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

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: Young offenders are not a homogeneous group, and it is necessary to identify their psychological and psychopathological differences according to some classification.
Objective: To characterize the psychological profiles of Colombian juvenile delinquents according to the type of offense, exploring possible differences.
Method: A descriptive, quantitative, and cross-sectional observational study was conducted with 200 young offenders aged between 14 and 18 years. The Children and Adolescents Evaluation System (SENA) was used, which measures 29 variables related to emotional and behavioral problems (internalized, externalized, contextual, and specific problems), areas of vulnerability, and psychological resources of the adolescent. Participants were grouped according to the type of offense: group 1 (offenses against persons), group 2 (property crimes), and group 3 (drug trafficking and possession offenses).
Results: The main finding was detecting clinical and statistical differences when comparing the groups. Comparison analyses showed statistically significant differences in 18 of the 29 variables. In all of these, the group 1 T scores were higher than those of the other groups, and the group 3 scores were lower than those of the other groups.
Conclusions: The findings reinforce the thesis that young offenders should not be considered as a single group or as a homogeneous group. This finding is consistent with authors and research that argue for and present evidence in favor of a differential classification of juvenile delinquency and the existence of a special group that has committed serious offenses.

By Jorge Emiro Restrepo, Sergio Andrés Acosta-Tobón

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: The research addresses the influence of emotional intelligence and professional quality of life on work commitment in a MINSA health center in Lima, based on the Emotional Capacity Theory and Karasek's demand control model.
Objective: This is a basic study, with a quantitative approach, cross-sectional and explanatory design.
Method: The population includes collaborators of the center selected by simple random sampling, resulting in a sample of 183 individuals. Questionnaires were used to collect data on the variables of interest, and the analysis was performed with SPSS 27, applying descriptive and inferential statistics.
Results: A significant relationship was found between the variables studied, highlighting the importance of emotional intelligence and professional quality of life for work commitment.
Conclusion: It is concluded that there is a relationship between these variables, without offering additional recommendations or solutions.

By Yoni Magali Maita-Cruz, Olguin Grandez-Culqui, Henry Lowell Allpas- Gomez, Rosa Estrella Pillman-Infanson, Daniel Barboza-Minaya, Flor Eduvines Hilario-Velásquez

In contemporary societies, accessibility constitutes a fundamental element to achieve the inclusion of people with disabilities; which should not only be addressed in a focused manner on a particular dimension, but on the contrary should be managed comprehensively, both in physical and virtual spaces. However, there are still institutions in which the basic conditions to guarantee accessibility for people with sensory disabilities have not been met, as is the case of the libraries of the city of Azogues. Therefore, this article was carried out with the objective of evaluating the accessibility of communication and information for people with sensory disabilities in the libraries of Azogues. A methodology was applied based on an ethnographic design, with a mixed approach and descriptive scope; The population was considered to be those in charge of the libraries located in Azogues, and non-probabilistic convenience sampling was also applied to select 30 people with sensory disabilities. As identified, the personnel of these entities do not have training in sign language, which limits communication with people with hearing disabilities, nor do they have materials available in Braille or audiobooks so that people with visual disabilities can access the information. information. It concludes on the gaps that have prevailed in terms of accessibility and inclusion, which makes it difficult to provide library services for people with disabilities, aspects that must be corrected.

By Jenny Fabiola González Sánchez, Diana Maribel Armijos Robles, Octavio Segundo Crespo Castillo, Luisa Patricia Ramón Pacurucu

Gamification in secondary mathematics learning is a strategy explored to motivate older people and improve school results. Various gamified strategies are being examined to achieve this effect. The theoretical foundations rest on the theory of flux and the theory of self-determination. The methods used include points and reward systems, récits and characters, challenges and competitions, progression and levels, as well as immediate feedback. The results indicate a positive impact on students' motivation and academic performance. Gamification has been shown to increase participation and engagement, leading to better math results. In conclusion, gamification offers effective strategies to promote second mathematics learning, although the need to adapt to the individual and dynamic desires of the class is reconnected. This approach can complement traditional pedagogical practices and improve the mathematics pedagogical experience of secondary students

By Maria Lexicer Moreira Parrales, Manuel de Jesús Mejía Carrillo, Mario Orlando Suarez Ibujes, Jhonny Santiago Torres Penafiel

This paper presents a novel method for recognizing human emotions from gait data collected in an unconstrained environment. The method uses a bi-directional long short-term memory (FL-BiLSTM) network that is optimized by an augmented trickster coyote algorithm for feature selection and classification. The study focuses on overcoming the limitations of existing gait recognition systems that struggle with changes in walking direction. The paper evaluates the performance of the proposed FL-BiLSTM classifier method on a dataset of gait sequences with different emotions and compares it with existing methods. The results show that the proposed method achieves high accuracy, sensitivity, and specificity in emotion recognition from gait.

By Prachi Jain, Vinod Maan

Spiritual Wellness promotion is primordial at a fundamental level. For Indigenous Peoples across the world spiritual wellness is their way of life. In India we have many traditional and tribal communities that practice a holistic, nature-centric spiritual wellness. Towards learning more about Indigenous communities and their spiritual wellness conducted this exploratory study among the Irulas of the Nilgiris District in Tamil Nadu India. Being one of earlier settlers of the Nilgiris Biosphere Reserve, the Irulas have played an important role in the maintenance of the forests and environment of the Nilgiris.
Methods: The study design is an ethnography qualitative study using In-depth interviews conducted using Dr. Kovach’s Conversation methodology for researching and documenting Indigenous Ontology. The Indigenous peoples are one of the Primitive Tribes of the Nilgiris District in Southern India known as the Irulas. The settlements that were accessed for the interview include villages in the eastern and western slopes of the Nilgiris.
Results: Using basic qualitative analysis of coding and theme generation, data allowed to derive 4 themes about spiritual wellness namely: What is Spirituality, Importance of participation, Sustaining Practices and Conviction. There is a shift and adaptation to contemporary spiritual practices driven by lack of access to their forests and grasslands and also because of education and exposure of the younger generation.
Conclusion: Development over time has resulted in changes in their natural environment as well as social environment leading to generational perception and practices of spirituality among women of the Irula tribes of the Nilgiris.

By Geetha Veliah, Padma Venkatasubramanian

The objective of this article is to evaluate the effectiveness of virtual simulators in training problem-solving skills in university students, a crucial aspect for their professional performance. To carry out this evaluation, a documentary review of various surveys and case studies was carried out. Academic articles, technical reports, and student and faculty survey data were analyzed to obtain a comprehensive view of the use of virtual simulators in higher education.
Research results indicate that virtual simulators not only improve students' theoretical understanding, but also allow them to apply their knowledge in controlled and safe environments, replicating real-world situations. These simulators provide an environment where students can make mistakes and learn from them without real consequences, strengthening their ability to address complex problems and make informed decisions. The case studies reviewed show specific benefits in various academic disciplines, highlighting a positive impact on academic performance and career preparation.
However, challenges and limitations were identified, such as the cost of implementing the simulators and the need for adequate training for instructors. Evaluating the use of virtual simulators for training problem-solving skills in university students is a crucial area of ​​study in contemporary education. The research reviewed highlights the growing importance of these educational technologies in promoting more interactive and practical learning, facilitating the development of skills essential for success.

By Diego Iván Cajamarca Carrazco, Diego Patricio Hidalgo Cajo, Jhon Alexander Ponce Alencastro, Néstor Típula Quispe

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: 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: The mental health of university students is a growing concern worldwide, as these young individuals face a series of emotional and psychological challenges during their transition to university life. Academic pressure, social demands, and adaptation to a new environment can affect their mental well-being.
Objective: To assess depression, anxiety, and stress in students from two universities providing educational services in the city of Puerto Maldonado, Peru.
Methods: Quantitative study, non-experimental design, analytical type. The sample consisted of 307 university students of both genders who were administered the Depression, Anxiety, and Stress Scale, an instrument with adequate psychometric properties.
Results: 42.7% of students showed symptoms of depression, 52.4% experienced anxiety, and 28.7% suffered from stress. High, direct, and significant correlations were also reported between depression and anxiety (rho= 0.757; p<0.05), depression and stress (rho= 0.726; p<0.05), and anxiety and stress (rho= 0.811; p<0.05). Additionally, a statistically significant association was found between anxiety and students' age, as well as between stress and gender (p<0.05).
Conclusions: It was concluded that students from two universities providing educational services in the city of Puerto Maldonado, Peru, presented symptoms of depression, anxiety, and stress. Therefore, it is suggested that universities implement early detection programs and psychological support services to address students' mental health issues.

By Jimmy Nelson Paricahua-Peralta, Edwin Gustavo Estrada-Araoz, Lesy Berly León-Hancco, Basilide Avilés-Puma, Cesar Elias Roque-Guizada, Percy Amilcar Zevallos-Pollito, Libertad Velasquez-Giersch, Alhi Jordan Herrera-Osorio, Dany Dorian Isuiza-Perez

Introduction: The phenomenon of alcohol consumption among university students, particularly in the field of health, is the subject of growing concern due to its potential impact on public health and academic performance.
Objective: Analyze the relationship between risky alcohol consumption and the academic performance of students studying in the health area at a Chilean university in the second semester of 2023.
Methods: The study with a descriptive and transversal quantitative approach, with a sample of 361 students who responded to the AUDIT questionnaire. Academic performance was characterized using the university's grading system.
Results: Regarding alcohol consumption, 81.7% (295 participants) showed low-risk consumption, 16.3% (59 participants) high-risk consumption, and the remaining 1.9% a possible consumption or dependence problem. Furthermore, a trend is observed in which students with problematic consumption are distributed between the categories of "good" (note 5) and "very good" (note 6), while risk and low-risk consumption are distributed between the categories of "very good", "good" and "sufficient".
Conclusions: The findings of this study show that, in general, alcohol consumption does not appear to have a significant negative impact on the academic performance of health students. Although approximately 20% of those surveyed reported problematic or risky consumption.

By Cristian Lermanda Peña, Carolina Sánchez Álvarez, Elson Oliva Vega, Ignacio Astudillo Ganora

Introduction: Pre-professional placements are a fundamental component of Social Work students' education, as they enable them to apply theoretical knowledge in real-world contexts. However, at the Technical University of Manabí, no prior research has been conducted on the intervention models utilized.
Objetive: The objective of the research was to determine the intervention models currently employed in the pre-professional placements of the Social Work programmed at UTM. The study aimed to characterize the models in terms of their objectives, structure, activities and evaluation mechanisms.
Methods: The study adopted a quantitative approach with an exploratory-diagnostic design. The population consisted of 510 students in the seventh and eighth levels. The sample comprised 426 students, selected through non-probability sampling. A 17-item questionnaire on intervention models was designed.
Results: The main results identified 10 applied models, with Case Management, Crisis Intervention and Behavior Modification being the most prevalent. Most include clear objectives, action plans and teacher supervision.
Conclusion: The effectiveness of the intervention models applied in the pre-professional practices is corroborated, however, systematic evaluation needs to be improved, the models need to be adapted to local needs and the articulation between theory and professional practice needs to be strengthened for a comprehensive training.

By Derling José Mendoza Velazco, Fabián Gustavo Menéndez Menéndez, María Andreina Salvatierra Choez, María Eulalia Briones Ponce, Iris María Sánchez Azúa

Introduction: transfusion safety is critical to prevent potentially severe adverse effects. A possible relationship between knowledge of health laws and management control in the Hemotherapy and Blood Bank Program of an EsSalud hospital in Peru was analyzed.

Objective: to determine whether greater knowledge of current regulations is associated with better management control practices and decreased transfusion risks.

Methods: observational, cross-sectional study in 319 participants through validated surveys to measure variables of interest. Analysis with descriptive statistics, chi square and Spearman correlation.

Results: a significant association was found between greater knowledge of health laws with better management control, decreased potential risks and greater user satisfaction (p<0,05).

Conclusions: it is essential to train health personnel in current legislation and regulations to optimize transfusion safety and quality.

By Efrain Pablo Montes Hijar, Edgar Elías Cuyubamba Pérez, Josselyn Heidy Manrique Meza, Dante Italo Hinojo Veliz

Introduction: Nursing staff are responsible for providing care to people in public health crises such as the COVID-19 pandemic. In previous epidemics, studies were carried out in developed countries with a quantitative approach in which it was observed that this group suffered from conditions in their mental health, although it was not possible to delve into their experiences or explore them in the Latin American context, so the aim of this study was to explore the experiences of nursing staff while caring for COVID-19 patients.
Methodology: Qualitative phenomenological study that allows identifying the experiences and feelings of the informants during the care they provided to people with COVID-19.
Outcomes: Two large categories were identified: 1) Emotions with three subcategories: a) Emotions at the beginning of the pandemic, b) Emotions during the pandemic and c) Emotions at the end of the pandemic; and 2) Qualities of nurses during the COVID-19 pandemic with three subcategories: a) Commitment to humanity, b) Companionship and c) Nurse-patient moments.
Conclusion: The experiences of the Mexican nursing staff who cared for people with COVID-19 focus on the emotions they experienced in three moments, at the beginning: fear and uncertainty; during the pandemic: fear, anxiety, stress and depression, and at the end of the pandemic: self-confidence and satisfaction when facing the pandemic with commitment to humanity, camaraderie, satisfaction and pride in having provided care to infected people despite various obstacles.

By Beatriz Paulina Espinosa Rivera , Juana Mercedes Gutiérrez Valverde, Miriam Paola Bretado de los Ríos , Clara Ivette Hernández Vargas, Martha Pérez Fonseca, Milton Carlos Guevara Valtier

Introduction: In Ecuador, deaths and complications attributed to the postoperative period occur.
Objective: Explore the functional requirements of a digital tool for postoperative monitoring, from the perspective of health personnel.
Methodology: It was descriptive phenomenological qualitative research. The population was made up of 69 Nursing and Medicine professionals who work in the surgery service of a second level hospital belonging to the Public Health Network in Quito. The information was collected in the months of November to December 2023.
Results: The results identified four key categories for the development of a digital post-surgical monitoring tool: general requirements, user-centered design (patients and professionals), and post-pilot requirements. They highlight the importance of clear databases, intuitive interfaces, alerts for signs of complications, and adequate training, optimizing the monitoring and management of postsurgical care.
Conclusions: The application must have a user-centered design, easy to use, with the option to record medical and personal data and the intervention carried out on the patient, so that all staff can know the same information and no errors are made.

By Erika Jesenia Murillo Suarez, Judith Francisco-Pérez, Patricia Benavides Vera

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

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

Introduction: The COVID-19 pandemic caused by the new SARS-CoV-2 virus was a big challenge to the world and was responsible for a vast number of deaths in a brief period; one of the countries with the greatest number of deaths was México. For this reason, studying this emergency is crucial.
Objective: study and compare the available statistics for Mexico about the COVID-19 pandemic and build a machine learning model that helps to identify the risk factors of the Mexican population.
Methods: This research is structured into three sections. Firstly, a worldwide and national statistical analysis, then a decision tree-based model, and lastly, research about the results of the vaccination campaign. Different databases were used to fulfill the objectives of each section.
Results: With international information, the number of cases and deaths were studied for a group of countries; in addition, this study compared daily cases and deceases in México, Colombia, and Spain. The national data was used to obtain different statistics and a decision tree-based model. For the vaccination campaign, various statistics were gathered.
Conclusions: Even though international statistics did not help determine if comorbidities had a significant effect on deceases, national statistics indicate that they were a risk factor for passing away due to COVID-19. Similarly, the decision tree model indicated that hospitalization was a common characteristic among deceased people. For the vaccination campaign, the lack of data was a problem in identifying the role this event had in the development of the pandemic; nevertheless, the international surveillance systems received an exceptional number of reports about adverse events; for this reason, each person should decide if they need a vaccine.

By Itzel Paola Cervera Arguelles, Hermilo Sánchez Cruz

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: there are very few studies related to bioethical principles, despite the fact that these are fundamental in the execution of clinical practice. Methodology: Applied research of quantitative type, with a non-experimental, cross-sectional design and descriptive approach, the sample size is 80 people determined by a simple random sampling, among seventh semester students at the Technical University of Ambato. Results: The results were that 80% of students performed the activities corresponding to the principle of autonomy, 80% of participants applied the principle of non-maleficence, 85.4% of people developed the activities for the principle of justice, and 83% of participants applied the necessary activities on the principle of beneficence. Discussion: Bioethics is known to have 4 principles that have an important role in nursing practice, these are non-maleficence, beneficence, autonomy, justice the principles should be used not only by nurses if not by all health personnel, to provide adequate care. Conclusions: Within this study it was determined that students apply bioethical principles in their externship practices through the activities determined by the questionnaire

By Kimberly Sabrina Zamora Ruiz, Luis Felipe Chileno Camacho

Introduction: Cervical cancer ranks second in gynecological cancer worldwide. 62-82% of cervical cancer patients present at an advanced stage and respond poorly to treatment. Assessment of chemotherapy response requires examination of the biomarker Vascular endothelial growth factor-A (VEGF-A), which is the main regulator of the abnormal angiogenesis process.
Objectives: This study aims to analyze the relationship between serum VEGF-A levels and the response to neoadjuvant chemotherapy in cervical cancer patients.
Methods: This research is Quasi-Experimental, pretest and posttest without control. Total sample: 30 stages IIIB cervical cancer patients underwent a pretest before cisplatin chemotherapy by measuring cervical lesions using ultrasound and serum VEGF-A levels using ELISA. 3 weeks after the third cycle of chemotherapy, a posttest examination is carried out like the pretest examination.
Results: The results showed a significant reduction in serum VEGF-A levels and cervical lesion diameter after chemotherapy (p=0.032), (p=0.000). In response to neoadjuvant chemotherapy, 21 patients responded negatively, and 9 responded positively. High levels of VEGF-A before chemotherapy gave a negative response (p=0.042) and low levels of VEGF-A after chemotherapy gave a positive response (p=0.049).
Conclusions: This study concludes that there is a relationship between high serum VEGF-A levels before chemotherapy with a negative response and low serum VEGF-A levels after chemotherapy with a positive response in cervical cancer patients.

By Milha Nidiya Marni, Pungky Mulawardhana, Puspa Wardhani

This essay analyzes how nursing professionals are prone to face ethical differences due to their own responsibilities associated with the care of people and the fact of working in a more complex health environment. In addition, it is analyzed how traditional nursing has been displaced by the increasing use of technologies. For this inquiry, philosophical thinking is proposed based on the criteria of Enmanuel Lévinas. To enter into the study of otherness and otherness is to try to define through his practices of care exposed by means of the profession. The application of humanization as a source of conscience is presented in it and at the same time it is valued as a transcendental element for a correct attention to the user. Examining the ideas of Lévinas in nursing makes us think about what is the purpose of the profession and how it should be used, this will lead to the fact that the profession has to focus on the users, the reason for the work done and the care provided to them is the reason to exist, that without the others there is no sense in the existence of being a Nurse. It is concluded that it is necessary to carry out a reflection on the current practice of nursing, in which the look from "the other" as the axis of care is incorporated and retaken.

By Humberto Elizalde Ordoñez, Laura Liliana Lescano Ortega, Josselin Sara Gavidia Villaroel, Johanna Alexandra Ninacuri Guachi, Joselyn Mishell Pila Reisancho

Aesthetics and the perception of beauty have significantly impacted cultural and personal norms over time. Technological advances in aesthetic medicine have made altering physical appearance more accessible, popularizing procedures such as botulinum toxin and chemical peeling. The aim of this article was to determine patient satisfaction with their personal appearance after undergoing various aesthetic procedures, as well as specific improvements in different areas of the face and skin. The methodology used was a cross-sectional descriptive study involving 67 patients at the "ESTICCA" Aesthetic Medical Center, analyzing demographic and psychosocial aspects through surveys, with data processed in SPSS software for statistical analysis, including Chi-square tests. The results obtained showed that the majority of the patients in the study experienced an increase in satisfaction with their appearance after aesthetic procedures, with significant improvements in specific areas of the face. In conclusion, it was suggested that aesthetic interventions improve not only physical appearance but also psychological and emotional well-being, highlighting the need for a holistic approach in aesthetic medicine.

By Doménica Sarahí Bunces Larco, Jaime Andres Villegas Chávez, Richar Jacobo Posso Pacheco, Jorge Ricardo Amancha Gabela

This study investigates the impact of the Wuqinxi Qigong exercise on improving dynamic balance in menopausal women in Paokmotong village, East Lombok District. The research employed a quasi-experimental design with a one-group pretest-posttest approach. Twenty-four menopausal women participated in a 5-week Wuqinxi Qigong exercise program. Data collection involved experimental techniques in two phases: preparation and actual data collection. The study recommends incorporating BMI characteristics, extending the research duration, and modifying exercises to address balance disorders in the elderly. This research contributes valuable insights into the potential benefits of Qigong exercises for enhancing dynamic balance in menopausal women, highlighting the importance of tailored interventions for this demographic group

By Dara Sandi, Bambang Purwanto, M.Kes, Sulistiawati, M.Kes

Villages have great potential to support economic development. Excellent products contribute to improving the village economy. MSMEs play an essential role in economic development in the village. However, MSME players have less knowledge and skills in running a business. The MSME actors do not utilize technology properly and find it challenging to use it. This study aims to develop an integrated industry village 4.0 platform and measure the capabilities of MSME actors. The research consists of preparatory, development, and assessment phases. This research involved 25 MSME actors in Srigonco and Bantur Villages, Malang Regency. The instrument consists of validation sheets, user satisfaction assessment questionnaires, pre-test and post-test questionnaires. Data analysis in this study is using qualitative and quantitative analysis techniques. This platform has features such as home page, business incubators, export cloud markets, and MSME Matching Fund. material, media, information, and IT platform validation tests obtained 85.2%, 89.33%, and 84.6%, respectively—the feasibility with excellent categories. MSME actors in the village experienced an increase of 0.40 on the medium criteria. This research is the basis for recommendations for partner villages to make policies related to developing MSME actors. Technology use in several Malang Regency villages can be applied more widely.

