intravascular coagulation (DIC).

By Ivonne Dayana Zamora Tapia, Francisco Xavier Poveda Paredes

Introduction: skin aging is a physiological process that causes concern in people by modifying the morphological characteristics of the skin; Beyond aesthetics, the skin is an organ with various functions, such as protection, hormone secretion, temperature regulation; Aging can be of two types: intrinsic, produced by the senescence of cells, extrinsic: produced by the interaction of all the components of the skin and external factors, the best known being ultraviolet (UV) rays from the sun.

By Anthony Fiallos, Zenia Batista Castro

Introduction: Urinalysis represents one of the most requested laboratory tests for the diagnosis and follow-up of urinary and renal system diseases. Although manual microscopy has been the traditional method, its process is characterized by being laborious and time-consuming. For this reason, automated systems have been introduced with the aim of improving the accuracy of the results.
Objective: To establish the relevance of the homologation of manual and automated urine microscopic analysis results through a literature review.
Methods: This study is based on descriptive research of bibliographic documents with a retrospective analysis. For the collection of information, various databases such as PudMED, Scielo, Google Scholar, Scopus, Elsevier were consulted. During the bibliographic search, 25 articles related to the subject of the study were found, for which the PRISMA methodology was used.
Results: by analyzing the different investigations, it was found that the automated analyzers showed an adequate concordance with manual microscopy for red blood cells, white blood cells and epithelial cells. However, in the case of bacteria and casts, a lower concordance was evidenced.
Conclusion: Urine microscopic analysis is crucial in medical diagnosis. The transition from manual methods to automated equipment has improved the efficiency and accuracy of the results. The comparison between both methods is fundamental to ensure the reliability of the results, which contributes to provide safe and appropriate treatments for patients.

By Jennifer Dayana Rugel Moposita, Víctor Hernán Guangasig Toapanta

Introduction: Childhood malnutrition, a serious public health problem in children and adolescents, with changes in body composition, homeostasis of the body, neurodevelopment and alterations in mental health. Objective: Describe the effects of malnutrition on neurodevelopment and children's mental health. Methods: Narrative review study, with a documentary, non-systematic and descriptive design in scientific databases: Pubmed, Scopus, SciELO, Redalyc and Google Scholar, using Health Sciences descriptors, whose selection criteria were complete articles published between 2018 -2023, in English and Spanish. Results: Families with better socioeconomic status have children with a higher risk of suffering from malnutrition due to overweight and obesity, while malnutrition is more common in children from low-income families in poorer countries; However, changes in the epidemiology of diseases due to malnutrition with emotional alterations were prevalent in developed countries, considered a global problem. People diagnosed with psychiatric illnesses, reported with childhood trauma, such as abuse and/or maltreatment, may be at greater risk of suffering from malnutrition due to eating disorders. Conclusions: Nutrition is the greatest environmental influence on childhood neurodevelopment, due to the impact on mental health that begins with maternal prenatal malnutrition, alters neurodevelopment and increases the postnatal risk of decreased cognitive function, behavioral disorders and greater susceptibility to neuropsychiatric disorders. Similarly, obesity during pregnancy predisposes the fetus to a phenotype with neurodevelopmental impairments, producing postnatal alterations in executive functions, decreased impulse control, and compulsive eating behaviors.

By Carolina Arráiz de Fernández, Gerardo Fernández Soto, Luis Rojas Conde, Fabiola Chasillacta Amores, Gerardo Fernández Arráiz, Maritza Cabrera

Soil transmitted helminths affect millions of people around the world, ascariasis can generate different symptoms in the patient, so clinical diagnosis requires an exhaustive study. To date, there is no gold technique for the identification of Ascaris lumbricoides. However, the standard detection method despite its low sensitivity is the thick Kato-Katz extension, which is often used for mapping national programs. This technique can be complemented with methods such as: formalin-ether concentration, Kato- Katz, McMaster, flotation techniques (such as FLOTAC and Mini-FLOTAC), aqueous biphasic system that may be complemented with indirect conventional techniques such as blood count and serological diagnosis (identification of antibodies), the usefulness of these methodologies is limited to evaluating the transmission of this helminth in endemic areas that point to possible elimination. Molecular diagnostics are a futuristic trend, sensitive and specific, but their high costs limit their use in these countries.