By Dwi Wulandari, Putra Hilmi Prayitno , Andi Basuki, Abdul Rahman Prasetyo, Fikri Aulia , Ari Gunawan, Afis Baghiz Syafruddin

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: 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

Athletes' inability to return and pursue their athletics is primarily motivated by their fear of re-injury. Sports injuries have been recognized as a significant deterrent to further physical exercise. This study aims to evaluate evidence-based strategies and interventions for preventing sports-related injuries, including pre-participation screenings, suitable training programs, equipment modifications, and injury prevention programs. A systematic review and meta-analysis (PRISMA) approach was used to gather, choose, and analyze publications on preventing sports injuries. Scopus, Web of Science (WoS), ProQuest, and Springer Link were used as databases for the study. The inclusion and exclusion criteria apply to the study.
Adequate treatment of sports-related injuries aids in the recovery of injured parts of the body and the prevention of future injuries. Athletes, coaches, and sports medicine specialists can collaborate to reduce the frequency and severity of sports-related injuries, encouraging safer and longer-lasting physical activity participation. Policies that reduce the likelihood of injuries players sustain can be achieved by implementing these evidence-based strategies and interventions into sports training and competition protocols.

By Argin, A. Gulanes , Stephen A. Fadare, A, Joy E. Pepania, Cosain, O. Hanima

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

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: 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: The Mapuche ancestral diet has been replaced by a westernized diet, which is characterized by the use of processed and quick-prepared foods.
Objective: To identify the quality of the diet of Mapuche communities that live in the communes of Lanco and Panguipulli.
Methods: A descriptive study was carried out through a survey created by the authors of the study, applied in person, in the houses of the subjects of the sample, which included characterization of the sample, eating habits and lifestyle.
Results: The survey was answered by 77 subjects, of whom 68.8% practice a Western diet, 98.7% are aware of the Mapuche diet, 100% have consumed Mapuche foods in the last year, and 90.9% want to increase the Mapuche food consumption.
Conclusions: These data conclude that some foods typical of the Mapuche ancestral diet continue to be prepared and consumed by the observed communities.

By Alyson Jiménez, Belén Millapán, María José Valdivia, Jorge Fernández

The study was carried out with the aim of evaluating the relationship between technostress and the academic performance of young university students. The research was developed from a quantitative perspective using a deductive and correlational explanatory method. A twenty-eight (28) question Likert scale type instrument was structured to measure the variables. The TE technostress construct was measured with an instrument adapted from the RED-Technostress scale and for the academic performance variable RA, the items were adapted from a scale of their own. Non-probabilistic convenience sampling was used, and the construct was evaluated with structural equation modelling supported by SPSS V24 software and its AMOS add-on. A total of 260 questionnaires were administered. As a result, it was found that there is a negative and insignificant relationship between technostress (TE) and academic performance (RA) (-0.184; p < 0.00). In relation to the dimensions of technostress and academic performance, we obtained scepticism (E) (-0.264; p < 0.00); fatigue (F) (-0.143; p < 0.00); anxiety (A) (-0.179; p < 0.00); inefficacy (I) (-0.214; p < 0.00); and addition (AD) (0.222; p < 0.00). In conclusion, the levels of technostress experienced by the young students were low, while the relationship between technostress and academic performance was negative; however, it is not the levels expected and evidenced in other studies. It is noted that this study contributes to understanding an understudied phenomenon in young educational populations that appears to behave differently from older populations in the business field.

By Juan Manuel Andrade Navia, Elvia María Jiménez Zapata, Rogelio Jiménez Zapata

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: 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

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: 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: Aerobic dancing, a popular form of physical activity, is a popular way for students to maintain fitness and well-being.
Objectives: This study aims is to investigates the influence of music listening habits on exercise performance, explores the psychological effects of music on physical fitness, analyzes individual differences in music preferences, and determines the physical fitness outcomes of incorporating music into exercise routines among selected students.
Methods: This study applied the mixed-methods approach using an embedded research design. The researcher specifically used questionnaires, interview guide questions, and observations and purposefully selected participants. The participants were 27 fourth- and third-year major students from Mindanao State University's College of Sports, Physical Education, and Recreation, enrolled in PPE 137 (Strength Training and Conditioning). Researchers processed the data using frequency counts and percentages from the questionnaire and derived themes from the interview guide questions.
Results. The results showed that most respondents were females (65.00%), aged 22 to 23 years (60.00%), and that listening to music during physical activity was sometimes (50.00%). The type of music listened to during physical activity was "fast-paced/energetic" (60.00%), and that listening to music enhanced exercise performance (40.00%). The importance of music as a motivational tool for physical fitness routine (40.00%) was found to be extremely important (40.00%), and that the type of music that impacts physical fitness was "yes" (100%). While the theme generated from the participants was Creating Engaging Experiences, with sub-themes including energizing, exciting, mood-setting, improving accessibility, and supporting the creation and planning of workout routines through music integration.
Conclusion. The study concludes that music is a vital source of encouragement for physical fitness regimens, promoting consistent workout routines.

By Stephen A. Fadare, Revin O. Insisto, Jerome N. De La Peña, Argin A. Gulanes, Abdulrahman D. Imam, Johaina I. Mangotara

The early detection and accurate staging of brain tumors are critical for effective treatment strategies and improving patient outcomes. Existing methods for brain tumor classification often struggle with limitations such as suboptimal precision, accuracy, and recall rates, alongside significant delays in processing. The current methodologies in brain tumor classification frequently encounter issues such as inadequate feature extraction capabilities and limited accuracy in segmentation, which impede their effectiveness. To address these challenges, the proposed model integrates Fuzzy C-Means for segmentation, leveraging its ability to enhance the accuracy in distinguishing tumor regions. Bounding boxes surrounding identified tumour regions are produced by the method by efficiently utilising calculated region attributes. The use of Vision Transformers for feature extraction marks a significant advancement, offering a more nuanced analysis of the intricate patterns within brain imaging data samples. These features are then classified using a Dyna Q Graph LSTM (DynaQ-GNN-LSTM), a cutting-edge approach that combines the strengths of deep learning, reinforcement learning, and graph neural networks. The superiority of the proposed model is evident through its performance on multiple datasets. It demonstrates an 8.3% increase in precision, 8.5% increase in accuracy, 4.9% increase in recall and 4.5% increase in specificity, alongside 2.9% reduction in delay compared to existing methods. In conclusion, the proposed method offers an efficient solution to the challenges faced in brain tumor classification. The study's findings underscore the transformative impact of integrating cutting-edge technologies in medical diagnostics, paving the way for more accurate, and timely health interventions for clinical scenarios.

By Ayesha Agrawal, Vinod Maan

Background: Clinical educators are essential in radiography education programmes. Transitioning from clinical practicing radiographers to academic educators is a rewarding journey. This study was designed to examine the experience of Radiography Lecturers in the Nigerian universities that converted from radiography practitioners to academic educators. Materials and methods: A Google form questionnaire-based study design was conducted among 35 radiography lecturers in Nigeria. Only lecturers in Nigerian Universities who had worked as radiography clinical practitioners before transited to academics and consented to participate in this study were included. The questionnaire captured responses on socio-demographic variables, challenges, barriers, successes of transition from practitioners to academic educators. Results: The majority 17(48.6%) of the respondents earned income of above #251,000.00 as a practicing radiographers. Of the 35 respondents, the majority 12(34.3%) each respectively earned #101,000.00 -#150,000.00 and #151,000.00 - #200,000.00 as an academic radiographers. Majority 17(48.6%) of the respondents agreed that the main challenge they are encountering as an academic educator is rigorous research activities. Family issues affected smooth transition process as 23(65.7%) of the respondents agreed to that. Majority 18(51.4%) perceived mentorship as the key factor responsible for smooth transition from practice to academic. There was statistically significant relationship between gender and challenges encountered by the responders (χ2 = 28.194, p = 0.00). Conclusion: The respondents experienced different challenges as they transited from clinical practice to academic. Mentorship is the key factor that militated against the smooth transition process. There was statistically significant relationship between gender and challenges encountered by the responders.

By Michael Promise Ogolodom , H.U.Chiegwu, Awajimijan Nathaniel Mbaba, Abdul Fatai K. Bakre, Elizabeth O. Balogun, Annmaris Chimebere Obasi, Emeka E. Ezugwu, Tessy Agwere Onwuka, Egop Egop Brownson, Misael Ron

Introduction: depression and anxiety are the most common mental disorders, with a significant prevalence in the general population, increasing after the COVID-19 pandemic. Mindfulness and Self-Compassion have been shown to improve emotional well-being, reduce symptoms of anxiety and stress, and increase overall well-being. However, the impact of group programs involving these interventions in mental health settings and clinical populations requires further exploration.
Methods: a quantitative study was designed with a prospective approach in a sample of 24 subjects with a diagnosis of depression or anxiety. A non-standardized group program based on Mindfulness and Self-Compassion was applied for eight weeks. Participants completed the Self-Compassion scale and the Pemberton Index before and after the intervention.
Results: The results indicate that the intervention had a significant positive impact on the participants. The dimensions associated with Self-compassion and Non-Compassionate Aspects presented statistically significant changes. Self-Compassion improved significantly, while Mindfulness showed no change. Subjective Well-being also improved significantly in all its dimensions.
Conclusions: the group intervention based on Mindfulness and Self-compassion had a significant positive impact on the participants. The results suggest that Self-Compassion practices may be more effective in promoting emotional well-being than those focused exclusively on Mindfulness, especially in the clinical setting. These findings are consistent with existing literature and raise an interesting debate about the clinical relevance of Self-Compassion alone compared to Mindfulness.

By Krystel Mojica, Andrea Lizama-Lefno, Ángel Roco-Videla, María Robles-Martínez, Marcela Caviedes-Olmos

Tourism is a multidimensional activity that involves various economic, social, cultural and environmental aspects, and among the types of tourism, nature tourism can be a risk factor for health, as travellers can be exposed to various diseases. The aim of the research is to analyse research trends on diseases caused by nature tourism in the SCOPUS database. The research paradigm is quantitative, based on a bibliometric study, using a descriptive and retrospective approach. Only review and research articles were considered, without language restriction. The behaviour of the research was positive and increasing, with a maximum peak of 30 research papers, predominantly research articles in the area of environmental sciences. The most productive country with 25 papers was the United States, while the most prominent affiliation was Griffith University with four research papers from Australia. Three lines of scientific research and the most productive authors in the subject were identified, as well as an analysis of the citation levels in the period. Nature tourism, also referred to in the literature as ecotourism or green tourism, is a type of travel that focuses on the exploration and enjoyment of nature's diversity, allowing travellers to connect with the land and biodiversity.

By Verenice Sánchez-Castillo, Rita Ávila Romero, Bernardo Gerardo Juárez Olascoaga

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: The COVID-19 pandemic has had a significant impact on the work activity of healthcare personnel worldwide, as it has altered their daily lives and modified their work performance, which has generated an increase in the incidence of burnout syndrome.

Objective: To determine the relationship between negative psychosocial factors and burnout syndrome in healthcare personnel in type I-4 hospitals of the Ministry of Health, Lima-2021, during the COVID-19 pandemic.

Methods: This is a descriptive design study, with a population of 19 325 subjects, including physicians, nurses and technical staff of type I-4 hospitals in Lima, Peru. The statistical sample was 377 participants; the variables established were: psychosocial factors at work and burnout syndrome.

Results: There was variability in the incidence of burnout syndrome, with 48.3% of the individuals presenting a low level, 49.4% a medium level and only 2.2% a high level. The correspondence between negative psychosocial factors and burnout syndrome indicates that the crossover between negative psychosocial factors of medium level and burnout syndrome of medium level, is the most frequent, with a value of 48.3 %.

Conclusions: It was determined that the crossover between medium-level negative psychosocial factors and medium-level burnout syndrome has a higher percentage distribution of frequency.

By Marcoantonio Barrientos Polanco, Juan José Danielli Rocca, Ana María Cossio-Ale

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: Although nursing autonomy is advancing with national legislation towards a competency-based approach, a positivist vision centered on biomedical aspects persists, limiting comprehensive care. Despite training and experience, role conflicts and oppression by the medical team persist, impeding freedom of decision and leading to job dissatisfaction.
Objective: To analyze the professional autonomy of nurses in type A, B and C health centers at the first level of care in Health District 09D04 - Febres Cordero.
Method: Qualitative, descriptive, and dialectical approach, based on the perceptions of nursing professionals about their autonomy in Health District 09D04.
Results: The perception of autonomy in the first level of health care is limited, under pressure and subject to demanding schedules. There are restrictions imposed by parameters and regulations, although benefits such as quality care and educational responsibility are recognized. Legal limitations, lack of support and restrictions affecting nurses' autonomy are also identified.
Conclusions: To empower nurses, a series of measures are required at both the practical and educational levels. These include the implementation of laws that support their autonomy, ongoing training, the promotion of a favorable work environment, and the strengthening of their educational background with a focus on leadership and solution-finding skills.

By Shirley Susan Quevedo Suarez, Lydia Sánchez Arce

Introduction: emotional intelligence is a concept that has become increasingly relevant in various areas of life, including work, interpersonal relationships, and education.
Objective: to determine if emotional intelligence is related to the academic performance of students at a public university in Peru.
Methods: quantitative research, with a non-experimental and cross-sectional correlational design. The sample consisted of 172 students, estimated using convenience sampling. The instruments used for data collection were the Emily Sterrett Test and the consolidated evaluation record.
Results: the Pearson correlation coefficient (r) for emotional intelligence and academic performance variables was 0.835 (p <0.05). This implies that students with higher levels of emotional intelligence tend to have better academic performance. Conversely, students with lower levels of emotional intelligence may experience difficulties in regulating their emotions, managing stress, and establishing healthy interpersonal relationships, which could negatively impact their academic performance.
Conclusions: there is a direct and significant relationship between emotional intelligence and academic performance among students at a public university in Peru. This finding underscores the importance of integrating the development of emotional intelligence into the university curriculum to promote a comprehensive educational approach that focuses not only on academic knowledge but also on the emotional well-being and personal growth of students.

By Mariela Soledad Cueva-Chata, Marisol Yana-Salluca, Nina Eleonor Vizcarra-Herles, Reynaldo Cutipa-Luque, Marleni Mendoza-Zuñiga, Guido Raúl Larico-Uchamaco

Introduction: the ability to comprehend written text is of utmost importance for educational progress in high school, given that most academic content is presented in this format, both in print and digital versions. Recent theoretical approaches and empirical studies in psychology and neuroscience have directed their interest towards explanatory models of reading comprehension that include motivational, neuropsychological and metacognitive elements.
Objective: analyze, by means of structural equations, the multivariate effects of motivational, neuropsychological and metacognitive factors on reading comprehension in a group of adolescent high school students with reading difficulties.
Methods: a quantitative, observational, cross-sectional study was conducted with a sample of 200 students between 11 and 18 years of age. Measures used: Academic Motivation and Attributional Styles Scale, Metacognitive Awareness of Reading Strategies Inventory, Regression Digit Retention Subtest, d2 Attention Test, and Inferential Reading Comprehension Test.
Results: only working memory showed a statistically significant direct effect on reading comprehension. Although academic motivation, selective attention, and metacognition did not have statistically significant effects on reading comprehension, there were statistically significant effects on reading comprehension.
Conclusions: although only working memory had an effect on reading comprehension, a circuit in which other motivational, cognitive and metacognitive variables are associated could be revealed.

By Juan Pablo Vélez-Valencia, Jorge Emiro Restrepo Carvajal

Introduction: relevance studies are a crucial tool to ensure the quality and effectiveness of master's programs, ensuring they meet the expectations of students, society, and educational institutions, the objective of the research was to evaluate the relevance of the Master's program in Clinical and Molecular Laboratory Diagnosis at the National University of Chimborazo concerning current trends, advances in science and technology, and professional demand.
Methods: descriptive investigation with a quantitative approach. The population consisted of 238 professionals, divided into two samples: "A" composed of 205 clinical laboratory professionals, and "B" composed of 23 employers in the same field. A non-probabilistic convenience sampling was used for both samples.
Results: the study confirmed the need to establish this master's program to improve the training of clinical laboratory graduates. 99 % of the respondents expressed interest in pursuing postgraduate studies, supporting the program's feasibility. The 23 employers supported the training of professionals with advanced studies, allowing them to update their knowledge. The program's relevance lies in addressing key areas identified as weaknesses, highlighting the urgency of improving training to provide more effective patient care.
Conclusions: the study confirmed the need for the master's program, with 99% of respondents interested and employer support, highlighting the importance of updating knowledge and improving skills to offer more effective clinical services.

By Ana Carolina González Romero, Carlos Iván Peñafiel Méndez, Josué Andrés Orozco Pilco, Aida Mercedes Balladares Saltos, María del Carmen Cordovéz Martínez, Wilian Ivan Chaguaro Ramírez, José Marcelo Ortiz Jiménez

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

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

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

In the current educational context, virtual reality emerges as a revolutionary tool. By immersing students in immersive simulated environments, it facilitates deep understanding of abstract concepts and practical application of knowledge. The present study seeks to analyze the application of virtual reality as a tool to improve leadership and teamwork skills among university students through a literature review. A literature review of existing literature on the topic of virtual reality and its application in higher education was carried out, focusing specifically on studies that address the simulation of leadership and teamwork situations. Relevant research that provided insight into the benefits and challenges of VR in this context was selected and reviewed. The results of the literature review revealed a variety of studies that support the potential of virtual reality to improve the leadership and teamwork skills of university students. Virtual reality has been found to provide immersive experiences, safe environments, and immediate feedback that promote the development of these skills. However, challenges such as assessing the impact and accessibility of the technology have also been identified.

By Willian Ricardo Navas Colon, Patricio Vladimir Mendez Zambrano, Jorge Fernando Carlozama Puruncajas, Gladys Veronica Llano Zhinin

The purpose of this article is to expose the processes of automatic learning or Machine Learning in Industry 4.0 based on a systematic review that allows the search for studies and research on the use of innovation technologies. To that extent, the proposed objective is developed through a mixed approach, that is, it integrates both a quantitative proposal regarding previous studies on the subject and also, consolidating a qualitative analysis that critically determines the effectiveness of machine learning in the development industrial and commercial, performance and well-being. In this way, the search is carried out in academic databases such as Scopus, Scielo, Dialnet and Redalyc so that research studies or degree works that propose appropriate implementation strategies and help to consolidate a discussion about the machine are linked. Learning in the fourth industrial revolution.

By Luis Stalin López Telenchana, Gabriela Joseth Serrano Torres, Ximena Alexandra Quintana López, Diego Marcelo Reina Haro

Background: Time optimization techniques are essential tools that have to make self-governance in order to complete any task on given time universally. The intensive care nurses (ICN) face many challenges at work due to fluid environment.
Purpose: Time optimization benefits good work execution by reducing burnout among ICN.
Methods: Multicenter quantitative experimental one group pre-test- Post-test design. Questionnaires were answered by ICNs(self-report) and also bythe shift incharge, and ICU incharge about the ICNs on work execution and Burnout, before and after nurse–guided time optimization video teaching.
Results: Participants were from two blocks (n =50). Nurse–guided time optimization showed fair work execution and burnout dropped from very high to average burnout. There was a weak positive correlation between work execution and burnout. Good compliance with time optimization sheet was found among ICNs.
Conclusions and Contributions to the Field: Time optimization and burnout were common problems in ICU. Nurse–guided time optimization intervention was an effective strategy in bridging the gap between the planning and execution of nursing care. However, burnout depends on various factors like long hours, stressful environment and family burden apart from time optimization. Continuous practice of these interventions with time optimization sheet will develop the nurse to become proficient in rendering quality care to critically ill patients.

By Angelin Santhakumari H, Manjula Annamalai, Porkodi Arjunan, Adithya. A. Venka

Background: Football is a popular sport in Latin-America and the rest of the world, the instruction of young football goalkeepers is key. Thus, the objective of this research is to compare two training methods for young goalkeeper trainees. Materials and methods: This study included 30 goalkeeper trainees, from 7 to 17 years old who were part of a football school in Santiago, Chile. The mobile app “My Jump” was used to calculate the ball’s flight time and hight in three vertical jump trials. Results: The results obtained in jump height present significant mean difference in the plyometric group of -4.005 (p= <0.0001. The control group did not show any significant change with a median of -0.6020 (p= 0.9865), in the plyometric group strength showed important changes with a mean difference of -4.064 (p= <0.0001). The results obtained for flight time present an important median in the plyometric group -35.92 (p= <0.0001). The control group remained unaltered with a mean difference of -5.875 (p= 0.8352), and in the plyometric group strength showed meaningful changes with a mean difference of -34.46 (p= <0.0001). However, no significant differences were observed between groups. Conclusion: The Authors recommend plyometrics training for goalkeeper trainees as it can improve jumping abilities, a vital condition for the sport.

By Ignacio Astudillo Ganora, Benjamín Gonzalez-Alvarado, Maite Guerra-González, Catalina Martínez-Jofre, Cristian Lermanda Peña, Macarena Massone Bustamante

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: the progressive increase of alcohol consumption justifies the demand of users in primary care, clinical and surgical units; resulting in the prevention of the use of this substance a priority for nursing professionals in relation to their functions and main objective to provide quality interventions to the individual, family, or community. Objective: to modulate the decisional balance, beliefs, and knowledge of nursing care towards alcohol through a nursing intervention. Methodology: psychoeducational intervention, quasi-experimental, of mixed type, explanatory character, by the qualitative is ethnographic, of longitudinal cohort, prospective, since it was carried out in time series with measurement before and after the intervention applying pre and posttest evaluation instruments during the time, in order to evaluate the effectiveness of a nursing intervention. Participation of an experimental study group, implementing 10 sessions of 60 minutes, distributed in the months of May and June 2023, respecting the educational, sociocultural context and reference and legal framework for the execution of research projects. Results: it was identified that students from 14 to 18 years old are the most at risk for the initiation of alcohol consumption (rs= .866, p<0.01) and 0 in the level of concurrence, it is confirmed that the nursing intervention was effective, decreasing alcohol consumption (rs= .090, p<0.01), improving caregiving attitudes (rs=.682, p=<0.05). Conclusion: it is important to promote an optimal state of health by putting preventive actions before preventive actions and intervening in an effective way at a lower school grade.

By Oscar Daniel Luna Hernández, Javier Salazar-Mendoza, María de los Ángeles Onofre Santiago, Sergio Martin Lozada Rodríguez, Edith Castellanos Contreras, Israel Ortiz Vargas, Jesús Radai López Posadas

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: Self-care in young adults is recognized as a crucial strategy for addressing Type II Diabetes Mellitus and improving patients' quality of life. It is essential to demonstrate the proper development of these practices to ensure their effectiveness.Objective: To determine the self-care capability in young adults with Type II Diabetes Mellitus. Methodology: A descriptive and cross-sectional study was conducted on 152 young adult residents of a community in the Sierra region of the state of Guerrero. Data collection was carried out using the Self-Care Agency Assessment Scale and a data form. Data analysis was developed using the SPSS v22 statistical package. Results: Females predominated with 54.6%, and the majority were married (46.7%). The average age was 29 years, and 42.7% had established diabetes for 1-5 years, the predominant range in the self-care timeframe (47.4%). According to the scale used, patients showed moderately adequate self-care knowledge. Regarding the scale's dimensions, most demonstrated moderately adequate capabilities, except in the nutrition dimension, where a low self-care capability of 77.6% was observed. Conclusion: Although current habits and behaviors reflect a moderately adequate style, except in relation to nutrition, it is recommended to inquire more deeply as this could be related to other elements. The role of health personnel is fundamental, and it is suggested to implement educational strategies to promote self-care.

By Juana Mercedes Gutierrez-Valverde, Carlos Alberto Catalán-Gómez, María de los Ángeles Paz Morales, Cynthia Berenice Rueda-Sanchez, Roger Quintana-Lagunas, Milton Carlos Guevara Valtier

Introduction: Smilax purhampuy is traditionally used for the treatment of chronic gastritis,
cystitis, arthritis and inflammation of the prostate; however, it lacks scientific studies that support its traditional use.
Objective: To estimate the chemical composition and antihyperuricemic activity of hydroalcoholic extracts from leaves and rhizomes of S. purhampuy.
Methods: The dry material of leaves and rhizomes of the species was used for the elaboration of the extracts by maceration with 80 % hydroalcoholic solvent. Total phenols were quantified by Folin-Ciocalteu and total flavonoids by the aluminum chloride colorimetric method. Antihyperuricemic activity was evaluated in rats using the potassium oxonate induction model; the extracts were tested at doses of 125, 250 and 400 mg/kg and allopurinol 10 mg/kg was used as a positive control. The uric acid content in blood serum was quantified and the enzymatic activity of xanthine oxidase was determined.
Results: In the phytochemical determinations, significant differences were observed in the content of each evaluated metabolite, fundamentally associated with the characteristics of each plant organ. The highest content of phenols (4.08 mg EAG/g) and flavonoids (1.01 mg EQ/g) was found in the leaf extract. The extracts of leaves and rhizomes showed a significant decrease in the levels of uric acid in blood serum (156.31 µmol/L y 167.58 µmol/L, respectively) and in the activity of the enzyme xanthine oxidase at all doses tested, being more marked in the extract of leaves at 400 mg/kg.
Conclusions: The results provide the first findings of the antihyperuricemic potential of the species and make an important contribution to the knowledge of its chemical composition.

By Pilar A. Soledispa Cañarte, Raisa Mangas Marín, Glenda M. Sarmiento Tomalá, Byron E. Zavala Soledispa

The research project focuses on developing an offline mobile application to explore the tourist routes of Malqui Machay, offering information about access roads and tourist establishments in the area. The Mobile-D methodology was used, interviews and surveys were carried out to collect information about tourists and technological needs. The lack of internet coverage in the area motivated the creation of an offline tool. The project, in collaboration with the Technical University of Cotopaxi, seeks to improve access to Malqui Machay and enhance its tourist attraction. Quantitative research, literature review, case study, field and technological research supported the development of the application, offering a solid theoretical basis and tools for its creation. Staying up to date with technological trends is crucial for future improvements in mobile applications

By Elian Jair Ordoñez Ninasunta, Darwin Yazmany Paez Ruiz, Cristian Darwin Borja, Johnny Xavier Bajaña Zajia

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

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: alcohol dependence is a public health problem on which multiple groups of researchers have focused their attention since it mainly affects the young population, as it is the most consumed drug in the world due to its easy access, which makes it imperative to advance in the understanding of this phenomenon. Objective: to determine the dependence and relationship that exists with the motivation to consume alcohol in nursing students. Methods: non-experimental, quantitative, descriptive, and cross-sectional research, in a sample of 363 undergraduate nursing students from two university regions, using simple random probability sampling, applying the Alcohol Use Disorders Identification Questionnaire (AUDIT) and the translation of the Drinking Motives Questionnaire-Revised (DMQ-R). Results: 47.4 % were 21 to 23 years old, 62.3 % were from urban areas; the largest number of students consumed occasionally (62.2 %) and 20.1 % were abstinent (women were the most frequent drinkers). The 97.2 % are motivated to consume alcohol and 0.3 % are highly motivated. Conclusions: there is dependence to alcohol consumption related to motivation in nursing students (rs=.6.97, p=<0.01). Therefore, it is necessary to implement interventions in prevention and health promotion, to limit access to the substance or reduce their intake patterns.

By Edith Castellanos Contreras, Johan David Utrera-Romero, Javier Salazar-Mendoza, Claudia Beatriz Enríquez Hernández, Israel Ortiz Vargas, María Esperanza Conzatti Hernández, Jesús Radai López Posadas, Pedro González-Angulo

Introduction: Clinical simulation is a training method that recreates safe and controlled clinical situations that help develop professional skills and promotes interprofessional collaborative practice through the development of specific competencies.
Objective: Determine the metric properties of a self-administered questionnaire that accounts for the level of satisfaction with simulated in-hospital clinical practice.
Methods: Based on expert opinion, an instrument was created that consisted of three dimensions. For statistical validation, it was applied to 291 students belonging to 6 careers distributed in three regions of Chile. Cronbach's Alpha was determined by dimension, in addition to performing a factor analysis to finally develop a standardized index for analysis.
Results: A Cronbach's Alpha was obtained in the dimension of Satisfaction with the role of the tutor teacher of 0.928, in that of Satisfaction with the role of the actor/actress of 0.89 and in Satisfaction with the organization and equipment of the CISH of a 0.904. The Factor analysis confirmed the relevance of the questions within the three established dimensions.
Conclusions: The developed instrument presented a high internal consistency, being a valid instrument to be applied to students in the area of health sciences in Chile.

By Blanca Aguila Millaquen, Angel Roco-Videla, Pamela Paredes Miño, Alejandro Lara Muñoz, Ma Eugenia Espinoza Garrido

Introduction. Post-traumatic stress is a potential psychological and behavioral consequence of exposure to a traumatic event, characterized by the inability to overcome an unpleasant experience. Medical students, especially during their internships, often encounter stressful situations and challenges.
Objective. This study aims to investigate the psychological impact of the COVID-19 pandemic on medical interns and identify the clinical and epidemiological factors associated with PTSD.
Methods. This cross-sectional observational study utilized the Posttraumatic Stress Disorder Symptom Severity Scale and a validated form for clinical and epidemiological factors. The study was conducted with medical students from the Universidad Privada San Juan Bautista and Universidad Nacional San Luis Gonzaga. Data analysis was performed using SPSS Version 25.
Results. This study revealed that 47.1% of medical interns experienced low levels of post-traumatic stress, 42.5% experienced moderate levels, and 10.3% experienced high levels. Clinical and epidemiological factors that showed a statistically significant correlation (p<0.05) with post-traumatic stress included working extra shifts, caring for COVID-19 patients, having infected relatives, and experiencing harassment or verbal aggression from patients, colleagues, or other hospital staff.
Conclusion. This study suggests that clinical and epidemiological factors, such as caring for COVID-19 patients, working extra shifts, and experiencing harassment or verbal aggression from patients or colleagues, are associated with post-traumatic stress in medical interns.

By Walter Gómez-Gonzales, María Zapana-Tito, Shiomara Dávalos-Durand, Maria Hernández-Uchuya, María Avendaño-Gabriel, Maria Gómez-Livias, Milagros Rojas-Carbajal, Lidia Vargas-Pancorbo

Introduction: Computer Vision Syndrome is also considered the ocular epidemic of the 21st century. It is essential to determine the number of individuals suffering from CVS and the associated factors.
Objective: To identify the factors associated with Computer Vision Syndrome in medical students and faculty at Peruvian Private University during the SARS-CoV-2 pandemic in 2021.
Methods: This was an observational, cross-sectional, retrospective, and analytical study. The participants included students and faculty members from the School of Human Medicine. The Computer Vision Syndrome Questionnaire (CVS-Q) from Google Forms was used. For bivariate analysis, the chi-squared test was used with a 95% confidence level. Frequency and proportion calculations were used for qualitative variables, and measures of central tendency and dispersion were calculated for quantitative variables.
Results: 56.0% of faculty and students suffered from computer vision syndrome (CVS). In the bivariate analysis, it was found that the use of eyeglasses (p < 0.004), a computer/cell phone screen distance of <45cm (p < 0.031), and a family history of visual diseases (p < 0.010) were associated with CVS.
Conclusions: There is a high prevalence of computer vision syndrome, with faculty members being the most affected. Factors associated with CVS were the use of eyeglasses, a computer/cell phone screen distance of <45cm, and a family history of visual diseases.

By Maria Zapana-Tito, Walter Gómez-Gonzales, Maria Fatima Gómez-Livias, Carlos Gamarra Bustillos, Luis Chihuantito-Abal

The objective of this article is to establish effective strategies for promoting motivation and commitment in learning from virtual university environments, for which, in the first instance, a bibliographic search is carried out on studies that expose activities and methodologies that build improvements in the aspects of analysis from platforms and the use of digitality in university teaching; Secondly, a categorization of the information collected in the studies is established so that functional strategies are selected for the motivation and commitment of university teaching; In the third instance, an analysis is constructed on the way in which these strategies and proposals for pedagogical application help to energize knowledge and practice it effectively in the student. Thus, a qualitative investigation is implemented to prepare a review of the literature that allows the examination of facts from previous studies and with this, an analysis is built around effective strategies that enhance the motivation for knowledge and the commitment to knowledge from the virtual environment. In conclusion, a discussion is proposed about the effectiveness of strategies in the university environment so that it is beneficial for the student's work and personal world.

By Andrea Pazmiño Arcos, Sonia Del Pilar Román Medina, Carolina Rodríguez Morales

Introducción: en el contexto universitario actual, la investigación y la práctica educativa no se centran únicamente en el rendimiento académico de los estudiantes. También se enfocan en comprender las expectativas que los estudiantes tienen respecto a la vida universitaria y cómo estas expectativas influyen en su bienestar emocional y, por ende, en su salud mental. Esto es crucial para ayudar a los estudiantes a completar con éxito su carrera profesional.
Objetivo: describir la orientación a la vida entre estudiantes de una universidad privada de la Amazonía peruana.
Métodos: investigación cuantitativa, de diseño no experimental y de tipo descriptivo transversal. La muestra estuvo conformada por 302 estudiantes de las carreras profesionales de Psicología, Derecho, Administración y Contabilidad a quienes se les administró el Test de Orientación Vital Revisado.
Resultados: se halló que la orientación a la vida del 75,2% de los estudiantes está direccionada a la disposición optimista, del 12,3% tiene una disposición hacia el pesimismo, el 7,9% se muestra pesimista, mientras que el 4,6% es optimista. Por otro lado, se encontró que la orientación a la vida se asocia con algunas variables sociodemográficas como la edad y el turno de estudio (p<0,05).
Conclusiones: la mayoría de estudiantes de una universidad privada de la Amazonía peruana muestran una tendencia hacia el optimismo. Esto sugiere que consideran que los eventos y circunstancias actuales de su vida no son totalmente favorables para su futuro, pero mantienen una actitud esperanzadora y positiva frente a las adversidades.

By Jimmy Nelson Paricahua-Peralta, Guido Raúl Larico-Uchamaco, Lesy Berly León-Hancco, Basilide Avilés-Puma, Llen Alin Meza-Orue, Jesus Alberto Alpaca-Ruiz, Gabriel Jesús Benites-Fernández, Dalmiro Ramos-Enciso, Giovanna Rocio Pizarro-Osorio

Introduction: Grassroots health workers are crucial in Vietnam's healthcare system. As the frontline of healthcare, closest to the community, they are considered the backbone for disease prevention, control efforts, and initial healthcare for the population. The Ministry of Health in Vietnam has endeavored to improve infrastructure, equipment, and workforce quality, along with providing mental health care for grassroots healthcare workers to effectively carry out health education, disease prevention, and well-organized healthcare services. This paper aims to investigate factors affecting depression, anxiety, and stress among grassroots health workers in An Giang Province located in the Vietnamese Mekong Delta region.
Methods: A population-based cross-sectional study was conducted using data from the 2023 Grassroots health workers in An Giang Province. A total of 466 grassroots health workers were selected. The Research method to collect quantitative data from the questionnaire tools was applied and data analysis was conducted using the SPSS 22.0.
Results: The research findings showed that 18.3%, 28.8%, and 16.8% of participants exhibited symptoms of depression, anxiety, and stress, respectively, predominantly at mild, moderate, severe, and extremely severe levels. Risk factors impacting mental health included income and benefits, COVID-19 infection, and prolonged symptoms affecting physical health, as well as workplace infrastructure.
Conclusions: Improving salary policies, physical health care, and upgrading workplace infrastructure will reduce the risk of mental health issues among grassroots health workers, both during the pandemic and in the future.

By Le Thi Hong Hanh, Tran Thi Huyen, Le Xuan Gioi, Le Minh Cong

The article examines the scientific advances about transformative pedagogies that are addressed from the global challenges that are currently presented in humanity marked by a profound ecological, social and political crisis, before which arises the need to rethink education systems, due to the constant dynamics of environmental devastation, inequality and conflict that characterize our era require urgent and transformative responses from education. Taking into account the ecological crisis and the social and economic implications that arise, the promotion of social change and sustainability has been identified as a priority. At the methodological level, a systematic review of the literature was carried out, identifying three main variables: transformative education and sustainable development; curriculum and environment towards sustainable education; and transformative education and climate change. In this sense, the results identified the main lines of action and interdisciplinarity that foster the development of critical thinking and guide the participation of the communities from the pedagogical aspects inside and outside the classroom. By way of conclusion, an emphasis is made on the epistemological variety that addresses the specific psychosocial problems that require a solution to generate changes focused on the construction that allow from the cultural guidelines to articulate the learning outcomes in an effective implementation of educational systems.

By Cristian Manuel Palencia Puche, Nubia Hernández-Flórez, Yurley Karime Hernández Peña

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: 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

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

The purpose of the research was to characterize the habitual consumption of processed and ultra-processed foods, as well as to analyze their nutritional composition in relation to the Nutrient Model proposed by the Pan American Health Organization (PAHO). 2.125 young people participated, with prior informed consent; A food consumption and frequency questionnaire was applied to each participant (a=0,784), including 75 foods and beverages classified into 13 categories. On the other hand, the labels of 89 brands of products purchased by the respondents were reviewed; the analysis included the presence of critical nutrients and the calculation of the percentage of energy contribution. The results revealed that 95% of the population purchased in the last month: desserts (99,1%); candy (95,1%), non-alcoholic beverages (84,8%), among others, with a significant difference in gender, area of residence, and economic income (P<0.050). The amounts of sodium, free sugars, total fats, saturated fats, and trans fats exceed what is indicated in the PAHO Model, by 69,0%, 54,0%, 35,0%, 23,0%, 15,0% respectively. The daily energy contribution per serving was 10,3% ±3,1%, this comes mainly from pre-cooked dishes (soups, broths, creams, instant noodles), 13,6%; beverages (soft drinks, juices, soft drinks, beer, juices and nectars) 13,1; French fries, 12,5%; sausages, 12,4%; pastries, 12,4%; snacks, 10,5%. Concluding that there is a high prevalence in the consumption of processed and ultra-processed foods, with levels of critical nutrients that exceed PAHO recommendations. These findings highlight the need to strengthen policies aimed at reducing the supply and demand of these products.

By Jimena Cabrera, Patricia Iza, Carlos Moreno, Verónica Guanga, Carmen Viteri

The objective of the research is to determine the incidence of healthcare waste management in the control of nosocomial infections associated with care. Its research study with quantitative approach, basic non-experimental type, with a cross-sectional causal correlational design. The population of 350 workers, with a sample of 250 workers who participated in data collection, two instruments were applied, the first was a questionnaire with 34 items and the second a questionnaire with 31 items, both questionnaires validated by expert judgment and assessed by Cronbach's Alpha reliability test, with the results for healthcare waste management α = 0.894 and for nosocomial infection control reliability was α = 0.871. For inferential analysis, ordinal linear regression statistics and the Nagelkerke coefficient were used. The results obtained from the evaluation of healthcare waste management in a San Juan de Lurigancho hospital revealed a considerably high incidence, with a worrying 48% classified as inadequate. This finding indicates a significant deficiency in waste management practices in the hospital that affects nosocomial infection control, reaching 45%, suggesting a direct incidence. The conclusion is that sanitary waste management is inadequate and has a negative influence of 75.3% on infection control.

By Rosa Estrella Pillman-Infanson, Carola Rosa Consuelo Gonzáles, Fernando Miguel Salas Pachas, Yoni Magali Maita-Cruz, John Melvi Lozano Castro, Patricia Gabriela Valdivia Jaimes

This study examines the intricate dynamics of patent valorization within Moroccan higher education institutions, highlighting a pronounced contrast between the efficiency of patent generation and the inherent challenges in their commercial exploitation. Leveraging a qualitative methodology, particularly through in-depth interviews with key stakeholders involved in the patent valorization process within public universities, the research uncovers the primary obstacles that impede the transformation of university patents into marketable innovations. These obstacles include a lack of specifically allocated funding for post-patent development phases, a deficiency in marketing and entrepreneurship skills among academic staff, limited interactions with the industry, and a regulatory framework perceived as restrictive. Based on these observations, we propose a set of strategic recommendations on two levels: national and university. Nationally, we recommend the establishment of dedicated valorization funds to finance key commercialization phases, a substantial revision of the regulatory framework to simplify and encourage the valorization process, and the implementation of incentive mechanisms to strengthen collaborations between universities and the industrial sector. Within university settings, it is crucial to integrate specialized training programs for researchers and valorization managers focused on intellectual property management and technology transfer, and to bolster existing valorization structures. These structures should be equipped with the necessary resources to efficiently identify and support patentable innovations. Furthermore, it is advised to promote the creation of incubators and accelerators within universities to support innovative startups emerging from academic research. The ultimate aim of this contribution is to provide strategic guidance for enhancing the effectiveness of university patent valorization, thereby fostering innovation and contributing to Morocco's economic development.

By Marzougui Yassine, Omar Elyoussoufi Attou, Moha Arouch

Introduction: dietary habits acquired during childhood mark a very important milestone in the prevention or development of chronic non-communicable diseases. The food education that preschool and school-age students receive are determining factors in the development of healthy lifestyles. However, the growing supply of unhealthy foods that are available to school students puts this condition at risk and contributes to the development of school overweight and obesity. The objective of the study is to determine if there is an association between the nutritional status of students and the supply of unhealthy foods near schools. Method: descriptive cross-sectional study developed during the year 2023. A georeferencing of the sales premises of different types of food was carried out in the surroundings of 4 schools in the commune of Pedro Aguirre Cerda, Santiago, Chile. The educational establishments are part of a private initiative that seeks to promote healthy living and eating habits. The nutritional status of pre-kindergarten, kindergarten and first grade students was evaluated and the association between nutritional status and the availability of unhealthy foods was determined. Results: most of the students evaluated maintain a good nutritional status. There is no association between the offer of unhealthy foods and an increase in the rate of overweight and obesity (determined by BMI) in schools. Conclusions: despite the availability of unhealthy foods in the educational establishment environment, low rates of overweight and obesity are observed.

By Claudio Villota Arcos, Álvaro Toledo San Martín, Jennifer Cornejo Leyton, Constanza Osorio Araya, Ximena Rodríguez Palleres

Introduction: Inclusive education is a global goal to promote the academic success of all students, regardless of their conditions or disabilities. In Portugal, Decree-Law No. 54/2018 replaced Decree-Law No. 3/2008, establishing a new legal framework for inclusive education. Aims: To assess the perception of primary school teachers in Portugal on inclusive education and the impact of mindfulness programmes on students with Attention Deficit Hyperactivity Disorder (ADHD). Method: Non-experimental study with quantitative and qualitative analysis. An online questionnaire was used with 415 teachers, and a focus group was conducted with five school members in Alto Alentejo. Results: Teachers perceive improvements in inclusion processes and benefits in attention, impulse control and behaviour of students, especially those with ADHD, in schools that apply mindfulness programmes. Conclusions: Integrating mindfulness programmes in the primary education curriculum would be beneficial, promoting socioemotional skills and improving the inclusion of students with special educational needs.