By Elena Johanna Pérez Laborde, Christian Raúl Ibarra Brito, Esteban Sebastián Pérez Salazar

Introduction: Sudden infant death (SIDS), first defined in 1956 by the American Academy of Pediatrics as the death of an apparently healthy child, less than one year of age, without comprehensive explanation, including a complete autopsy and examination detail of the death scene, this event occurs especially during sleep. It is a syndromic diagnosis that is reached by exclusion and is likely to have different etiologies. The objective of this bibliographic review is to compile updated information on the main risk factors involved in sudden infant death, establishing prevention measures applicable within society.
Methodology: Literature review study based on the search for information using recognized electronic databases in health sciences such as PubMed, Scopus, Scielo, Science direct, Google Scholar, using keywords such as sudden death; infant; risk factor's; prevention, unexpected death including original scientific articles published in the last five years, without language restriction, 100 articles were reviewed of which 30 were chosen.
Results: Information is collected that allows establishing sleeping position and drug consumption by caregivers as potential causes of sudden death in infants, in addition to the use of campaigns as the main strategy to eradicate the causative factors.
Conclusions: Sudden infant death is a syndrome that frequently occurs in children under 6 months of age, constituting an important health problem. It is determined that the sleeping position is the factor that causes it most frequently and that it can be modifiable.

By Mónica Tixi Moya, Edisson Fiallos

Introduction: Cystatin C, a protein with stable plasma concentration and exclusive renal elimination, has been highlighted as a promising early marker of cardiovascular risk in diabetic patients due to its relationship with renal function and inflammation.
Objective: To identify in the existing literature the association between Cystatin C and cardiovascular risk in patients with diabetes, evaluating its potential as a marker by means of a systematic review.
Methods: We performed exhaustive searches of scientific databases and selected ten studies that met the inclusion criteria. These studies focused on the evaluation of Cystatin C expression profiles and their effectiveness as a marker in the diagnosis and prognosis of cardiovascular disease. The PRISMA method was used.
Results: The studies reveal that cystatin C is closely associated with type 2 diabetes, predicts cardiovascular disease, and provides an accurate assessment of renal function in diabetic patients, highlighting its usefulness as an early marker of complications. Furthermore, elevated cystatin C levels correlate with increased mortality and cardiovascular risk, surpassing in accuracy other traditional markers, positioning it as a key indicator in the comprehensive assessment of risk and prognosis in diabetic patients.
Conclusions: Cystatin C shows promising links with diabetes and cardiovascular risk in diabetic patients, suggesting its usefulness as an early marker. Although it offers the potential for detecting renal and cardiac complications, further research is required before its widespread clinical implementation.

By Maritza Anabel Tisalema-Panimboza, Edison Arturo Galárraga-Pérez

Introduction: Research competencies in Nursing professors are a neuralgic dimension in university processes. In this sense, it is useful to recognize opportunities to enhance their development and overcome hindering barriers. A first step in identifying these shortcomings is to delve deeper into the phenomenon that, although it is highly studied, its approach is not always consistent with real needs.
Objective: Analyze current approaches to the development of research competencies in Nursing teachers.
Methods: Integrative review for a critical and reflective analysis of contents of documents published between 2017-2023 with a clear methodology and theoretical reference, selected in the month of November 2023. Keywords identified in DeCS and MeHS and Boolean operators were used: “research in Nursing” AND “teachers” AND “Nursing” AND “competency-based education”. The search strategy was carried out in the Index, SciELO, and Dialnet databases. The flow chart (PRISMA) was used to formulate the search strategy, 96 articles were identified and reviewed, of which 14 were useful regarding the evolution of the category. The following inclusion criteria were considered: original or review studies, available in full text, that declared the methodology applied, published in English and Spanish.
Conclusions: And elements were identified that deal with qualities of the phenomenon from the legacy and significance of research in Nursing, the conceptions of research competencies, the impact on professional training with a research focus and the culture of research and development of the professor.