By Teresa Isabel Costa De Oliveira Martins Matos, Ana Isabel González-Contreras, Isabel Alonso-Rodríguez, María Carmen Martínez-Muciano

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

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

The research addresses the problem of technical training and qualified labor in Civil Construction workers in the urban area of the Pichari district, La Convention Cusco 2022. The general objective is to analyze the influence of technical training on the quality of the workforce in this sector. Adopting a quantitative approach, explanatory level and a non-experimental design, the hypothetical deductive method was applied in a basic type study. The population consisted of 156 Civil Construction workers in Pichari, and the selected sample was 120 participants through non-probabilistic convenience sampling. The results revealed a significant relationship between technical training and skilled labor, supporting the alternative hypothesis. Levels of technical training and skilled labor varied, with most workers located at middle and high levels. The alternative hypothesis, which maintains that Technical Training significantly influences Skilled Labor, was supported with a two-sided significance of 0.000, a Log Likelihood of 18.176, a Chi-Square of 34.923 and a Nagelkerke Pseudo Square of 0.292. In conclusion, the research highlights the importance of technical training to improve the quality of labor in civil construction.

By Jhonatan Huaman-Urbano, Nerio Enriquez-Gavilan, Aydeé Lopez-Curasma, Julio Amarildo Romero-Sandoval, Naara Eunice Medina-Altamirano, Mariano Hamilton Pachas-Niño

Introduction: in the university context, self-efficacy extends beyond mere confidence in a student's academic abilities; it is considered a fundamental pillar that impacts their academic performance, intrinsic motivation, ability to face challenges, and psychological well-being. However, its absence could trigger a series of negative effects on the student and their educational experience.
Objective: to determine if self-efficacy is significantly related to academic procrastination in a sample of students from a public university in Peru.
Methods: quantitative research, non-experimental design, and cross-sectional correlational type. The sample consisted of 185 students, estimated through probabilistic sampling. The instruments used for data collection were the General Self-Efficacy Scale and the Academic Procrastination Scale, both with adequate psychometric properties.
Results: the students were characterized by moderate levels of self-efficacy and low levels of academic procrastination. Additionally, it was determined that the Spearman's rho correlation coefficient for the variables of self-efficacy and academic procrastination was -0.687 (p <0.05). This means that as the belief in one's own ability to succeed academically increases, the tendency to postpone academic tasks decreases.
Conclusions: self-efficacy is significantly related to academic procrastination in a sample of students from a public university in Peru. This finding underscores the importance of implementing interventions to strengthen students' self-efficacy while strategically addressing academic procrastination.

Objective: to determine if self-efficacy is significantly related to academic procrastination in a sample of students from a public university in Peru.

Methods: quantitative research, non-experimental design, and cross-sectional correlational type. The sample consisted of 185 students, estimated through probabilistic sampling. The instruments used for data collection were the General Self-Efficacy Scale and the Academic Procrastination Scale, both with adequate psychometric properties.

Results: the students were characterized by moderate levels of self-efficacy and low levels of academic procrastination. Additionally, it was determined that the Spearman's rho correlation coefficient for the variables of self-efficacy and academic procrastination was -0.687 (p <0.05). This means that as the belief in one's own ability to succeed academically increases, the tendency to postpone academic tasks decreases.

Conclusions: self-efficacy is significantly related to academic procrastination in a sample of students from a public university in Peru. This finding underscores the importance of implementing interventions to strengthen students' self-efficacy while strategically addressing academic procrastination.

By Giovanna Rocio Pizarro-Osorio, Marleni Mendoza-Zuñiga, Betsabe Lilia Pizarro-Osorio, Guido Raul Larico-Uchamaco, Maribel Mamani-Roque, Milton Raul Mamani-Roque, Roberto Anacleto Aguilar-Velasquez, Tatiana Carmen Huamani-Calloapaza, Ronald Pachacutec-Quispicho

Introduction: With the arrival of the pandemic, educational centers, universities, institutes, have had to adapt to the trend of virtual education in its various modalities, face-to-face, blended or hybrid, due to the limitations imposed by illness, travel or geographical distance, an aspect of greater prevalence today, which has imposed changes in the ways of carrying out daily activities that have included even the development processes to achieve new knowledge.
Objective: To explore trends in virtual education research methodologies.
Method: Documentary review.
Results: Despite the haste imposed by the situation, there are options that deserve to make viable the continuity of research as an academic activity; according to the information gathered, it requires some adjustments or adaptations according to the training characteristics of each institution.
Conclusions: Changes in society have prompted adjustments in institutional training processes, posing demands towards an adaptation that fosters interaction and meaningful learning. The pandemic accelerated the transition to virtual education, challenging educational institutions to find innovative solutions, which has also affected research, which has had to adapt to virtuality. There are positive experiences that can be shared and replicated to strengthen training and research processes in virtual environments and promote academic development in the social sciences.

By Mauro Guerra Chacón, Leonor Huamán Camacho , Clemente Pardo Hidalgo, Lida Maribel Cosme Solano , Reyna Olano Del Castillo, Sucena Elizabeth Moreno Moreno

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: 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

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: Currently, digital resources have changed the way we live in areas such as education and health. This scenario was reinforced after the COVID-19 pandemic, where society had to quickly adapt to virtual scenarios to access health services. In this way, electronic health (eHealth) is positioned as a relevant issue in the training of university health professionals and as a way to make higher education relevant to the innovation and digital transformation experienced by the health system. This research proposes as a general objective to analyze the degree of association between university education models and the development of health literacy for health and rehabilitation students. Method: The study, quantitative descriptive-correlational and cross-sectional design, brings together the self-perception in eHealth competences, through the application of the eHealth Literacy Scale (eHeals), to 60 participants who were studying their professional practice to access the title of Speech Therapist. Results: The results reveal a significant difference between students who participated in an electronic health skills training pro-gram compared to those who were not part of such a program in their university education. Conclusion: The implementation of digital health literacy programs in higher education increases the ability to search for and evaluate the quality of health information online.

By Lorena Martinez-Ulloa, Arturo Flores, Yolanda Maldonado-Aguayo, Sergio Fuentealba-Urra, Andrés Rubio , Jenny Guerrero, Claudia Ravazzano

The potential for using information technology to improve physical activities covers a large scope. The integration of information technology has impacted almost every aspect of our lives in the dynamic modern world, transforming not only how we work and communicate but also how we interact with one another and with physical activities. This study aims is to provide a comprehensive overview of the current trends in the use of information technology (IT) to promote and enhance physical activity. This study utilized randomized controlled trials, quasi-experimental studies, observation, systematic reviews, and meta-analyses with a bibliometric approach in the context of a literature review. The researcher looked through many electronic databases, including PubMed, Google Scholar, PsycINFO, Elsevier, CINAHL, and the Cochrane Library, to find studies that fit the title. They chose sixty (60) papers for this study, and thirty-six (36) of them were analyzed in detail and met the requirements checklist to find and combine studies published in English between 2015 and 2023 that met the review criteria.

By Stephen A. Fadare, Argin A. Gulanes, Jholan De la Cruz Torres, Epiphany Marie N. Guiao, Jozen P. Tagaylo

Background: Persistent high-risk HPV infection is the main cause of cervical cancer. Sexually active women are at risk of HPV infection, especially if they have multiple sexual partners. To detect HPV, the HPV DNA test can be conducted using menstrual blood samples as an alternative to cervical cancer screening.
Objective: This study aims to analyze the comparison of results between HPV DNA screening with menstrual blood in sanitary pads and cervical swabs in women with single and multi-partner sexual.
Methods: This study was an analytical observational study with a cross-sectional design. The sample used was 44 women (21 single partners and 23 multiple sexual partner) aged >18 years, sexually active, experiencing regular menstruation. Menstrual blood samples in sanitary pads and cervical swabs were examined PCR method. Statistical tests used Mann Whitney with a significance level of p≤0.05, diagnostic test and ROC description.
Results: HPV DNA was found in 47.6% (10/21) in menstrual blood and 47.8% (11/21) in cervical swabs with a significance value of p=1,000 in women with single sexual partners. HPV DNA was detected in 82.6% (19/23) in menstrual blood and 87% (20/23) in cervical swabs with a significance value of p=1,000 in women with multiple sexual partners. Menstrual blood in sanitary pads has a sensitivity value of 90.32%, specificity 92.31%, positive predictive value 96.5%, negative predictive value 80% and accuracy of 91.32% to detect HPV DNA.
Conclusion: The conclusion from this analysis shows that there is concordance between HPV DNA screening with menstrual blood in sanitary pads and cervical swabs with high accuracy values

By Nurul Avifah Rahman, Pungky Mulawardhana, Puspa Wardhani

Aim: to determine the rate of mortality of cases with chronic kidney disease and its risk factors admitted to hospital with COVID-19 in Almaty City, Kazakhstan.
Methods: Patients with coronavirus infections who were hospitalized at a hospital in the Kazakhstani Almaty region from June 2020 until June 2022 are included in the retrospective analysis. The Unified National Electronic Healthcare System (UNEHS) provided the database extraction. Individuals were considered eligible if they had been admitted to the hospital with the primary diagnoses of U07.1 (COVID-19, detected virus) and U07.2.
Conclusion: In Almaty, Kazakhstan, hospitalization outcomes for coronavirus patients with and without chronic kidney disease were assessed in this study. Analysis was done on the impact of comorbidities and sociodemographic characteristics on mortality. While there are many ways to prevent and manage chronic kidney disease (CKD), coexisting medical diseases, particularly viruses that cause pandemics, might complicate matters. Thus, to prevent unplanned infectious disease outbreaks, a thorough disease management plan must be established

By Garazhayeva Laura, Gaipov Abduzhappar, Kauysheva Almagul

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

Introduction: Species of the genus Smilax are a vital source of potentially useful compounds that may be effective as nephroprotective agents, but there is little scientific evidence to support such claims.
Objective: To analyze the chemical composition and nephroprotective activity of hydroalcoholic extracts of leaves and rhizomes of Smilax purhampuy.
Methods: Hydroalcoholic extracts were elaborated by maceration and analyzed by gas chromatography-mass spectrometry (GC-MS). The gentamicin-induced nephrotoxicity model was tested in Wistar rats at a dose of 80 mg/kg i.p. and extracts were administered orally at doses of 100, 200 and 400 mg/kg. Serum creatinine and serum urea were quantified, and histopathological observations of the kidneys were performed.
Results: In the extract of leaves, 33 compounds were identified, where the majority were palmitic, linoleic and linolenic acid. In the extract of rhizomes 23 phytoconstituents were recognized, predominantly stearic acid, dihydrocorinanteina and palmitic acid. There was evidence of a significant decrease in the level of creatinine and urea in the groups protected with extracts of leaves and rhizomes with respect to the gentamicin group in a direct relationship to the dose of the extracts. Renal histopathological changes were observed in the gentamicin group, while the groups receiving the extracts decreased the severity of damage.
Conclusions: The results indicate that Smilax purhampuy has a potential role in improving gentamicin-induced kidney damage, providing the first findings on its nephroprotective activity.

By Pilar A. Soledispa Cañarte, Raisa Mangas Marín, Glenda M. Sarmiento Tomalá, Patricia I. Manzano Santana, Iván A. Choez Guaranda, Byron E. Zavala Soledispa

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

In the post-pandemic era, organizational challenges have intensified, particularly in leadership and management within the retail sector. This study focuses on the pivotal role of Emotional Intelligence (EI) in shaping leadership styles among human resource managers. Given the complexities introduced by the pandemic, which include managing remote teams and addressing heightened emotional stressors, the study argues that leaders must possess a profound understanding of both their own and their team members' emotional dynamics. Employing a quantitative approach, the study surveyed 385 human resource managers across Peruvian retail companies to assess how EI influences their leadership styles. The analysis utilized ordinal logistic regression, revealing that EI significantly affects leadership modalities, accounting for 27.2% of the variation in leadership styles. This suggests that EI is a critical predictor of effective leadership. The findings underscore the necessity for HR leaders to excel in emotional management, which is essential not only for improving team cohesion and workplace atmosphere but also for enhancing overall business profitability. The study concludes that in the evolving retail landscape, fostering leaders with high EI could be the key to navigating post-pandemic challenges effectively.

By Miguel Sebastián Armesto-Céspedes, Karina Raquel Bartra-Rivero, Edith Yomona-Ruiz, Jhonny Richard Rodriguez-Barboza, Elma Ruth Valdivia-Ramírez, Yvonne Jacqueline Alarcón-Villalobos

Medical tourism constitutes one of the growing industries within the area of health services, not only because of its competitive advantages, but also because of the multiple benefits attributed to it. In addition to providing economical care for illnesses, it also stands out for its contribution to general health through relaxation experiences. In this scenario, medical aesthetic tourism constitutes one of the most popular modalities, which also offers different possibilities for recreation during recovery. With the objective of analyzing the potential of medical aesthetic tourism in Colombia, a documentary review study was conducted, organized in a rigorous protocol for the selection of sources and thematic content analysis. The research findings show that medical tourism in general and aesthetic medical tourism specifically constitute an important industry in the Colombian context, since its synergies with conventional tourism and other economic sectors are seen as drivers of development and sustainable growth. For future studies, it is recommended to delve into helix relationships, standards, medical and tourism, and the integration of other sectors through strategic alliances.

By Carlos Alberto Gómez Cano, Javier Mauricio García Mogollón, Verenice Sánchez Castillo

Widespread use of data display terminals (DUTs) in a work environment could represent a risk for developing ocular pathologies and dangers. One way to determine the presence and severity of these symptoms is through the CVSS17 questionnaire. In this study, visual symptoms were evaluated in the administrative staff of an Ecuadorian public hospital. The results indicate no association between visual symptoms and gender (contingency coefficient 0.085, p=0.83). A moderate but not statistically significant association was found between symptom intensity and age (contingency coefficient of 0.344, p=0.347). However, there is a statistically significant positive association between symptom intensity and type of contract (contingency coefficient 0.40, p=0.049, Cramer's Test V 0.3, p=0.049). Symptom severity is mild in 38% (95% CI 24.0% - 51.9%), followed by 34% of moderate symptoms (95% CI 20.4% - 47.6%), according to the percentages obtained in the CVSS17 questionnaire. It is suggested that visual hygiene be improved, the work environment optimized, and regular visual stimulation breaks established to prevent visual symptoms. These measures, assessed by the CVSS17 questionnaire, provide a healthier working environment.

By Abigail Torres, Edmundo Navarrete Arboleda, Santiago Salazar

Working memory is a mental process that allows the human being to store and elaborate in a transitory way the information received by the senses, so it is important to complement this with the quality of life, the latter considered as the welfare present in a person with their achievements, health and healthy eating; this superior function in conjunction with the quality of life can be affected by various factors such as any disability.
The purpose of this research is to evaluate executive functioning from the perspective of working memory and quality of life in people with disabilities institutionalized in the city of Ambato. The methodology was quantitative, non-experimental, and cross-sectional with descriptive characteristics in a correlational analysis. It was worked with two assessment instruments, the INECO, which assesses executive functions including working memory, and the INICO for the evaluation of quality of life, with 46 participants between 18 and 60 years of age.
The results show a low performance in working memory, as well as a low quality of life in the self-report, from the caregiver's perspective a high quality of life is perceived. It has also been recorded that the working memory variable is not related to quality of life scores. It is concluded that there could be a possible affectation in the prefrontal cortex of the participants, which affects the performance of the quality of life of those evaluated.

By Flores Hernández Verónica Fernanda , Ponce Delgado Agueda del Rocío , Bonilla Basantes Paulina Jhojana

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: 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: 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. Occupational and recreational activities are the most important causes of exposure to solar radiation, the cumulative effect of which could lead to the development of skin cancer.
Objective: Determine dermatological injuries associated with sun protection among outdoor workers in the Provincial Municipality of Huánuco in 2023.
Methods: An analytical observational study of a census nature was carried out. The instrument used was validated through five expert evaluations, obtaining a Kappa index of 0.94. The reliability of the instrument was evaluated using the α-Cronbach coefficient of 0.68 and Kuder-Richardson 20 of 0.69. The sample included 300 subjects. The techniques used were behavioral observation, interviews and surveys. The statistical analysis consisted of the use of Chi2.
Results: A statistically significant association (p < 0.05) was found between sociodemographic variables, hours of sun exposure, and sun protection practices. However, there was no association between dermatological injuries and sun protection practices in workers exposed and not exposed to solar radiation (p > 0.05).
Conclusion: Dermatological injuries were observed due to solar radiation exposure in both groups, including those engaged in outdoor activities and those with minimal sun exposure.

By Agustina Celis-Martel, Carlos Alberto Saavedra-Leveau, Patricia Karen Paucar-Lescano, Dennis Alfredo Flores-Celis

Introduction: The characteristics of telehealth and telemedicine pose a challenge for its successful insertion into the professional training curriculum in the areas of health. To date, no research has been carried out that addresses the integration of telehealth and telemedicine in the academic curriculum of Chilean universities.
Objective: Design an instrument that allows measuring the self-perception of students in the area of health sciences in relation to their level of knowledge of basic aspects of telehealth and digital skills.
Method: A 12-item instrument was designed with a Likert scale from 0 to 7, made up of two dimensions: Basic elements associated with telehealth (7 items) and skills associated with the use of technologies (5 items). It was applied to 308 students from five Chilean universities in the area of health sciences, the sample was intentional non-probabilistic.
Results: A Cronbach's Alpha of 0.9035 was obtained for dimension 1 and 0.9729 for dimension 2. The factor analysis confirmed the existence of the two proposed dimensions.
Conclusions: The instrument designed allows us to measure the perceived level of health sciences students in relation to the basic elements associated with telehealth and the skills for using technologies.

By Marcela Hechenleitner carvallo, Jacqueline Ibarra Peso, Carlos Zúñiga san Martín

Introduction: The last decade has been characterized by an increase in people's interest in eating a plant-based diet (PBD). This dietary pattern partially or wholly excludes foods of animal origin, from which different subgroups of diets are derived, which are defined by the type of food of animal origin that is excluded or consumed.
Objective: Describe the nutritional status of students on a PBD at the Adventist University of Chile.
Methods: This is a descriptive observational study, with non-probabilistic snowball sampling. The primary variable was nutritional status, secondary variables were CVR, PBD subgroups and motivations.
Results: A total of 50 subjects participated, with a mean age of 23.4 years, 56 % of whom were women. The predominant nutritional status was normal with 66 %, and low cardiovascular risk (86 %). According to the questionnaire, the majority of the students reported a flexitarian diet (48 %), with the most frequently mentioned motivation for a DBP being health and wellbeing (94 %).
Conclusions: At the Adventist University of Chile, students who follow a plant-based diet tend to have a normal nutritional status, with their main motivation being related to obtaining health benefits. These findings could contribute to understanding the dietary trends and motivations behind plant-based diets in university students.

By Jorge Fernández, Xabier Saavedra, José Torres

Background: Hysterosalpingography (HSG) is a useful radiographic investigation involving the use of contrast medium for the management of infertility in females. It is however, not only a costly procedure but it is also a semi-invasive procedure and carries some radiation risks. One principle of radiation protection is justification of practice which means that the overall benefit of the procedure should outweigh the radiation risks. The aim of this study was to determine justification of HSG procedure by assessing the rate and pattern of pregnancy success among infertile women who underwent HSG procedures at a tertiary hospital in South Eastern Nigeria between 2016 and 2020. Methods: A retrospective cross-sectional study of a sample of 222 women, aged 20-46years (mean 32.55 ±8.16years) who underwent HSG examination at the hospital between 2016 and 2020 was made. The data of eligible subjects were collected from the archives of radiology department of the hospital. Results: The result showed that 121 (54.5%) out of 222 of the patients achieved pregnancy with proper follow up infertility management. Of the 121, 48(39.67%) were in the 25-29 years age group and 35(28.93%) in the 30-34years age group. The commonest pathology found was uterine fibroid 71(32.0%), followed by tubal blockage, 42(18.92%) while the least occurring pathology was salpingitis isthmica nodosa 1(0.45%). Conclusion: There was a strong positive correlation between the age of patient, the HSG findings and the rate of pregnancy success. The procedure is justified in all the age groups except for the >45years group.

By Hyacienth Uche Chiegwu, Daniel Chimuanya Ugwuanyi, Michael Promise Ogolodom, Emmanuel Emeka Ezugwu, Victor Kelechi Nwodo, Nwamaka Chizube Ikegwuonu, Inwang Edet Usoro, Juliet Chidimma Onwu

In a context where agroecology has become an increasingly relevant alternative to promote sustainable and environmentally friendly agricultural practices, this project seeks to provide an efficient tool for mapping and visualizing agroecological crops in a specific geographic area, allowing farmers, researchers, and planners to evaluate and promote sustainable agricultural practices. This project will describe the methodology used for creating the thematic map, which will include data collection on agroecological crops through surveys and records, as well as the processing and analysis of this information within the Google Earth environment. The accuracy and reliability of the mapping technology used will be evaluated, ensuring that the results are dependable and precise. The obtained results will provide a clear and accessible visual representation of the spatial distribution of agroecological crops, thereby facilitating informed decision-making for agricultural planning and the promotion of sustainable practices. The ultimate goal is to contribute to the promotion and practical application of agroecology by providing a useful and easily accessible tool for mapping agroecological crops in a specific geographic area. The hope is to foster interest in sustainable agriculture and encourage the adoption of environmentally friendly practices in the agricultural sector, thus contributing to a more sustainable and equitable future in agriculture.

By Pedro Vélez Duque , Paulo Centanaro Quiroz , Juan Javier Martillo , Arturo Alvarado Barzallo

Introduction: depression, anxiety, and stress are mental health conditions that affect university students worldwide. In the university context, where students face a series of academic, social, and personal challenges, these conditions can manifest in various ways, impacting both emotional well-being and academic performance.
Objective: to assess depression, anxiety, and stress in a sample of students from a public university in Peru.
Methods: a quantitative, non-experimental, descriptive cross-sectional study was conducted. The sample consisted of 115 students of both sexes who were administered the Depression, Anxiety, and Stress Scale, an instrument with adequate psychometric properties.
Results: low levels of depression, anxiety, and stress were identified. Additionally, high, direct, and significant correlations were reported between depression and anxiety (r= 0.821; p<0.05), depression and stress (r= 0.849; p<0.05), as well as between anxiety and stress (r= 0.855; p<0.05). Moreover, statistically significant differences were found regarding stress and the participants' sex (p<0.05).
Conclusions: students from a public university in Peru exhibited symptoms of depression, anxiety, and stress. Therefore, it is recommended to implement psychological and emotional support programs to improve students' mental health.

By Tatiana Carmen Huamani-Calloapaza, Marleni Mendoza-Zuñiga, Giovanna Rocio Pizarro-Osorio, Guido Raúl Larico-Uchamaco, Marisol Yana-Salluca, Nancy Yana-Salluca, Katia Perez-Argollo, Osbel Mora-Estrada, Edward Jimmy Pandia-Yañez

Hong Kong Special Administrative Region, Macao Special Administrative Region, and Guangdong Province will all jointly host the 15th National Games of the People's Republic of China in 2025. For Macao, it will present a chance to expand the cultural and sports sectors while also enhancing the one industry environment dominated by the gambling industry. Macau has the chance to build a study tour center and a sports learning brand by taking advantage of the National Games craze. This study, using Macao as an example, examined the viability of developing sports study tours there and employed the SWOT analysis method to identify the strengths (S), weaknesses (W), opportunities (O), and threats (T) associated with doing so. According to the survey, when it comes to creating sports study tours, Macao has advantages in terms of facilities, location, culture, brand, and institutions. Traveling without learning is one drawback; study tour evaluation needs to be improved; teaching study tours is not a vocation; and the Macau Sports Study Tour is constrained by tourism goods, visitor abilities, and the surrounding environment. In addition to developing sports study tours, Macao has the chance to grow coastal tourism, which will support the industry's diverse development. Additionally, sports study tours will support government department mergers and reorganizations to redefine their functional orientation as well as industry integration. Sports study tour is threatened by the lack of a framework for policy support, supervision, and evaluation.

By FatFai Ieong

At the end of the SARS-CoV-2 pandemic, a scenario is observed that leaves repercussions in the Universities, among them it affected the students both in their performance, as well as in the social field, to cover these deficiencies, the role of the professor and the tutors was decisive. Therefore, the objective of this article is to describe the influence of the communication and motivation of the tutor on the consumption of psychoactive substances in times of pandemic. The research was quantitative, non-experimental, longitudinal, a data collection instrument with a Likert scale was used through digital media to students of the system of technological universities in Mexico. A descriptive evaluation was carried out and the Spearman test was applied to determine the correlation between communication and motivation on drug use, as results it was possible to define that both have a very strong positive correlation (r=0.83).

By Carlos Vázquez Cid de León, Salvador Montesinos González, Ernesto Domínguez Herrera, Wileidys Artigas

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: 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: 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: Academic satisfaction is a fundamental component that influences students' educational experience and directly impacts their academic performance and overall well-being.
Objective: To determine whether coping with stress and self-efficacy predict the academic satisfaction of university students.
Methods: A quantitative, non-experimental, predictive, and cross-sectional study was conducted. The sample consisted of 301 students who were administered the Academic Stress Coping Scale, the General Self-Efficacy Scale, and the Academic Satisfaction Scale, all instruments with adequate psychometric properties.
Results: Preliminarily, it was found that academic satisfaction correlated significantly and directly with coping with stress (r= 0.449; p<0.05) and self-efficacy (r= 0.521; p<0.05). Likewise, coping with stress was found to correlate significantly and directly with self-efficacy (r= 0.438; p<0.05). Regression analysis demonstrated a suitable fit for the model (F= 53.128; p<0.05), where coping with stress (β= 0.302; p<0.05) and self-efficacy (β= 0.491; p<0.05) explained 27.3% of the total variance of the academic satisfaction variable.
Conclusions: Coping with stress and self-efficacy predict the academic satisfaction of university students. Therefore, the implementation of specific strategies is recommended, thus fostering a more conducive academic environment for student well-being and academic success.

By Edwin Gustavo Estrada-Araoz, Guido Raúl Larico-Uchamaco, Nelly Olinda Roman-Paredes, Euclides Ticona-Chayña

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 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: Disruptive behavior, characterized by actions that interrupt or hinder the development of educational activities, has been the subject of increasing attention and interest in the academic field due to its significant impact on the school environment and the teaching-learning process. In this context, effectively intervening in these cases is crucial to create a safe and conducive school environment for learning.
Objective: To evaluate the effectiveness of a psychoeducational program on soft skills to reduce disruptive behavior in students in the Peruvian Amazon.
Methods: Quantitative study, experimental design, and pre-experimental type. The sample consisted of 243 students from the fifth cycle of regular basic education. A psychoeducational program based on social skills was developed, and to assess its effectiveness, a questionnaire was administered before and after the intervention, which had adequate psychometric properties.
Results: Statistically significant differences (p<0.05) were identified between the overall scores of the disruptive behavior variable before (71.79) and after (48.20) the implementation of the psychoeducational program. Likewise, significant differences were observed between the average scores of the dimensions of classroom climate, effective communication, and interpersonal relationships before and after the intervention (p<0.05).
Conclusions: The application of a psychoeducational program is effective in reducing disruptive behavior in students in the Peruvian Amazon. Therefore, it is recommended that future educational initiatives consider implementing similar programs to foster an enriching school environment that promotes personal growth and positive interactions.

By Manuel Felipe Guevara-Duarez, George Jhon Cruz-Visa, Leydy Katerine Collado-Gabriel, Edwin Gustavo Estrada-Araoz, María Isabel Puma-Camargo, Llen Alin Meza-Orue

Introduction: A funa is a form of public rebuke, often carried out through digital platforms, in which a person or entity is exposed to behaviors considered inappropriate, unfair, or immoral. This practice may include disclosing personal or professional information about the person or entity, often seeking to generate a social reaction or collective punishment. This research aimed to construct and validate a scale to measure the fear of funa in social networks. Method: The present study had four phases, with a total sample of n=901: (1) construction, validation, and adjustment of the items by experts (n=10), (2) pilot application n=50, (3) application for exploratory factor analysis (EFA) n=319 and (4) application for confirmatory factor analysis (CFA) n=522. Results: The EFA revealed two underlying factors in the scale, "Anxiety about funas in social networks" and "Fear of the consequences of funas in social networks". The confirmatory factor analysis showed a good psychometric fit of the model. The CFA showed a good psychometric fit: χ² (19) = 78.999, p < .001; RMR = 0.051; GFI = 0.961; RMSEA = 0.078; NFI = 0.967; RFI = 0.952; IFI = 0.975; TLI = 0.963; CFI = 0.975; PRATIO = 0.679; PNFI = 0.656; PCFI = 0.662. Conclusions: This research aimed to construct and validate a scale to measure the fear of funa in social networks. The constructed FFSN is valid and showed a good psychometric fit.

By Jonathan Martínez-Líbano, María-Mercedes Yeomans-Cabrera

In the field of nursing, "the other" and "otherness" focuses on the recognition and understanding of the cultural, social and personal diversity of individuals. This perspective takes into account particularities, beliefs and experiences as crucial elements in the health care, in addition contemporary nursing recognizes that each person is unique and has an identity that goes beyond their medical condition. When facing the "other", nursing professionals strive to understand their values, beliefs and cultural contexts To provide truly person-centered care, in this sense, nursing care focuses on establishing an empathetic and respectful connection with the patient, recognizing and valuing their individuality. Otherness becomes a bridge to understand differences and adapt health care to the specific needs of each individual, taking into consideration a holistic approach, considering not only the physical aspects, but also the emotional, cultural and social aspects of the patient, which involves working in interdisciplinary teams to integrate different perspectives and knowledge , thus promoting more complete and effective care.
In conclusion, the nursing approach towards "the other" and otherness lies in recognizing, respecting and valuing the uniqueness of each individual, thus promoting more human, sensitive and person-centered care.

By Humberto Elizalde Ordoñez, Ximena del Pilar Andino Guamanzara , Narcisa de Jesús Jiménez Juela , Sonia Elizabeth Chacón Sevillano, Evelyn Alexandra Romero Romero, Tatiana Karina Rosales Maldonado

Introduction: the implementation of ergonomic principles in the field of dentistry is beneficial for the personnel, assistants and patients, since it helps to facilitate an efficient and well-coordinated way of working, with costs that are adjusted to the objectives and needs of each of the parties involved.
Objective: to identify the main ergonomic risk factors of the students of the Dental Care Unit of the UNACH.
Method: this is a cross-sectional study, with a descriptive type of research, with a quantitative-qualitative approach and observational modality on the part of the researcher. The population is 120 students of the dental care unit of clinics I and IV of the National University of Chimborazo in the period October - March 2019 to 2020. We proceeded with the application of a survey using as an instrument a questionnaire of questions, this questionnaire was designed with the specific focus of inquiring about the knowledge about ergonomic risks.
Results: showed that, in spite of an acceptable knowledge, the working postures registered are mostly incorrect, which is reflected in the reported discomfort, mainly at the back level. As a contribution to the analysis, the ergonomic risk prevention protocol developed as a result of the study focused on body positions, work tools and personal protective equipment. Its implementation is aimed at improving work comfort, reducing stress and reducing injuries derived from incorrect postures during clinical interventions.

By Oscar Daniel Escobar Zabala, Annushka Malpartida Caviedes, Verónica Cecilia Quishpi Lucero, Marco Vinicio Moreno Rueda, Pricila Calva Miñaca, Giovanna Gutiérrez Gayoso, Verónica Alejandra Guamán Hernández, Carmen del Rocío Vásconez Samaniego

By Comité Editorial – Revista Salud, Ciencia y Tecnología

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

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: Diaphragmatic weakness caused by mechanical ventilation includes many different alterations derived from the muscle inactivity during this process. Structurally, the diaphragm undergoes atrophy due to its lack of use. One of the relevant treatments used to aid this muscle’s strengthening is the transcutaneous electrical nerve stimulation (TENS) which consists of the superficial application of an electrical current. Objective: To stablish the programming for transcutaneous electrostimulation on mechanical ventilation induced diaphragmatic weaknees. Materials and methods: An exhaustive systematic review of the scientific literature. The data compilation was performed though scientific database, including: Pubmed, Scielo, and Google Scholar. The information was evaluated using the PRISMA method, within the last 5 years. Results: The results pointed that a two-phase symmetrical stimulation was the predominant pattern. With a stimulation frequency between 30 Hz to 50 Hz, which proved to be effective and beneficial. The electrical pulse duration varied between 200 to 400 microseconds, showing a favorable effect with therapeutic properties. Conclusions: The use of TENS improves the functional capacity of the diaphragm significantly.

By Elizabeth Patricia Sangoquiza Chicaiza, Stalin Javier Caiza Lema

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

Introduction: the sensation of a phantom limb is experienced by people who have had an amputation or loss of one of their limbs and continue to perceive its presence; in most cases it occurs within days or in the first month.
Objective: determine which are the most used physiotherapy techniques in the treatment of phantom limb sensation and which of them is the most effective.
Material and Method: a search was carried out in main databases such as PubMed, Scopus, Cochrane and ScienceDirect, under the guidelines of the PRISMA model, for the last 5 years, where 9 studies were selected.
Results: there are several techniques that are applied in phantom limb pain such as: mirror therapy, graded motor images, neurofeedback training, repetitive magnetic cranial stimulation, BCI training and virtual reality. These showed a prolonged reduction in pain, improving quality of life and therefore activities of daily living. The most outstanding result indicates that virtual reality and repetitive transcranial magnetic stimulation reduces DMF and its characteristics despite the fact that the most used is mirror therapy because it is economical and easy to apply.
Conclusion: the physiotherapeutic techniques used in the sensation of the phantom limb are diverse that help to improve the symptoms in the short-term depending on the treatment to be applied, avoiding surgical and pharmacological interventions.

By Evelyn Jahaira Changobalin Tite, Josselyn Gabriela Bonilla Ayala

Introduction: Obesity is a chronic disease characterized by a high percentage of fat in the human body, caused mainly by endogenous (genetic), biological and exogenous causes (life habits), representing a serious public health problem. Objective: To know the nursing interventions in childhood obesity. Methods: A systemic review of scientific articles was carried out using the PICO strategy. The search was carried out according to PRISMA parameters where initially 40 articles were obtained, of which 18 were included under inclusion criteria such as: Original studies, clinical trials, systematic reviews and meta-analysis, free access, English and Spanish languages and that have been published. between the years 2019 and 2023; while, the exclusion criteria were: degree thesis and documents that did not meet the inclusion criteria. The databases were: ELSEVIER, MEDLINE, Redalyc, SCIELO, Latindex, Dialnet, Latin REV, Scopus using descriptors in health sciences (DECS) from Bireme and the Medical Subject Headings (MESH) from the National Library of Medicine in English. , such as: (interventions) AND (childhood obesity AND (Nursing). Results: Nursing interventions focused mainly on improving eating behaviors and reducing sedentary lifestyle. Those related to the family were more successful, because, by training adults the quality of life of the child is improved. Conclusions: The training of nursing staff is essential for the management and care of childhood obesity.

By Katherine Mishelle Yagchirema Yancha, Evelin Fernanda Velasco Acurio

Introduction: the development of digital technologies in the area of medical sciences has progressively advanced in recent years, initially conceptualized as electronic health, whose characteristics were fundamentally informative, its main tool being the internet and extending to other services such as mobile health and telehealth of great importance for medicine. Objective: the present systematic review aims to determine the main digital technologies in the health area, developed during the years 2020 to 2022 and their applicability in the different fields of medicine.
Methods: the methodology used was based on the review of original research articles on four categories of study: electronic medical records, telemedicine, mobile health and data analysis, obtained from the Scopus, Web of Science, ProQuest and EBSCO databases. Thirty articles were selected, respecting the screening and eligibility criteria considered in the PRISMA protocol. Results: the results of the review showed the remarkable development in the application of electronic medical records and telemedicine in the different areas of health, constituting between them 60% of the publications; mobile applications and data analysis were the ones with the lowest results, but with the greatest technological innovation.
Conclusion: we conclude the importance of the applicability of new technologies developed during the health emergency in different health areas

By Jorge Alcides Loayza Effio, Yolanda Josefina Huayta Franco, Willian Sebastian Flores Sotelo

Introduction: the health crisis caused by the SARS-CoV-2 virus affected not only the population, but also highlighted the deficiencies and strengths of the health system worldwide. Hospital biosafety protocols and standards had to be activated to protect health professionals, among whom were nursing staff.
Objective: to characterize the biosafety conditions during the professional practice of nursing staff before and after COVID-19.
Methods: a study with a qualitative approach was carried out, based on a systematic review, whose method was the historical-logical one. The databases used in the search process were PubMed, Web of Science, and Scopus, from which 26 articles from indexed journals were obtained.
Results: 61.53 % of the documents reviewed were published in English and 38.46 % in Spanish. In addition, Scopus was the database with the greatest number of publications with 34.61 %, Scopus-PubMed-WoS followed it with 15.38 %, and PubMed-Scopus with 11.53 %. The characterizing elements identified were the biosafety protocol, physical and psychological repercussions, and improvement opportunities in biosafety.
Conclusions: the situation experienced by health personnel - nurses and physicians - during the pandemic was characterized by a shortage of biosafety supplies and care, little experience in implementing biosafety protocols, and a lack of training programs. Therefore, measures must be taken to train both the public and this professional sector, as well as to update these skills continuously.

By Leticia Gil Cabanillas, Elida Mirtha Bravo Benites, Lester Byron Rodriguez Lazaro, Carmen Rocío Ricra Echevarría

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

Introduction: currently, the consumption of addictive substances is closely related to digestive, psychiatric, neurological and infectious pathologies, as well as to various types of cancer, cardiovascular diseases and family problems.

Objective: to characterize the influence of health interventions in the management and prevention of substance abuse in young students during the last 10 years.

Method: the systematic literature review was conducted following the guidelines of the PRISMA 2020 statement. In addition, the PICOT structure was used to formulate the research question. MEDLINE, IBECS, LILACS, CUMED, WILEY, ScienceDirect, Emerald Insigh and EBSCO Host databases were searched. DeCS and MeSH descriptors were used, in Spanish, English and Portuguese with AND, OR and NOT operators. Eligibility criteria: experimental and quasi-experimental studies published between 2013 and 2023.

Results: 140 research studies were identified based on the inclusion criteria, of which, based on the screening, 21 were eliminated for duplication, 52 for title, 44 for abstract reading and 20 for full-text reading, leaving three articles for analysis.

Conclusions: the present systematic literature review made it possible to identify, evaluate, analyze and synthesize the available scientific evidence with methodology of interventions in the Latin American and Caribbean context that can serve as references for updating and new generation of knowledge

By Miguel Angel Lopez Ocampo, Edith Castellanos Contreras, Javier Salazar Mendoza, Israel Ortiz Vargas, Claudia Beatriz Enriquez Hernández, Diana Luz Rodríguez Landa, Ramses Aquino Castellanos, Ernestina Méndez Cordero

Background: The incorporation of gamification into physical exercise has facilitated the exploration of its mental health benefits. Analysing the nexus between gamified physical exercise and mental well-being has yielded substantial and promising outcomes. The creation of applications to enhance adherence to physical exercise presents a multifaceted challenge, necessitating a multidisciplinary and innovative approach that encompasses psychological, motivational, and physiological factors pertinent to physical exercise. Gamified physical exercise emerges as an innovative strategy for addressing public health challenges. Objective: This study aims to evaluate the relationship and impact of gamified physical exercise on mental health, through an analysis of published empirical studies. Methods: An exhaustive literature search was conducted in the SCOPUS and Web of Science databases, spanning from 2017 to 2022, adhering to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Results: The search yielded 8 articles providing empirical evidence on the interplay between gamified physical exercise and mental health. 75% of these studies ascertain a positive correlation, indicating enhancements in self-efficacy, stress levels, sleep quality, depression, mood, life satisfaction, and, in some instances, increased engagement in physical exercise. Conclusions: Gamified physical exercise exhibits a favourable impact on mental health, accompanied by ancillary benefits such as enhanced social relationships, motivation for ongoing exercise, enjoyment, and adherence.

By Eva Ariño-Mateo, Josefina García-Carretero, Isabel Alonso-Rodríguez, Elena Olmos-Raya

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: 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 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

The need to innovate student-centered educational practices adapted to constant changes highlights the importance of deepening reflection and pedagogical contextualization. The aim of this research was to identify the relationships between reflection and pedagogical contextualization. A systematic review of the relationship between reflection and pedagogical contextualization in innovative educational practices was conducted, using the PRISMA methodology to ensure rigor and transparency. The search was carried out in the SciELO, Dialnet, and Redalyc databases, initially identifying 328 documents, with 9 articles selected for the study. The interdependence between reflection and pedagogical contextualization is revealed, emphasizing their crucial role in innovative educational practices; this drives innovation, being essential for questioning and adapting practices. Additionally, adaptation to context and constant evaluation are fundamental for success, facing challenges such as equity and resistance to change. It is concluded that this interdependence will enable the design of educational interventions that promote a culture of reflection; furthermore, the importance of adapting pedagogical practices to the context and the participation of the educational community in the innovation process is recognized.

By Laura Cristina Barba-Miranda , Jesús Orlando Gómez-Rivero

Introduction: heart failure is one of the most prevalent diseases, generally managed through a medical-surgical approach with the placement of implantable cardiac devices (ICDs). Cardiac rehabilitation in these patients involves various physical exercises that focus on improving quality of life. This study aimed to gather information to determine the exercise modality with the best short-term clinical outcomes, that are also appropriate to patients with ICDs.
Methods: a systematic literature review was conducted by searching for clinical studies in the Scopus, PubMed, ScienceDirect, and SpringerLink databases from 2019 to March 2024. Medical Subject Headings (MeSH) terms were employed, and the search followed PRISMA guidelines.
Results: ten Randomized Clinical Trials (RCTs) were identified; one trial addressed patients with pacemakers (PM), one study included subjects with implantable cardioverter-defibrillators (ICD), three trials focused on patients with cardiac resynchronization therapy (CRT), three studies involved subjects with both ICD and CRT, and two trials included patients with left ventricular assist devices (LVAD). A total of 379 subjects participated, of which 291 were in the exercise intervention group. Four exercise modalities were found: interval aerobic, moderate continuous, combined (resistance and strength), and High-intensity interval training (HIIT).
Conclusions: combined resistance and strength training was determined as the modality with the best short-term clinical outcomes for patients with implantable cardiac devices.

By Katheryn Alexandra Carrión Moreno, Stalin Javier Caiza Lema

Introduction: In Ecuador, older adults or senior citizens are considered to be those over 65 years of age, in whom a high number of falls have been observed, causing a significant rate of morbidity and mortality in recent years. The increase in the frequency of falls in older adults contributes directly to an increase in injuries and medical conditions.
Methodology: The present research was conducted under a quantitative approach using the PRISMA method, which allows for the characterization of falls among older adults in primary health care based on numerical data, as well as obtaining perceptions and risk factors present in a specific population, employing a literature search across multiple databases, including PubMed, SCOPUS, Web of Science, Google Scholar, among others.
Results: Through exhaustive research, it was determined that falls can have origins in both internal and external factors, resulting in physiological, psychological, and social changes in older adults.
Conclusions: Among the main causes involved in falls among older adults are the use of psychotropic medications, alcoholism, age, as well as muscle weakness, recurrent falls, visual and auditory deficits. Early detection of risk factors associated with falls in older adults allows for early and targeted intervention, which can help reduce the incidence of falls and their negative consequences.