By Anibal Espinosa Aguilar, Michel Oria Saavedra, Gloria Concepción Rojas Ruíz, Carlos Oscar Lepez

Introduction: Post-COVID motor and respiratory sequelae have become a public health problem for rehabilitation teams around the world. Diaphragmatic myofascial release may be a strategy to improve respiratory parameters measured with flowmetry. The objective of this research is to determine the effect of diaphragmatic myofascial release on respiratory function measured with flowmetry in healthy university students.

Method: Quasi-experimental study of before and after design, 32 healthy subjects, divided into 15 men and 17 women, with an average age of 23.97 years, a basal flowmetry was performed, immediately diaphragmatic myofascial release was performed for 10 minutes in a supine position, and then, perform flowmetry after diaphragmatic release. The flowmetry values pre and post diaphragmatic myofascial release showed different results, PEF (peak expiratory Flow) pre versus post, shows a statistically significant difference (p=0.04). Meanwhile, the FEV1 value (Forced expiratory volume in 1 second) showed a statistically non-significant difference (p=0.37).

Conclusions: Diaphragmatic myofascial release can be a manual strategy to improve lung capacity.

By Ignacio Astudillo Ganora, Julián Arroyo-Alvarez, Anthony Briceño-Latoche, Sebastián Cea-Avila, Rayen Marquez-Muñoz

Introduction: Health institutions are inserted in an organizational conglomerate and where each of the organizations that make up society are subject to management as a fundamental pillar for their permanence in the system. There is an element that in the evidence of the implementation of care management models has not been raised as a critical success factor and that is essential in the organizational structure. This is evidence-based design (EBD). Therefore, the objective of this article is to explain the relevance of DBE in the implementation of care management models.
Development: The design of healthcare facilities is a complex process that not only creates and allocates physical spaces, but also shapes the dynamic flows of patients, staff, visitors, equipment and information. In this context, it is relevant that nurse managers are participants in the prior planning and programming process, so that they are involved in making structural decisions that allow patients' needs to be resolved.
Conclusion: With the current unprecedented increase in hospital construction, it is imperative to integrate the institutional management model, the financing model and the care management model and consider the environmental characteristics that influence the well-being of patients, visitors and personnel are identified and incorporated into future hospital designs.

By Javier Rojas-Avila, Katiuska Lídice Reynaldos-Grandón

Introduction: Medical education has undergone a remarkable transformation driven by technological advances in recent decades. The progressive integration of digital tools and innovative technologies has significantly enriched access to educational resources and improved clinical practice.
Objective: This analysis aims to evaluate the impact of various emerging technologies in medical education and their influence on clinical practice, highlighting improvements in skills and diagnostic accuracy, as well as the personalization of learning.
Methods: A comprehensive analysis of pilot studies and systematic reviews was conducted that evaluated the impact of various technologies on medical education. Data collected from leading institutions were examined and statistical techniques were used to evaluate the effectiveness of these technological interventions.
Results: Pilot studies demonstrated significant improvements in surgical skills and diagnostic accuracy of medical students who benefited from virtual reality and clinical simulators. The application of artificial intelligence and machine learning has also improved the interpretation of medical data and early diagnosis of diseases.
Conclusions: The continued integration of emerging technologies into medical education shows promising potential to personalize learning and improve patient care. However, challenges such as data security and appropriate training must be addressed to ensure successful implementation and lasting impact on clinical practice and medical education.