By Klever Leguizamo, Ricardo Recalde-Navarrete

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

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

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: opportunistic mycoses, caused by fungi in individuals with compromised immune systems, are on the rise, posing significant challenges in healthcare. This article reviews antifungal resistance with the aim of highlighting its increasing incidence and the need for new therapeutic strategies and precise diagnostic methods. The necessity for standardized laboratory protocols and the implementation of sensitive techniques for early detection and optimal treatment is emphasized.
Methods: a systematic review was conducted using PubMed, Scopus, and Google Scholar; search terms and Boolean operators such as "(Opportunistic Mycoses) AND (Antifungal Resistance)" and "(Antifungals) AND (Resistance Genes)" were used. Additionally, the guidelines established by the PRISMA statement were followed, and the PICO approach was employed.
Results: twelve studies were evaluated; 58,33 % (n=7) assessed antifungal resistance, while 41,67 % (n=5) addressed aspects such as mechanisms of action and genetics. 66 % of the studies evaluated resistance in Candida spp., while 16,7 % analyzed resistance in Aspergillus spp., making them the most studied pathogens. Various resistance genes were evaluated in all studies; moreover, fluconazole was found to be the most studied antifungal, followed by amphotericin B and voriconazole.
Conclusion: early identification of antifungal resistance, the development of new therapies, and the standardization of diagnostic methods are essential to mitigate its impact on public health.

By Natalia Raquel Aguiar Muñoz, Carlos Fernando Yauli Flores

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

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

Re-emerging diseases, especially zoonoses, represent a public health problem with a profound impact on global dynamics. The COVID-19 pandemic has caused serious damage to the physical and mental health of the population, who are still not over the shock provoked, when not very encouraging news appear, a particular outbreak of smallpox known as monkeypox (MPX) that has the health authorities on alert. A bibliographic review was carried out with the purpose of showing the repercussion of zoonoses, especially MPX, on the mental health of the population. The MeSH descriptors were entered into the search servers PubMed, Elsevier, Scielo and LILACS in Spanish and English, finding several studies referring to the impact caused by pandemics on mental health, especially psychosocial disorders, isolation, and economic recession, as well as fear, loneliness, disconnection, and depression. In June 2022, the first case of MPX-related suicide is reported. Psychological evaluation is needed in suspected and confirmed cases of MPX, especially those patients admitted to isolation wards, allowing early identification of mental involvement and/or history of mental illness.

By Carmen Barba, Chiquinquirá Silva de Méndez, Carolina García, Yenddy Carrero

Poor communication of bad news can have a significant negative impact on patients, triggering stress, anxiety and deterioration in their overall health status. The aim of this study was to interpret the delivery of bad news in medical practice through a literature review for the proposal of an approach to improve effective communication skills among health professionals. To achieve this end, a literature review was conducted following the guidelines of the PRISMA 2020 methodology, using sources such as PubMed, Lilacs and Scielo. From this search, 16 articles relevant to the topic of study were selected. The findings underline that the ability to adequately communicate bad news is not optional, but an essential competency within professional practice, thus highlighting the importance of this topic in the medical setting. It is concluded that it is crucial for health professionals to be adequately prepared to communicate bad news, which implies the development of protocols and specific recommendations on prognosis and treatment, and the fostering of a doctor-patient relationship based on trust and mutual respect

By Pamela Alexandra Sánchez Sandoval, Libia Karina Reyes Espinoza, Dayanara Cecilia Burbano Pijal

Introduction: The teratogenic agents during the embryonic period can result in disorders in organ differentiation. Concerns regarding medication use during pregnancy heightened after the thalidomide case in the 1960s, underscoring the need for a balance between caution and effective treatment, given the lack of clear information on risks. The aim of the research was to understand teratogens as factors that increase mutability and highlight the relevance of preventive strategies to ensure fetal and maternal health. Methods: Literature review using the PubMed database, Scopus and Web of Science was conducted. Forty-four articles, documents, clinical trials, and systematic reviews published in English were included. Teratogens and their effects, as well as preventive strategies for teratogenic congenital defects, were explored. Results: Risks associated with specific substances were examined, highlighting their effects on the fetus and providing epidemiological data. Preventive measures such as vaccination, folic acid supplementation, and control of metabolic diseases were addressed. Conclusions: During pregnancy, it is crucial to avoid exposure to chemicals, drugs, and medications that may harm the fetus. Caution should be exercised with the use of medications, and alcohol, tobacco, and illicit drugs should be avoided. Preventive strategies such as vaccination and folic acid supplementation reduce the risk of congenital malformations and promote a healthy pregnancy.

By Karina Paredes-Páliz, Joselyn Armendáriz-Ramos, Anabell Urbina Salazar, Alberto Renato Inca Torres

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

This study delved into the enteric protozoa of swine, their importance in swine production and as zoonoses. The lack of knowledge about them is a major problem facing pig production, mostly in backyard conditions associated with a low socio-cultural and sanitary level, the easy transmission between conspecifics and also to humans, producing economic losses and compromising human health in favorable hygienic conditions for the development of diseases. Searches were made in Scopus, Web of Science, Redalyc, EBSCO, Scielo and Google Scholar databases. A combination of search terms such as ("Protozoa" OR "gastrointestinal" OR "Zoonosis") AND ("Swine") AND ("Importance") and descriptors such as "Incidence" "Prevalence", "Pathogenesis", "Transmission" were used. The bibliography consulted showed that Balantidiosis and Cryptosporidiosis are among the most common gastrointestinal diseases produced by protozoa in pigs, causing infections at this level and transmission to humans through the consumption of contaminated food or water, direct contact with infected pigs and environmental contamination. The bibliography consulted showed that Balantidiosis and Cryptosporidiosis are among the most common gastrointestinal diseases caused by protozoa in pigs, causing infections at this level and transmission to humans through the consumption of contaminated food or water, direct contact with infected pigs and environmental contamination. The research reflected the wide worldwide distribution given in good measure by the resistance of these protozoa to adverse environmental conditions, direct and indirect transmission, vulnerability in immunologically and socioeconomically sensitive human populations, as well as economic losses in the swine industry. The paper concludes by reflecting on the impact of gastrointestinal protozoa on swine and public health, with the need to raise human awareness on hygienic sanitary measures and safe food and water consumption

By Jaine Labrada Ching, Darwin Rafael Villamarín Barragán, Marcelo Alejandro Jiménez Villa, Laura Sofia Castaño Trujillo

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

Introduction: The application of Oral Health Policies (PSB) has a great influence on the achievement of Sustainable Development (SD) of communities, promoting an improvement in the quality of life.
Objective: Analyze the proposals for Oral Health Policies in the Sustainable Development of communities.
Method: The research methodology was a documentary, descriptive design, extracted from scientific databases such as Scopus, Scielo, Web of Science, Pubmed, Redalyc and Proquest in a total of 53 articles, from the years 2018 to 2024, in languages of English and Spanish.
Results: The great importance of applying Oral Health Policies (PSB) is demonstrated through the implementation of new programs, in order to ensure the sustainable development of communities, understanding the great challenge of the work of the dental professional within the fulfillment of the SDGs, highlighting that its work is framed beyond the curative clinical area, since it has an important performance as a scientific discipline in promoting health by positively affecting the social determinants of health-disease processes and therefore in the construction of communities.
Conclusions: The efficiency of the Oral Health Policy (PSB) will have a great influence on the sustainable development of communities, first of all, because it is a fundamental right and, in the coming decades, the high rates of oral diseases must decrease since they are Preventable diseases, but if left untreated it can even trigger periodontitis and cardiovascular problems.

By Renato Ramses Diaz Moreno, Lilly Rocío Moreno Chinchay, Moisés Adolfo Sánchez Moreno , Franco Martin Diaz Moreno, Marcos Andrés Sánchez Moreno

Introduction: The identification of postmortem persons using dental comparison is very useful in the case of finding bodies in an advanced state of decomposition for various reasons, and this is where dentistry plays a significant role, since it has the possibility of providing ante mortem data on the deceased for comparison and definitive identification.

Objective: The general objective was to know the possibilities and limitations of odontological comparison in the identification of postmortem persons.

Methods: A systematic review of the literature was carried out in the Scopus, Pubmed and Google Scholar databases, in the period 2018 to 2023, where 210 articles were totaled, with a final selection of 20.

Results: In relation to the number of publications, Europe and Asia led in this category. The type of study that stands out is the case report of observational studies with comparative analysis, and the systematic review. As aspects addressed most frequently are, the role of the forensic odontologist, 3D scanning, microcomputed tomography, cone beam computed tomography and the importance of ante mortem and postmortem dental records in the identification of postmortem persons, by means of dental comparison.

Conclusions:  The possibilities and limitations of odontological or dental comparison will depend directly on the full, safe and reliable accessibility of the ante mortem and postmortem information

By Lucy Escobar Chauca, Mario Jesus Villamar Diaz, Alejandro Aldana Cáceres, Efrain Pablo Montes Hijar

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

People with visual impairment face difficulties in maintaining optimal oral hygiene, due to the possible lack of knowledge about proper oral cleaning techniques. The objective of the study was to describe oral hygiene habits in people with visual impairment in children with visual impairment in the "La Joya" Specialized Educational Unit in the city of Otavalo, Ecuador. The study had a descriptive, observational, prospective and cross-sectional approach. Two techniques were used: surveys, using questionnaires, and interviews, using the interview guide. The population included parents of children with disabilities, teaching and administrative staff, as well as personnel trained in the education of children with visual impairment. Simple random probability sampling was used for the survey, with a total of 51 people, and non-probability purposive sampling was used for the interview, identifying two key informants. The findings showed an inclination toward educational interventions focused on hearing and touch, with special emphasis on specialized teaching and the use of adapted materials, such as dental models and Braille booklets, to promote oral care. Financial support for dental treatment is a crucial factor. The results highlight the need for a pediatric dentist at the "La Joya" Specialized Educational Unit. It is concluded that there is a notable lack of attention to oral cleanliness in children with visual impairment, mainly due to poor knowledge and follow-up by educational personnel, health professionals and parents

By Adriana Katherine Quezada Quiñonez, Brised Abigail Lara Lita, Katherin Alejandra Gúzman Proaño, Pamela Alexandra Sánchez Sandoval

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: 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

Osteogenesis Imperfecta (OI) is a rare genetic disorder characterized by brittle bones and susceptibility to fractures. Management of OI focuses on minimizing fractures and improving bone strength. Denosumab and bisphosphonates have emerged as potential therapeutic agents in OI management due to their ability to modulate bone turnover. This literature review aims to explore the role of denosumab and bisphosphonates in the treatment of OI, highlighting their mechanisms of action, efficacy, and safety profiles. A comprehensive search was conducted across various databases, to identify relevant studies investigating the use of denosumab and bisphosphonates in OI management. The review discusses the molecular pathways underlying the pathogenesis of OI and how denosumab and bisphosphonates intervene in these pathways to improve bone quality. Furthermore, the review summarizes the findings from clinical trials and observational studies evaluating the effectiveness of denosumab and bisphosphonates in reducing fracture rates, improving bone mineral density, parathyroid hormone changes, calcium and phosphate quantity, and also enhancing functional outcomes in patients with OI. Additionally, considerations regarding optimal dosing, timing of initiation, and potential adverse effects of denosumab and bisphosphonates in individuals with OI are discussed. The synthesis of existing evidence underscores the promising role of denosumab and bisphosphonates as adjunctive therapies in the management of OI, although further research is warranted to elucidate their long-term efficacy and safety profiles in this patient population.

By Agus Kresnadi, Tri Wahyu Martanto, Arif Zulkarnain, Hizbillah Yazid

Laparoscopic surgery in the removal of ovarian cysts is one of the most widely used procedures in the world today due to its multiple advantages, but the procedure is not free of complications. The aim of this study was to analyze, by means of a literature review using PRISMA 2020 methodology, the laparoscopic surgical complications of ovarian cysts. The study was framed in the exploratory research level, using hermeneutics to analyze the systematic review developed in the databases Medline, PubMed, ScienceDirect and Google Scholar, from which 16 documents were finally included. It was shown that the main complications of laparoscopic surgery are vascular and intestinal damage, but less serious and frequent complications such as bladder and urethral damage, hernias and infections can also occur. We found that laparoscopic surgery has emerged as the preferred modality for the investigation, diagnosis and treatment of a wide range of diseases, including ovarian cystectomy. Although this form of minimally invasive surgery has numerous advantages, including a lower incidence of complications, it is not without risk. It was concluded that, although the rate of complications in laparoscopic surgery is lower compared to conventional surgery, more research is needed to improve existing procedures, ensure their safety and create new methods

By John Alex Torres Yánez, Evelyn Natividad Analuiza Rea, Tania Abigail Cevallos Fuel

Introduction: The use of closed infusion systems for the administration of intravenous fluids has shown a notable impact on reducing Central Line-Associated Bloodstream Infections (CLABSI); however, their adoption in Chile remains limited. Objective: This study aimed to assess the role of closed infusion systems in preventing CLABSI. Methods: A rapid literature review was conducted, consulting databases such as Web of Science, SCOPUS, PubMed, SciELO, CINAHL, the Cochrane Library, and BVS. The searches were carried out in the Spanish, English, and Portuguese languages; only studies with a quantitative approach were included, with no time limit and that answered the research question. The Canadian Task Force on Preventive Health Care criteria were utilized to analyze the level of evidence and grade of recommendation. Results: Out of the nine articles reviewed, 11 % presented Level IA evidence, and 88.9 % presented evidence and a recommendation grade of IIB, indicating that patients receiving intravenous fluids through open containers are at a two to five times higher risk of developing CLABSI compared to those using closed systems. Conclusion: The employment of closed systems for the administration of intravenous fluids via CVC is associated with a significantly lower risk of acquiring CLABSI compared to the use of open systems. This finding underscores the necessity of promoting the use of closed infusion technologies as a preventative measure in the clinical setting.

By Naldy Febré, Cristian Rocco, Teresa Vergara, Pamela Ivanovic, Andrea Sakurada, Marcela Quintanilla, Paola Viveros, Noskar Navarro, Miguel Valencia-Contrera, Katherine Olguín

Leishmaniasis is a persistent disease caused by the bite of a sandfly carrying the Leishmania parasite. Clinical manifestations include lesions of the skin, mucous membranes and internal organs. Parasite diagnosis is characterized by direct observation of the parasite by staining methods. Immunological tests determine the patient's humoral response. Molecular tests, such as conventional PCR, identify the subgenome and genome of the parasite by amplification of a specific DNA or RNA sequence. This research provides a set of techniques applicable to the diagnosis of leishmaniasis, with the loop-mediated isothermal amplification method (LAMP) being a rapid DNA or RNA sequence amplification test that does not require sophisticated equipment and has a sensitivity and specificity of 100 %. In addition, the efficacy of artificial intelligence using database-driven algorithms to diagnose cutaneous Leishmania was examined. A literature review of scientific articles in databases such as PubMed, SciELO and Elsevier was carried out to perform a descriptive analysis of current and future diagnostic methods in Leishmaniasis.

By Lorena Elizabeth Cobo Carrasco, Elena Johanna Pérez Laborde

Pulmonary TB (TBP), caused by the bacillus Mycobacterium Tuberculosis (Mtb), is one of the most prevalent and deadly infectious diseases worldwide. With approximately a quarter of the global population affected, TB is one of the main causes of mortality within the spectrum of infectious diseases. Given this reality, there is an urgent need to explore and analyze new strategies that offer hope in the fight against this disease. The present article aims to offer an analytical review of emerging strategies in the treatment of TB. To achieve this objective, a comprehensive review methodology has been adopted, covering a wide range of recent bibliographic sources, including academic research and specialized literature. The purpose is to compile and synthesize the most significant and up-to-date contributions in the field, thus providing a clear and current overview of advances in the fight against TB.

The article is structured in key sections covering the introduction to the basic concepts of TBS, the epidemiology and the interaction between Mtb and the host immune response, focusing on granuloma formation. In addition, pharmacodynamics and conventional treatments are discussed, along with a critical review on drug resistance. It concludes by highlighting the need for innovation and personalization in treatments to address drug resistance, offering a comprehensive view of the current challenges and solutions in TB management.

By Andrés Caicedo Lozada, Gabriela Echeverría Valencia

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

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

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: In Latin America, the relationship between social education and social work has been a topic of growing interest, with a focus on the convergence and epistemological differences between both disciplines.
Objective: This study aims to critically analyze scientific production in Latin America between 2017 and 2022 in relation to the professional identity of Social Work and Social Education.
Method: A retrospective review of scientific production was carried out between 2017 and 2022, quantifying published articles, methodologies used, participants, research countries and content analysis.
Results: After analyzing 102 documents, 82 relevant publications were identified. A predominantly female participation was observed in the social intervention category and an incipient recognition of social education as a scientific discipline in Latin America.
Conclusions: The convergence between social education and social work in Latin America presents challenges and opportunities to strengthen professional identity, promoting social justice and the development of communities in diverse and fragmented contexts.

By Yasna Anabalón Anabalón, Emmanuel Vega Román, María Soledad Ascencio Cortés, Angel Roco-Videla

This article delves into using benthic diatoms as bioindicators of water quality, focusing on their ability to detect eutrophication and pollution resulting from industrialization and urbanization. We systematically analyzed 1099 articles from databases such as Web of Science and Scopus using PRISMA methodology, evaluating the efficacy, role, utilities, limitations, and influence of environmental factors of diatoms. The results show variability in water quality monitoring methods, from multivariate analyses to formulas based on species abundance. We highlighted the need for adaptability and validation of specific indices such as IDP and DDI, principally due to limitations in their transregional applicability. In South America, only four countries have developed their methods for assessment using diatoms, while others still rely on international standards. This fact underlines the importance of implementing effective local policies to manage water resources. Finally, we concluded that diatoms are crucial biological indicators for monitoring aquatic ecosystems, although challenges such as complexity in taxonomic identification and lack of standardization condition their effectiveness. In addition, biogeographical and environmental factors play an essential role in the diversity of these species, being necessary for understanding and anticipating changes in aquatic environments.

By Patricio Méndez-Zambrano, Rogelio Ureta Valdez, Luis Tierra Pérez, Ángel Flores Orozco

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: 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

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

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

Oral diseases have a significant impact on aesthetics and well-being, particularly affecting adolescents. This developmental phase is marked by noticeable physical and psychological changes, where self-image and social perception become crucial and can adversely influence self-esteem. The study conducted in May 2023 at UNIANDES University, Ecuador, aimed to describe the oral health of dental students, analyzing how dental aesthetics affects perfectionism and self-worth. Classified as descriptive, observational, prospective, and cross-sectional, detailed questionnaires were administered to first-, fifth, and sixth-semester students, providing in-depth insight into the interaction of these factors in a university setting. The study found that concern for dental aesthetics increases with academic progression. Students in advanced semesters show a growing concern for the appearance of their teeth and are more willing to seek cosmetic dental treatments. This attitude is accompanied by a more frequent comparison with the teeth of others and an awareness of the social impact of their dental aesthetics. Such findings highlight a direct correlation between the level of study and dental self-perception, emphasizing the need to include psychosocial support in dental training. It is concluded that progress in the dentistry career entails a greater self-criticism of dental aesthetics, highlighting the importance of educational strategies to manage expectations and promote mental health

By Reyes Espinoza Karina, Cristhian Resabala, Johan Ibarra

Introduction: mastocytosis is a rare disease triggered by the KIT D816V mutation that increases the proliferation and survival of mast cells in several organs. Mast cells have crucial receptors such as KIT, TLR, complement (C5aR, C3aR), MHCI, MHCII, MRGPRX, and FcεRI that allow them to activate and degranulate in innate and adaptive immune responses. The prevalence of mastocytosis is 10 cases per 10,000 individuals worldwide and is classified into cutaneous and systemic mastocytosis, affecting both children and adults.
Objective: characterize the specific biomarkers crucial for the prognosis, diagnosis, and monitoring of Mastocytosis.
Method: a bibliographic review was conducted by searching information in databases such as Pubmed, ScienceDirect, and Google Scholar from March to May 2024, including a total of 35 English articles published in the last 10 years and several published before 2019 that contributed relevant information to the topic.
Results: it has been determined that prognostic biomarkers help identify severe forms of the disease. Meanwhile, diagnostic and follow-up biomarkers are utilized to confirm the disease and evaluate its progression and treatment effectiveness. Additionally, it has been demonstrated that biomarkers can determine the risk of anaphylaxis, as well as the subtypes of mastocytosis.
Conclusion: biomarkers for the prognosis of mastocytosis, such as basal serum tryptase (BST) and hereditary α-tryptasemia (HαT) were characterized. In addition, diagnostic and monitoring biomarkers such as the KID D816V mutation, analysis of extracellular vesicles (EVs), CD25+/CD2+/CD30+, MITF, miRNAs, LBP, CXCL7, TGF-β1, PDGFRβ, IL-6, leukotrienes, prostaglandin, histamine, and IgE.

By Viviana Estephania Núñez Reyes, María Elizabeth Proaño Pérez

This study sought to describe and summarize the effects of nursing interventions for the promotion of healthy lifestyles in the elderly with arterial hypertension. The scope of the use of these interventions makes it possible to appreciate the related problems in neurological, cardiovascular, and renal complications. The current situation is a problem without achieving criteria, which need to be clarified through systematic reviews with livelihoods. For this review, a bibliographic search was carried out using an electronic database manager that includes searches at: Scopus, Wiley Online Library, Magiran, Sid, Cochran, Embase, Pubmed (Medline), Web of Science, Embase, Ovid, Cinahl, and Google Scholar, according to the Prism guidelines. The result has been 47 articles with temporary relevance between 2019 and March 2024. As a search criteria, keywords were used: (I) nursing intervention; (II) healthy lifestyles; (III) older adults; (IV) arterial hypertension. The systematic analysis highlights that age, gender, ethnicity, and family history have been associated with the factors that cause arterial hypertension. In conclusion, four clinical factors have been determined that must influence the adoption of healthy lifestyles in older adults with arterial hypertension. These factors tend to impact their consciousness of the disease: the need to control blood pressure, the management of related diseases, and the prevention of complications. It can be intervened with patient education protocols, drug administration with the respective physical care and care in older adults with arterial hypertension, individually and in groups, in order to promote self-management in your health for modification in lifestyles, helping to avoid or reduce high blood pressure.

By Sonia Verónica Sotamba Duchi, Paola Maricela Machado Herrera, Angélica Salomé Herrera Molina, Verónica Sofia Quenorán Almeida

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

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

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

This study aimed to investigate the efficacy of tranexamic acid (TXA) in the treatment of melasma, a skin condition that poses challenges due to its chronic nature and variable response to conventional therapies. Methodology: A systematic review of randomized clinical trials was conducted to evaluate the efficacy of tranexamic acid (TXA) in the treatment of melasma. The literature search covered studies from 2019 to October 2023 in various electronic databases. Studies that met strict inclusion criteria were selected, prioritizing controlled and randomized clinical trials. The safety and efficacy of TXA in various formulations and routes of administration, such as oral, transepidermal, and intradermal, were evaluated. Results: The findings demonstrated that TXA, in its different forms of administration, led to a reduction in the Melasma Area and Severity Index (MASI) scores, indicating improvements in skin pigmentation and dermal microcirculation. Reductions in epidermal melanin density and the number of pendulous melanocytes were observed. Additionally, the efficacy of TXA combined with other therapeutic agents, such as ascorbic acid or platelet-rich plasma, to improve melasma was highlighted. Conclusion: TXA emerges as an effective therapeutic option in the treatment of melasma. Its ability to improve MASI scores suggests a positive effect on skin pigmentation and dermal microcirculation. However, challenges such as treatment tolerability and recurrence rates persist.

By Zenia Batista Castro, Grace Anabel Tituaña Ortega

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

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

Asherman's syndrome is a condition characterized by the presence of uterine adhesions or uterine synechiae that are caused by unintentional trauma, severe infections or endometrial hypoxia in a pregnant uterus. The aim of the study was to identify the main risk factors and diagnostic alternatives for Asherman's syndrome through literature review. In an effort to better understand Asherman's syndrome, a descriptive documentary study reviewed articles published from 2019 to 2023 in high-impact journals, selecting 17 for analysis. These included case studies and theoretical sources, highlighting the still unknown pathophysiology of the syndrome. It was confirmed that diagnosis is mainly based on hysterosalpingography and hysteroscopy, although these methods do not guarantee complete endometrial recovery, leading to high recurrence rates and low conception success rates. This underscores the need for complementary therapies to restore the uterine cavity and prevent new adhesions. In addition to the medical challenges, the study highlights the significant emotional and psychological impact of the syndrome, underscoring the importance of emotional and psychological support for those affected, as well as the need to raise awareness and support research to improve their quality of life. In conclusion, partial or total obstruction of the uterine cavity by adhesions is noted as a risk, emphasizing the need for a multidisciplinary approach to treatment. The study highlights the absence of clinical guidelines and awareness in Ecuador, which hinders the management of this condition

By Dra. Nancy Yolanda Urbina Romo, Daniel Alejandro Sánchez Álvarez, Dra. María Ilusión Solís Sánchez

Introduction: acute diarrhea is one of the main causes of mortality in children under 5 years of age around the world. They disproportionately affect underdeveloped countries, where access to health services, drinking water and sanitation is limited. Objective: this review identifies the most relevant and recent studies associated with the topic, recognizes the most common infectious agents and determines the laboratory techniques used for their diagnosis. Methods: the literature was reviewed from sources such as Elsevier, PubMed, Scopus, SciELO and Google Scholar during the period March-May 2024, published in the last 5 years and several studies prior to 2019 that contributed relevant information to the topic. Results: previous studies reveal that acute childhood diarrhea is mainly characterized by its fecal-oral transmission, caused by Rotavirus and Adenovirus, and sometimes by Escherichia coli, Salmonella spp., Giardia lamblia and Entamoeba histolytica, among others. Acute diarrhea is characterized by the presence of three or more soft or liquid stools per day, and is classified according to its duration. Fecal increase, dehydration and electrolyte abnormalities are associated complications and constitute clinically useful elements for its diagnosis. For viruses, rapid tests and PCR are used, for bacteria, cultures and antibiograms, and for parasites, coproparasites, ELISA and PCR. Conclusion: These disorders represent a significant health challenge, with a considerable impact on morbidity and mortality, originating from viruses, bacteria and parasites. The diagnosis is made through physical, coprological examinations, immunochromatographic and molecular tests.

By Edwin Alexander Rodríguez Naranjo, Carlos Fernando Yauli Flores

Introduction: information and Communication Technologies have emerged as prominent tools in the educational field, especially in the training of Nursing students. Although their contribution to the development of skills and competencies is undeniable, it is crucial to recognize that, on their own, they cannot ensure the effective transmission of fundamental aspects such as professional ethics and team collaboration, essential aspects to offer quality health care. In this sense, the challenges and proposals that computer tools offer for higher education in Nursing were examined.
Methods: an exhaustive review of the scientific literature was carried out, consulting various databases recognized in the academic field such as Scopus, PubMed, SciELO, Pro Sciences and Google Scholar.
Results: the impact that technology and communication has achieved in nursing education is relevant, considering that it generates confidence in the execution of its practical application in the teaching-learning process.
Conclusions: the training of Nursing professionals with updated technology recognizes the challenges they face, which maximizes the benefits of technology both in higher education and in clinical practice, ensuring optimal service provision for the educational society.

By Rosa María Zambrano Garcés, Marcia Verónica Pogyo Morocho, Carmen Victoria Molina Calle

The object of this study is to explore how teaching strategies based on increased reality can improve the understanding of theories and demonstrations in mathematics courses for higher education students. Realized an exhaustive revision of the academic literature relative to the use of the increased reality in the teaching of mathematics. We identify and analyze studies that investigate the impact of reality increased in the understanding of abstract mathematical concepts, as well as in the motivation and compromise of students. In addition, we will examine specific applications of increased reality used in educational contexts to teach theorems and demonstrations. The results reveal that the teaching strategies are based in reality and offer many benefits for the understanding of theorems and demonstrations in mathematics courses for higher education students. These benefits include improved visualization of abstract concepts, greater interaction and active participation, adaptability to the individual needs of students, immediate feedback and greater motivation and compromise. In combination, these results suggest that the increased reality has the potential to significantly transform the form into which one teaches and learns the mathematical concepts in higher education institutions.

By Daniel Gustavo Parrales Mendoza, Carlos Alfredo Hernández Dávila, Alex Rolando Moyota Paguay, Fabián Roberto Allauca Pancho

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

Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, also known as Müllerian aplasia, is a rare congenital anomaly affecting the female genital tract, characterized by the absence of the uterus, cervix and upper vagina in women with normal appearance, karyotype 46 XX and normal endocrine function. The aim of the study was to interpret the main risk factors, clinical criteria and diagnosis of MRKH syndrome and its psychosocial impact through a literature review. A descriptive documentary literature review was conducted, analyzing articles published between 2019 and 2023 in high-impact journals. Sixteen articles were identified, including case studies and theoretical sources of information. The syndrome was found to affect approximately 1 in 4,000 to 5,000 women, with possible genetic basis. Two types are distinguished: type I, with absence of the uterus and vagina, and type II, with additional kidney and skeletal malformations. Diagnosis is made by ultrasound and MRI, and treatment includes the creation of a neovagina through surgical or non-surgical procedures. The syndrome carries a significant emotional and psychological burden due to infertility and sexual difficulties. It was concluded that MRKH involves risk factors such as family history, primary amenorrhea and normal development, requiring a multidisciplinary approach and including treatment options. In Ecuador, the lack of protocols and awareness presents challenges for those affected. It is vital to raise awareness of this condition and support research to improve the quality of life of those affected

By Dra. Nancy Yolanda Urbina Romo, Nicole Ahily Serrano Escobar, Dra. María Ilusión Solís Sánchez

Introduction: Interstitial cystitis is a clinical syndrome characterized by increased urinary frequency and pelvic pain, primarily affecting women. Two phenotypes of this disease have been identified, each with a different mechanism. Proper diagnosis is essential, as it can be confused with a urinary tract infection. Amitriptyline, a tricyclic antidepressant, has shown benefits in the treatment of interstitial cystitis by acting on symptoms and improving patients' quality of life. Its mechanism of action includes blocking the reuptake of neurotransmitters associated with pain.
Objectives: The main objective of this study is to review the main benefits of amitriptyline in relation to interstitial cystitis, analyzing its efficacy and safety.
Methods: A literature review was conducted using the Prisma method. Clinical trials and systematic reviews addressing the benefits of amitriptyline in patients with interstitial cystitis were included.
Results: After selecting 15 relevant articles, it was found that amitriptyline can reduce symptoms and improve the quality of life of patients with interstitial cystitis. Additionally, a significant improvement was observed in patients treated with amitriptyline compared to other treatments. Amitriptyline demonstrated an anti-inflammatory, nervous system modulating, and urodynamic effect in patients with interstitial cystitis.
Conclusions: Amitriptyline may be an effective and safe option in the treatment of interstitial cystitis, improving symptoms and quality of life for patients. It is suggested that this drug may act as a neuromodulator, anti-inflammatory, and urodynamic agent in patients with interstitial cystitis.

By Ana Paula Chato-Noroña, Edison Arturo Galárraga-Pérez

The present study focuses on gnathostomiasis, a parasitic disease caused by the nematode gnathostoma that affects both humans and other animals, with a prevalence of 0,14 %. The aim of the study is to analyze the main research related to gnathostomiasis, its diagnosis and treatment. To achieve this objective, a systematic review of clinical cases, observational and retrospective studies of the disease was carried out, following the PRISMA methodology. The literature search, conducted between 2018 and 2022 in the Web of Science, Scopus, PubMed, Redalyc and Dialnet databases, resulted in the identification of five articles relevant and pertinent to the topic. The study findings indicate that gnathostomiasis, on the rise in Latin America and Asia, is transmitted mainly through the consumption of raw fish infected with Gnathostoma larvae. Although preventive measures and treatments, such as albendazole, are available, their efficacy is limited, and it is difficult to implement changes in dietary habits. Therefore, more research is needed to better understand the disease, develop more effective diagnostics and treatments, and raise awareness among physicians of its increasing global prevalence.

By Gisnella María Cedeño Cajas, José Andrés Zaporta Ramos, Andrea Stefannia Flores Villacrés, Cesar Guevara

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

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

This review compiles information on the therapeutic applications of cannabinoids as a basis for their application in medicine as a treatment strategy. The main objective of this review was to analyze the therapeutic benefits of cannabinoids such as: pain relief, antitumor effect, cell cycle regulation and immune stimulation. Information was compiled from various scientific databases, such as PubMed, BioCell, Scielo, Elsevier, Redalyc, MDPI, PLOS, JAFC, BJPS and Medicinal Chemistry Research, searching by keywords and selecting according to the inclusion criteria. It was possible to identify the therapeutic potential of those that endorse their interaction in receptors, thus the remarkable antitumor effect, pain relief and immune stimulation. However, the effectiveness of cannabis products varies according to the stage of the disease and dosage. It was concluded that the endocannabinoid system (ECS) offers important therapeutic activities for some diseases, whose molecular mechanisms of action have been assessed in different experimental models. The clinical applications of cannabis have been documented in several pathologies such as: cancer, epilepsy, glaucoma, arthritis, asthma, Alzheimer, Crohn, sclerosis, insomnia and Parkinson, the current legislation has opened the way for its industrial production and therapeutic use under the control of regulatory entities

By María Ilusión Solís Sánchez, Shirley Carolina Flores Guillen, Matías Josué Luna Mena, Eliana Camila Puedmag Altamirano

DNA barcoding is a tool for species identification and classification, overcoming traditional limitations; being fundamental for multiple studies and applications. This article will review the progress of the application of DNA barcoding for algal identification; as it presents advantages such as accuracy in species identification, its applicability to various stages and conditions for ecological studies and intraspecific genetic variability, which according to its approach will depend on several factors. DNA barcoding applications in microalgae, such as its molecular identification, is fundamental for diversity and ecology; expanding knowledge about microalgae; being useful in monitoring harmful algae (HABs) that are a danger to aquatic ecosystems; In addition, DNA barcoding of microalgae is used in biotechnology and food industries. In Peru, taxonomic research is of lesser incidence because there is no method that provides precise identification at the species level, among other reasons, but this DNA barcoding technique has proven to be an efficient tool for research in the conservation and management of organisms that are difficult to access or complex to differentiate, such as microalgae. To conclude, DNA barcoding represents an essential tool in modern microalgae research, which should be developed in Peru, as it has significant potential to advance our knowledge and management of these crucial organisms in Peruvian aquatic ecosystems.

By Diego Hiroshi Takei-Idiaquez, Flor Matilda Yupanqui-Morales, Alessandro Daniel Chavez-Alberto, Ariana Ulloa-Osorio, Hermila Belba Díaz-Pillasca, Linder Ramírez-Viena, Aida Nerida Falcón-Cerna, Carlos Roberto Pesantes-Rojas

The integration of forensic toxicology into clinical laboratory protocols proved crucial in improving emergency response, as it examined the harmful effects of chemical substances and their interaction with the body. Identifying the causative agent of poisoning was complicated by non-specific symptoms and the emergence of new psychoactive substances. These substances, designed to mimic the effects of drugs of abuse, were regulated internationally.
According to Alza and Hancco, the use of illicit substances such as marijuana and cocaine was common in cases of domestic violence in Peru. Ponce Renata reported an increase in the use of these substances and alcohol in crimes in Riobamba, Ecuador.
For a rapid and reliable response in emergencies, toxicological studies were needed to identify the causative agents and to collaborate with health workers. The timely availability of tests was limited, so this study was essential to establish cause-effect relationships and improve response protocols and the recognition and handling of toxic substances.

By Anthony Javier Yaguargos Daza, Álvaro Paúl 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

People with visual impairment face challenges in maintaining optimal oral hygiene, as they may lack knowledge of proper oral cleaning techniques. The objective of the study was to describe oral hygiene in people with visual impairment in the city of Ibarra, Ecuador. It was an observational, prospective, cross-sectional and descriptive study. Surveys were conducted with 30 blind people from the Center for Specialized Therapeutic Attention for People with Disabilities (CATEPED) in the city of Ibarra, Ecuador. The findings revealed that there was a significant prevalence of oral problems among the population studied. Despite showing good oral hygiene in general, the lack of knowledge about the use of fluoride toothpaste and the need to replace toothbrushes periodically are aspects of concern. These results highlight the importance of implementing educational and dental care programs specifically designed for people with visual impairment in order to improve their oral health and prevent dental disease. The need for increased attention to the oral health of people with visual impairment is highlighted, as well as the importance of education and access to appropriate dental services. These results highlight the importance of implementing educational and dental care programs specifically designed for people with visual impairment in order to improve their oral health and prevent dental disease. The need for increased attention to the oral health of people with visual impairment is highlighted, as well as the importance of education and access to appropriate dental services. The results underscore the importance of addressing the specific needs of this population, both in terms of oral hygiene awareness and in the provision of tailored dental care. It is critical to develop comprehensive strategies that address existing barriers and promote optimal oral health for people with visual impairment

By Karina Reyes Espinoza, Helen López, Alejandro Jumbo, Milena Castillo

Introduction: Type 2 Diabetes Mellitus (DM2), or non-insulin-dependent, is a chronic disease characterized by insulin resistance or reduced insulin levels, which in turn contribute to high glucose levels. This condition, together with the associated chronic inflammation, generates several complications, one of them is an imbalance in the hemostatic system.
Objective: To identify laboratory hemostatic tests and their clinical usefulness in patients with type 2 Diabetes Mellitus.
Methods: A bibliographic review was carried out in various databases of interest, including articles published in the last 5 years, in addition to those articles published before 2019 that limited relevant information on the topic.
Development: Original articles that analyzed hemostatic tests in patients with DM2 were reviewed and it was established that the main tests that are altered are TTP, MPV, fibrinogen, PAI-1, VWF and DD, since they have presented consistent results in different research.
Conclusions: It is necessary to perform hemostatic tests in patients with DM2, since it has been seen that untreated patients may present thrombotic disorders that, in the long term, can generate cardiovascular alterations.

By Nathaly Beleén Freire Sánchez, Daniela Alexandra Rosero Freire

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

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

Cleft lip alveolar palate (FLAP) is a congenital malformation that affects the facial and oral structure of individuals who suffer from it, this can hinder proper oral hygiene thus creating dental biofilm, defined as a microbial community that forms on the surface of the teeth and oral tissues and is a critical factor in the development of dental caries and periodontal diseases. The objective of this research was to compare the levels of dental biofilm present in two groups of children: those with FLAP from the "Rostros Felices" Foundation and children without FLAP belonging to the "Ana Luisa Leoro" Educational Unit, in Ecuador, in order to identify possible differences in the accumulation of biofilm and its consequences. The methodology used was based on a non-experimental, cross-sectional, analytical and observational design. The technique applied to obtain the necessary information was the O'Leary index that was used as a measuring instrument, applied to the research sample, which showed a questionable (23.3%) and deficient (16.7%) index in children of the "Rostros Felices" Foundation, while in the children of the "Ana Luisa Leoro" Educational Unit there was an acceptable (26.7%) and questionable (20%) level. It is concluded that children with FLAP have higher levels of dental biofilm compared to those without this condition, highlighting the need to reinforce education and preventive practices in the oral health of these patients

By Verónica Alicia Vega Martínez, María Belén Muñoz Padilla, Leslye Dayann Cuaspud Estrada, Saralía Belén Radrigán López

Introduction: A production was created with scientific literature that approaches and introduces care focused on palliation, which is provided by nursing professionals, with a perspective from their ideal competencies for the management of patients who are approaching the end of life and your families. Methods: qualitative-hermeneutical study, narrative-interpretive and documentary in nature based on literature review. Objective: interpret and integrate conceptual frameworks referring to suitable and quality palliative care with a humanized approach based on the practices of the nursing role. Development: Currently, palliative care requirements are progressively increasing in various parts of the world, but “only 14% of people who need palliative care receive it” (WHO, 2020). Through the critical analysis of scientific literature, we seek to determine the ideal capabilities of palliative care nursing professionals, to guarantee the quality of life of people while it comes to an end, and answers are also given to questions that arise in integration. conceptual from the nursing role and its competencies, which were evaluated through structure indicators (those that measure the characteristics with which health services and physical, occupational, organizational and financial resources are presented), process indicators ( that measure the quality of care provided to the patient) and outcome indicators (that measure the success of the health care provided) (Mejía et al., 2020). Conclusions: It was evident that the nurses present in the palliative care services have their own competencies to perform in that field; it was also possible to identify the importance of providing mandatory, continuous and advanced training to the professional nurse in palliative care, since the nurse It is considered the main element in the care of the person and their environment under these conditions.

By Cristhian Yesid Rincón Gómez, Daira Katrina Valoyes Martínez, Laura Rincón Álvarez, Maryuly Silva Bárcenas, Maria Andreina Pulido Montes

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

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

Background: IMH causes loss of central vision and it restricts the activities of a patient, therefore posing a threat to the patient’s quality of life. Modern developments in surgical interventions as well as the organization of medical care enhance the effectiveness of treatment while a detailed analysis of it is needed.
Objective: Consequently, the purpose of this particular research is to examine organizational medical care among the specified population of patients with IMH, in regard to their quality of life and the efficacy of contemporary treatment regimens.
Methods: To accomplish this, the current study applied narrative synthesis strategies and reviewed literature on IMH diagnosis, management for surgical solutions, and patient outcomes. This assessment encompassed previous and current therapy methods together with patient enlightenment and follow-up with impact on vision clarity and general quotient.
Results: From the current review, it was evident that surgeons are now using facilities such as small-gauge vitrectomy and pharmaceutical substances including ocriplasmin, which enhance macular hole closure rates and near visual acuity levels. Teaching has been done to patients/clients and organized follow-ups as part of the organizational care to improve quality of life as perceived by patients from follow-up questionnaires representing a significant improvement in visual function and activities.
Conclusion: This paper outlines that patients with IMH require a structured and coordinated, cross-professional approach to its management in conjunction with contemporary surgery revealing drastic enhancements to visual acuity levels and the overall wellbeing of a patient

By Dastan Kyrykbayev, Marfuga Amanzhanovna Oteulieva, Ardak Mukhamedzhanovna Auezova, Gulnar Kairatovna Zhurgumbayeva

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

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

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

Health literacy consists of a set of cognitive and social skills and the ability of individuals to understand and use health information. Low levels of health literacy leads to higher rates of hospitalization, mortality, and premature death, as well as poor adherence to treatment regimens, reduced prevention and poorer health status, with a negative impact on individual and collective health. In Portugal, the most vulnerable groups (the elderly, the unemployed, low levels of education) have "problematic" or "inadequate" levels of literacy. This article therefore reflects on the importance of creating training and capacity-building programs for health teams and professionals in health literacy, concluding that the responsibility for promoting health literacy is a collective one, with health professionals playing a central role in this regard, and that it is up to health organisations to prepare work teams in health literacy and monitor their progress.

By Maria Leonor Carvalho, Maria Inês Carvalho, Marta Carvalho, Susana Valido, João Tomás, Sandy Severino, Luís Sousa

Falls and fall-related injuries are considered an important public health problem, with implications for the health and well-being of older people and society in general. This review aims to analyze updates on the topic of falls, in order to understand the magnitude of the problem, associated factors and main preventive interventions. Assessment and intervention must be multifactorial and directed at clinical and environmental factors. Education and promotion of physical activity and exercise emerge as the most effective interventions in reducing the risk of falls in older people. From this reflection emerge the bases for the practice and formulation of health policies in the area of patient safety, in order to minimize the risks of falls and their occurrence in aged people, in hospital environments and community contexts.