By Justiniano Felix Palomino Quispe, Leopoldo Choque-Flores, Alisson Lizbeth Castro León, Luis Villar Requis Carbajal, Lucio-Arnulfo Ferrer-Peñaranda, Lindomira Castro Llaja, Elvira García-Huamantumba, Roberto Carlos Dávila Morán, Leonardo Velarde Dávila

Introduction: Scoliosis is characterized by three-dimensional changes in the spine, mainly in the thoracic and/or lumbar region, leading to musculoskeletal and pulmonary changes and changes in the person's functionality. After corrective spinal surgical intervention, the intervention of a rehabilitation nurse becomes essential, in order to guide and optimize the person's training and empowerment, in this phase of health-disease transition.
Clinical Case Report: Clinical case study, inherent to the situation of a person undergoing corrective surgery for scoliosis. The nursing process was carried out, through data collection, evaluation, diagnosis survey, rehabilitation nursing interventions, and the respective results assessment. The numerical pain scale, the body balance assessment, the Barthel Index, the Functional Independence Measure and the Timed Up and Go test were used as assessment instruments. Based on the International Classification for Nursing Practice and the Rehabilitation Nurse Specialist standard of care document.
Discussion: The rehabilitation nursing plan implemented for the person undergoing corrective surgery for scoliosis contributed beneficially to the improvement of the ventilation pattern, muscle strength, mobility, gait, independence in carrying out self-care and increased functionality. There was an increase in knowledge and training in techniques to adapt to their situation, favoring a safe transition to home after hospital discharge.
Conclusion: In view of musculoskeletal and ventilatory changes, a Motor Functional Reeducation and Respiratory Functional Reeducation plan is extremely important, in association with the person's teaching and training plan.

By Luís Sousa, Carla Raposo, Nelson Guerra, Fabiana Faleiros, Geyslane Albuquerque, Sandy Severino

Introduction: myotonic dystrophy type 1 is an autosomal dominant genetic disease with highly variable expressivity. Among the systemic alterations that are part of the clinical manifestations are neurodegeneration and premature aging, which is why it is part of progeroid syndromes. Objective: to describe progeroid dermatological manifestations in type 1 myotonic dystrophy. Clinical case: 44-year-old patient who, at the age of 9, confirmed a clinical diagnosis of myotonic dystrophy type 1. A family history with the same genetic disorder was collected. It presents dysmorphic signs in the skull, face, extremities and in different organs, among which are bilateral sensorineural deafness, early-onset cataracts, as well as dermatological manifestations such as seborrheic dermatitis and other lesions reminiscent of ichthyosis. Conclusions: DM1 is often referred to as a progeroid syndrome, which implies assuming that it exposes the usual underlying mechanisms of aging that are also those that participate in the pathogenesis of DM1 and in turn justify the dermatological manifestations observed.

By Deysi Licourt Otero, Melissa Toledo Licourt, Belkys Candelaria Gómez, Ilena Aurora Díaz Hernández

Introduction: Bezoars are indigestible substances that accumulate in the gastrointestinal tract, most often in the stomach. Gastric Trichobezoar (GT) is the most common bezoar found in the stomach. According to their content, bezoars are divided into plant bezoars, capillary bezoars, lactose bezoars and medicinal bezoars. The most common complications reported over the years include gastric mucosal erosion, gastric or small bowel ulceration and perforation, gastric outlet obstruction, intussusception, obstructive jaundice, protein deficiency enteropathy, pancreatitis, and death. The treatment is surgery.
Clinical case: A 4-year-old female patient presents with cough and odynophagia, accompanied by abdominal pain located in the epigastrium, which persists and is exacerbated by movements, does not radiate, is accompanied by an unquantified rise in temperature, imaging studies are performed where it draws attention. Abdominal echo with report of mass at the level of the epigastrium, abdominal x-ray was performed with evidence of levels. They performed a simple abdominal tomography which confirmed the presence of a foreign body in the stomach classified as a bezoar.
Evolution: Exploratory laparotomy + gastrostomy + trichobezoar extraction + gastric raphia was performed, a procedure without complications. Stable patient, without oxygen support, no signs of respiratory distress, tolerates feeding, better pain control, with good post-surgical evolution.
Conclusions: Trichobezoars are extremely rare and pose diagnostic and treatment problems. Although laparoscopy currently seems to have promising results in expert hands, laparotomy remains the most successful surgical treatment. Postoperative psychological treatment is essential to correct patients' psychological and behavioral alterations and prevent their recurrence.

By Freddy Alexander Aldaz Vallejo, Tatiana del Rosario Pérez Landázuri, Devora Estefania Manzano Quisimalin, Jennifer Carolina Martínez, Estefany Elein Bonilla Ortiz, Jhoselyn Misheel Guerrero Ramos

Chlorine dioxide is a powerful and cost-effective oxidizing agent that has demonstrated anti-cancer activity both in vitro and in vivo. Its proposed mechanism involves the release of free radicals, which disrupt the delicate oxidative balance within cancer cells. In case report, the patient has voluntarily opted for compassionate chlorine dioxide therapy over continuing conventional chemotherapy and immunotherapy due to side effects and uncertain survival outcomes. The concentration of the chlorine dioxide solution was 1/100 times lower than the LOAEL threshold, ensuring that not compromise the patients' health. This is the first follow-up in patient diagnosed with metastatic prostate cancer, who shown tumor reduction at distant sites from the primary tumor with no side effects. This preliminary observation suggests that chlorine dioxide and its free radicals could be potential mediators of an anticancer response. However, it is imperative to emphasize the importance of conducting rigorous clinical trials to validate these initial findings.

By Manuel Aparicio-Alonso, Verónica Torres-Solórzano

Introduction: Necrotizing enterocolitis (NEC) is a serious intestinal disease characterized by intestinal inflammation and necrosis. This disease is one of the most common diseases of the digestive system in newborns and mainly affects premature babies who survive the early neonatal period. NEC was first described in the 1940s and 1950s; Since then, many physicians and scientists have devoted extensive research efforts to understanding the pathogenesis of NEC, developing treatments and interventions to prevent the disease, and improving treatment strategies.
Clinical case: Premature male patient, 10 days old, born by emergency cesarean section at 28 weeks of gestation, newborn weight and height not in accordance with his gestational age, antibiotic therapy is rotated during hospitalization in a neonatology specialty, he reports respiratory difficulty, neonatal anemia, blood transfusion is decided plus CPAP via nasal cannula, an abdominal X-ray was performed which reported intestinal perforation.
Evolution: premature infant of 28 weeks of gestation, with respiratory distress and weight not in accordance with his age, is admitted to neonatology where laboratory tests are performed that indicate anemia plus low oxygen levels, complemented with transfusion plus CPAP, patient responds favorably. Abdominal X-ray was performed showing intestinal perforation; he was referred to pediatric surgery which showed necrotizing enterocolitis.
Conclusions: NEC is a rare entity in premature patients, the importance of the clinical picture for the imaging examination complements the effective diagnosis to reduce its possible complications and avoid mortality.

By Freddy Alexander Aldaz Vallejo, Andrea Maribel Quezada, Jaime Raúl Sotamba, Maite Lisbeth Vásquez, Mateo Sebastián Suarez

Introduction: During the pandemic, nursing staff in the palliative care unit had to quickly adapt to an unknown situation, marked by uncertainty and constant changes in their action protocols.
Objective: Determine the perception of nursing care in patients with terminal-stage cancer in times of pandemic in the palliative care unit in a hospital in the city of Guayaquil.
Method: Qualitative, exploratory and phenomenological approach, guiding an interview with 15 nurses of the palliative care service.
Results: The absence of an institutional model of palliative care in the hospital stands out, although the Ministry of Public Health (MSP) guidelines themselves are used and are not socialized. Despite the dedication of the health team, there are shortcomings in resources, a lack of specialized training and the need to select personnel with a vocation for palliative care. The needs of the patients include the eradication of symptoms and the relief of physical discomfort, while the needs of the nurse refer to the change in the service due to the emotional impact produced by the suffering of the patients. During the course of Covid-19, the isolation of the patient was generated, promoting their loneliness and anguish, in addition, the lack of resources, medical assistance and the support of their families predominated.
Conclusions: Comprehensive care, covering medical, psychological, social, economic and spiritual aspects, emerges as a crucial factor to alleviate physical discomfort, provide emotional support and preserve the dignity of patients during this stage.

By Flor Mejia, Amelia Morillas