By Luís Sousa, João Tomás, Sandy Severino, Susana Valido, Maria João Santos, Helena José

Introduction. Sexual harassment is defined as unwanted or non-consensual sexual behavior that occurs in verbal, non-verbal, physical, psychological, or visual forms and is experienced at different ages and contexts. Aim. To describe the level of recognition of situations of sexual harassment in medical students at the Andrés Bello University, Concepción, Chile. Methods. This is a descriptive cross-sectional study. A total of 94 students from first to seventh grade participated voluntarily and anonymously. Data were obtained through the application of an online survey and then analyzed with IBM SPSS Statistics v.20 software. Results. The age was 23.1 ± 1.9 years. Most of them were in their third year of college and identified as women. A total of 42.6% (n=40) admitted to having suffered sexual harassment at some point on or off the university premises, with the most frequent situation being the direct receipt of offensive jokes, jokes or compliments with sexual intent (51.1%; n=48). Women were the ones who most recognized situations of sexual harassment. Conclusions. A considerable proportion of the participants, mostly women, acknowledged situations of sexual harassment.

By Ignacia Batarce-Soto, Pamela Castro-Carter, Yamil Darraz-Esparza, Camila Jiménez-Salgado, Konstanza Maturana-Morales, Gabriela Ojeda-Olivares, Alexis González-Burboa

Introduction: prior to the COVID-19 pandemic, workers were exposed to psychosocial risks that were aggravated, negatively impacting their health. This has generated a boom in its study; however, theoretical ambiguities persist.
Objective: to explain the theoretical ambiguity present in the study of psychosocial risks at work.
Methods: the analytical article explores the theoretical ambiguity of psychosocial risks in the workplace. It incorporates various sources of information, including classical authors and contemporary approaches. Additionally, the authors offer critical insights and provide considerations for future research in the field.
Result: there is a theoretical-conceptual ambiguity in the study of psychosocial risks at work. It is recommended: 1. To generate less abstract conceptual proposals to address semantic confusion and lack of taxonomic clarity. 2. Adopt an interdisciplinary conceptual approach that includes perspectives from psychology, sociology, and occupational health nursing. 3. Incorporate qualitative methodologies instead of continuing to use quantitative approaches, questioning the appropriateness of measuring a construct with traditional methods that have theoretical omissions. 4. develop unifying theoretical proposals.
Conclusions: there is an urgent need for integrative theoretical proposals. In the opinion of the present authors, these proposals should have a low level of abstraction and include interdisciplinary perspectives that transcend psychology and sociology, as well as use qualitative methodologies.

By Miguel Valencia-Contrera, Flérida Rivera-Rojas, Naldy Febré

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: The CYP2D6 gene is highly polymorphic and is involved in the metabolism of a wide variety of drugs and xenobiotics. Three allelic variants of the gene (rs3892097, rs1065852 and rs28371725) have been studied in relation to breast cancer, but the degree of genetic linkage between them is unknown.
Aim: To test whether the three breast cancer-associated SNPs are inherited en bloc.
Methods: Genotypes of 280 SNPs of the CYP2D6 gene were obtained from the 1000Genomes database and linkage disequilibrium between the three breast cancer-associated SNPs and the other 277 SNPs in the gene was analysed. A threshold of r2= 0.7 was used to identify loci in linkage disequilibrium.
Results: A strong correlation was found between rs3892097 and rs1065852 in Europe and Latin America. In addition, eleven polymorphisms with a high level of linkage were identified, four of which have a non-synonymous mutation effect.
Conclusions: Both polymorphisms could have a causal effect on breast cancer or that one of them is associated by linkage. Continuing to study both polymorphisms and considering the eleven new polymorphisms for analysis would be of relevance to deepen knowledge in relation to breast cancer in women.

By Sergio Vladimir Flores, Angel Roco-Videla, Raúl Aguilera-Eguía, Román Montaña

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: The COVID-19 pandemic generated a significant increase in anxiety and fear in the population, especially in those with chronic conditions such as fibromyalgia. Although there is no evidence that fibromyalgia is a predictor of hospitalization or mortality associated with COVID-19, the infection can worsen fibromyalgia symptoms.
Methods: This study focused on evaluating the ability of psychosocial pain factors, such as pain intensity, pain catastrophizing, impact of fibromyalgia, and kinesiophobia, to predict fear of COVID-19 in women with fibromyalgia. A quantitative, observational-analytical design was used, with a sample of 33 women diagnosed with fibromyalgia. Fear of COVID-19 was assessed through a questionnaire and scales were used to measure the predictor variables.
Results: it was found that pain catastrophizing was the most significant predictor variable of fear of COVID-19. The correlation between pain catastrophizing and fear of COVID-19 was moderate, and the multiple regression model that included this variable predicted fear of COVID-19 with an adjusted R2 of 0.248.
Conclusions: Fear of COVID-19 in women with fibromyalgia is related to pain catastrophizing. This study suggests that pain catastrophizing may be an important factor as a predictor of fear in new studies associated with new outbreaks of this disease.

By Erick Atenas-Nuñez, María Jesús Muñoz-Yáñez, Andrea Lizama-Lefno, Ángel Roco-Videla, Marcela Caviedes-Olmos

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: 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

Introduction: Multiple pathologies can affect the umbilical cord, either due to infectious causes or malformation causes (acquired or congenital). However, the persistence of the omphalomesenteric duct and the urachus are the most frequent congenital malformations, especially in the pediatric setting, but not in the case of adults. Case report: The case of a 68-year-old male patient from a rural area, a farmer, with an enterocutaneous fistula, who received surgical treatment, is presented. He went to the consultation due to yellowish fluid leaking from the umbilical region, pain, and erythema, with a history of prostatectomy, osteoarthritis, and arterial hypertension. He was admitted with a diagnostic impression of cellulitis vs wall abscess. According to the assessment by the surgical team, a clear discharge of intestinal fluid was observed through the navel, for which reason emergency surgical resolution was decided for exploratory laparotomy. The patient reports discharge of yellowish fluid from the navel since childhood; there is a high suspicion of a picture compatible with the persistence of the omphalomesenteric duct in the adult. Evolution: The patient underwent surgery with the following finding: A fully patent omphalomesenteric duct (enteroumbilical fistula) was found 70 cm from the ileocecal valve, plus incidental appendectomy. He was discharged on the eighth day of hospitalization. with a favorable evolution, outpatient treatment, and outpatient control. In addition, a bibliographical review in scientific databases such as Pubmed, Scopus, Proquest, Lilacs, Scielo, and Google Academic. Conclusions: surgical treatment with a favorable evolution, outpatient treatment, and outpatient control.

By Mantilla Sarmiento Gabriela, Carlos Alejandro Rojas Merchan, Mauro Rogelio Crespo Guillén, María Cristina Galindo Quezada , Rosa Elvira Minchala Urgilés

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: Hansen's disease or leprosy is an infectious disease caused by Mycobacterium leprae, which mainly affects the skin, peripheral nerves and mucosa of the upper respiratory tract. It has a chronic course as old as humanity itself.

Clinical case: The clinical case of a 51-year-old male patient, native and from the Olmedo canton, province of Manabí, with a farmer occupation, who began to present in November 2008 with macular, hyperchromic skin lesions, which progressed, is presented. to multiple nodules, located in the lower limbs and then spreading to the upper limbs, thorax and abdomen, neck and face. The set of clinical parameters and positive biopsy results allowed the case to be classified as Lepromatous Leprosy (multibacillary). Triple multitherapy (Dapsone, Rifampicin, Clofazimine) was prescribed, showing an improvement in the number and size of the lesions at the end of therapy.

Discussion: This is the first clinical case of lepromatous leprosy detected in the Olmedo canton, Manabí province, Ecuador. Due to the novelty in the territory, the patient had this condition for years without being diagnosed or treated adequately and even once under treatment, there were delays in acquiring the medications that extended their application from 12 months to a period of 25 months.

Conclusions: The clinical case presented highlights that Hansen's Disease is an emerging health problem in the Olmedo canton, highlighting the need to make sustained efforts for its identification, treatment and prevention in the territory.

By Carlos Regino Alejandro Polanco, María Alejandra Rivadeneira Lucas, Lester Willian Loor Vinces, Cindy Giselle Díaz Contino

Introduction: Tuberculosis (TB) is the most common cause of death from a single infectious agent. Tuberculosis is primarily a disease of the lungs, but it can also affect other parts of the body and cause extrapulmonary tuberculosis (EPTB). Approximately 5% of all cases of EPTB are tuberculous meningitis (TMB), caused by the spread of Mycobacterium tuberculosis in the meninges and cerebrospinal fluid (CSF). MTB is the most devastating form of tuberculosis and continues to cause high morbidity and mortality, with approximately 50% of patients dying or suffering neurological sequelae and complications. The aim of the present study is to learn more about the etiologic, clinical and diagnostic presentation of this pathology. Clinical Case: We present a 46-year-old male patient who reports productive cough of approximately 9 months of evolution with presence of diaphoresis, no evidence of weight loss, 15 days ago the patient reported cough accompanied by hemoptysis, reason for which he went to the nearest health center. His evolution was torpid and his tuberculosis was complicated to tuberculous meningitis where compatible signs and symptoms were evidenced, and immediate treatment was started with isoniazid, rifampicin, pyrazinamide, ethambutol and later four months with isoniazid and rifampicin. Conclusion: The rapid diagnosis of MTB requires an understanding and a joint analysis of the clinical, radiological and laboratory findings of our infected and uninfected patients and the evaluation of prognoses.

By María José Romero Ochoa, Hanny Alejandra Corvalan Reinthaller, Marlene Elizabeth Sánchez Mata, Allison Paulette Sánchez Ocampo, Belén Estefanía Sánchez Guevara, Patricia Estefanía Vásconez Espín, Marina Alexandra Vilema Condor

At a cardiological level there are several similar pathologies, and among them those that have a high percentage of similarity in terms of clinical features are Takotsubo cardiomyopathy and Acute Myocardial Infarction. Presentation with dyspnea, chest pain and a history of a stressful situation, as well as electrocardiographic signs such as ST segment elevation, allow us to suspect both pathologies. Coronary angiography with coronary arteries without obstruction and the echocardiographic image where alterations in the contractility of the left ventricle and the shape of an octopus fishing trap are observed are the main bases for the definitive diagnosis of broken heart syndrome, as in the present case. The clinical part manifests itself as an acute coronary syndrome with ST elevation, but when performing the invasive approach, no occlusion is found in the coronary arteries, which is why it is classified as Takotsubo cardiomyopathy. Regarding treatment, follow-up, continuous monitoring and elimination of the triggering factor are essential to shorten recovery time and reduce the recurrence rate.

By Kerly Yuliana Apolo Loayza, Mónica Gabriela Vásconez Cherrez, Sonnia Villegas Paredes, Ángel Luis Córdova Parra

A hernia is when part or even all of an internal organ protrudes through an abnormal opening in the wall of the cavity that houses that organ. An inguinal hernia, which is a protrusion of part of the intestine through the abdominal wall into the inguinal region, occurs frequently in both children and adults. Two common problems that can occur as a result of an inguinal hernia are obstruction, which refers to blockage of the intestine, and strangulation, which occurs when the blood supply to the herniated tissue is interrupted. An inguinal hernia occurs when a portion of the intestine moves through an area of low resistance in the lower abdomen, and this anatomical space is called the groin. A hernia can cause a portion of the intestine to bulge into the groin area, forming a noticeable bulge. As time progresses, hernias may experience an increase in size. An incarcerated hernia occurs when the hernia sac undergoes prolonged inflammation that prevents the herniated structures from returning to their original position. As a result, venous blood flow to the internal organs and lymphatic system is interrupted, leading to a gradual and lasting impact on the hernia. This causes compression, reduces circulation, which can lead to oxygen deprivation in the tissues (ischemia) and cell death (necrosis), and can even perforate the bowel and trigger severe inflammation of the abdominal lining (peritonitis). We report a 4-month-old male infant patient with incarcerated inguinal hernia since birth, who underwent laparoscopic surgical resolution.

By Freddy Alexander Aldaz Vallejo, Brigithe Nicole Andaluz López, Karen Michelle Cajamarca Chicaza, Andrés Geovanny Puchi Timbe, José Roberto Lema Balla, Nicole Samanta Aguilar Zumba, Enma Lisseth Espinoza Barreto, Miguel David Alvarez Saltos

Introduction: The combined management of Wilkie's syndrome and myasthenia gravis presents unique challenges. It highlights the complexity of these conditions: Wilkie's syndrome involves duodenal compression by the superior mesenteric artery, while myasthenia gravis affects neuromuscular transmission.
Case Presentation: We present the case of a 26-year-old young woman with a history of myasthenia gravis who abruptly developed dysphagia, later discovered to be caused by aorto-mesenteric compression known as Wilkie's syndrome. The need for a multidisciplinary approach is emphasized to integrate gastroenterological and neurological treatments, adapting to potential complications such as muscle weakness that can hinder the management of Wilkie's syndrome.
Conclusions: Interdisciplinary coordination is crucial to improving clinical outcomes and the quality of life for patients, highlighting the importance of future research to optimize the comprehensive management of these complex diseases.

By Mariuxi Carolina Vera Miranda, John Israel Galarza Mendoza, María Belén Herrera Pinto, Emanuel Josueph Yanez Veloz, Luis Dario Vásconez Nuela, Jorge Andres Calderon Ramirez, Shirley Medelaine Mero Rendon, Evelyn Paulette Lozano Briones, Anthony Josué Solano Freire, Mireya Isabel Villon Rodríguez, Leydi Pilar Gallardo León, Stephanie Susana Alberca Bonila, Pamela Elizabeth Vega Chanalata, Gabriela Fernanda Crespo Carrión

Broad-spectrum anticancer treatments have limited cell selectivity. The sites of action of these treatments are targeted at blocking cell division and inducing apoptosis. This has a negative impact on the viability and proliferation of healthy cells, which can cause deterioration in the patient's quality of life. In this case report, an older patient with non-Hodgkin's lymphoma, follicular pattern grade 2 with invasion to the L3 vertebra, concluded a combination chemotherapy regimen of cyclophosphamide, doxorubicin, vincristine, prednisone (CHOP). However, the patient reported severe and prolonged adverse reactions that caused physical and emotional complaints, thus she refused to continue with the subsequent radiotherapy. Given the impact on quality of life and uncertain survival, by personal decision, the patient started compassionate therapy based on chlorine dioxide (ClO2). This low-cost anticancer agent causes apoptosis in cancer cells by destabilizing the oxidative balance through the release of reactive oxygen species. ClO2 treatment was administered orally and by enema at a concentration below the EPA-reported toxicity threshold, in order to not compromise healthy cells, given that they do not experience the high levels of oxidative stress of cancer cells. During ClO2 treatment, the patient reported no adverse reactions and an increase in bone density was observed in pathological terrain. Rigorous clinical studies are needed to analyze the temporal sequence of the increase in bone density.

By Manuel Aparicio-Alonso, Verónica Torres-Solórzano

Introduction: Integrating virtual reality (VR) in education is emerging as a transformative tool to improve practical learning. This proposal asks about its application within the training of certified nursing assistant to improve students' practical skills in training. Objectives: The main objective is to assess whether VR technology can improve understanding of complex concepts and skills in nursing education. This involves evaluating the effectiveness of VR in fostering meaningful, self-directed learning experiences that potentially prepare students more effectively for the health workforce. Methods: Implementing a pilot VR program within a controlled educational environment is proposed. The impact of this integration will be assessed through surveys and analysis of academic performance, focusing on the acquisition of professional skills and competencies. Results: Expected outcomes include greater student participation and better learning outcomes. The work highlights the benefits of VR in improving in-depth understanding of procedures and concepts through immersive experiences. Conclusions: The expected benefits after the incorporation of VR in nursing training include an improvement in the professional qualifications of students and an innovation through the introduction of immersive learning methodologies. Despite the potential challenges of its implementation, the results are expected to support the integration of VR as a complementary educational tool, reducing the gap between traditional learning and technological advancement in nursing education.

By Miriam Tesouro Dorribo, Isabel Alonso-Rodríguez, María Carmen Martínez-Murciano, Anthea Gara Santos-Álvarez, David Jorge Pérez

Electrical burns are one of the most drastic traumas to which an individual can be exposed; being able to directly or indirectly compromise almost all tissues of the human body. They cause more than 3,000 admissions to specialized burn units in the United States. Up to 40% of serious electrical injuries are fatal, resulting in approximately 1000 deaths per year.
Its incidence depends on the type of exposure to electricity: low voltage, due to contact with electrical cables or plugs. High voltage, due to occupational exposures and power lines while climbing trees or poles. These voltages are more likely to cause injuries to deep tissues and internal organs compared to low voltage injuries and also the degree of body surface area burned.
Its approach constitutes a challenge, since the risks of visceral involvement are added to the morbidity and mortality inherent to the burn. Early treatment of intra-abdominal complications allows a more conservative approach, reducing ostomies and their associated comorbidity. It is preferable to manage the abdominal defect by preserving the tissues themselves and restoring the midline. In our case, it was feasible to perform a primary closure of the abdominal wall. Your treatment will depend on factors such as: the amount of tissue lost, intra-abdominal contamination, general condition, and factors such as: physical resources and experience of the hospital. Mortality from burns ranges between 3 and 55%, those with the highest risk of death are those at extreme ages, higher degrees of burns, injuries associated with inhalation, and injuries in patients with comorbidities.

By José Vicente Fonseca Barragán, Lorena Katiuska Toscano Ortiz, Gabriel Alexander Minda Mina, Pablo Bruno Minda Espín, Patricio Alberto Castillo Peñaherrera, David Israel Rea Chauca, Angie Milena Valdez Bautista, Mirtha Marisol Bautista Arana, Yurvis Marilyn Blanco Martínez, Dionis Carolina Cariel Reyes, Patricia Jordana Valdivieso Estupiñán

Introduction: Ulcerative colitis is a disease whose causes are multifactorial. Current therapies, such as monoclonal antibodies, present risks, prompting the search for non-pharmacological alternatives such as intermittent fasting. To detect inflammatory conditions, the levels of calprotectin and C-reactive protein are measured.
Objective: To evaluate the effects of intermittent fasting in a 34-year-old patient with ulcerative colitis, on the inflammatory markers calprotectin and C-reactive protein (CRP).
Clinical case: 34-year-old Caucasian woman diagnosed with ulcerative colitis in remission, she participated in an 8-week pilot study on intermittent fasting. After the intervention, it was observed that there were no significant changes in her PRC levels, however, calprotectin increased from 15 mg/kg to 1279 mg/kg, indicating an inflammatory bowel condition in the initial stage given that the patient was asymptomatic.
Conclusions: Calprotectin determination is a more appropriate marker to identify intestinal inflammation in early stages. Intermittent fasting could be a complementary therapeutic strategy to extend the periods of symptom remission in this disease.

By Claudio Villota-Arcos, Angel Roco-Videla, Carolina Pino-Astorga, Daniela Mendoza-Puga, Mauricio Bittner, Tatiana Corbeaux-Ascui, Raúl Aguilera-Eguia

Lipomas are benign tumors of mature adipocytes. In general, they can occur throughout the body, but they commonly predominate in the upper part of the trunk and extremities. They are the most common mesenchymal cell tumors, their location in the mesentery being extremely rare. Mesenteric lipoma is a rare condition reported in the literature, it should be considered in the differential diagnosis of unexplained abdominal pain. This report describes a rare case of mesenteric lipoma in an adult patient. Despite the benign nature of this tumor, it tends to grow to large dimensions, as is the case of our patient, which correlates with an increase in complications. Small, asymptomatic mesenteric lipomas generally do not require treatment, being diagnosed incidentally through routine abdominal imaging, or they may present with variable abdominal symptoms depending on the size, location, and rate of growth of the tumor. Complementary tests such as ultrasound and computed tomography of the abdomen are useful for diagnosis, the latter being the gold standard and complete surgical resection is the only treatment, with an excellent prognosis. We will describe the case of a giant mesenteric lipoma, which atypically caused acute abdominal pain, and we will carry out a review of the literature on this rare condition in adult patients with certain comorbidities, taking into account the infrequent location of its location for this type of tumors and its in turn, through a histopathological study, rule out any type of malignant behavior.

By José Vicente Fonseca Barragán , Armando Quiñonez Valencia, Alison Nicole Vásquez Vélez, Jhonatan Francisco Morillo Trujillo, Lucia Mayte Medina Guevara, Wendy Estefanía Chinchin Correa, Víctor Ernesto Soliz Calle, Patricia Jordana Valdivieso Estupiñán, Melissa Valeria Cantos Marcillo, Carlos Steewarth Gudiño justicia

Contamination of hospital surfaces by patients colonized with Acinetobacter represents a risk of nosocomial infections. The imperative need to prevent intrahospital transmission and dissemination has prompted the implementation of approved agents with high biocidal capacity and low toxicity. In one hospital, it was documented in real time the safety of decontamination with ClO2 at 60 ppm for 30 minutes in unoccupied inpatient rooms by antimicrobial culture and ATP bioluminescence assays. After decontamination, sampling of surfaces occupied by patients colonized with Acinetobacter, no viable culturable spores or metabolic activity was reported. At follow-up, previous and subsequent patients did not develop Acinetobacter infections, and no sign of microbiological contamination was observed after room decontamination. These results suggest that ClO2 can be used as a safe and economical antimicrobial agent with feasibility for integration into medical practices.

By Manuel Aparicio-Alonso, Alma Guadalupe Avalos-Contreras, Verónica Torres-Solórzano

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

Arteriovenous malformation (AVM) is a genetic vascular anomaly that can significantly affect daily activities. Its occurrence varies by race and gender, being more common in women. This report examines AVM in two siblings, aged 12 and 14. Clinical, radiological, and pathological evaluations revealed differing tumor sizes, expansions, and causes of vascular enlargement. Consequently, the siblings received different treatments: one underwent embolization, while the other had a wide excision. Both approaches resulted in favorable outcomes. AVM is a vascular neoplasm that may present at birth or be discovered later, often during routine check-ups or after trauma. The familial nature of AVM in this case emphasizes the variability in presentation and treatment response. Established diagnostic and therapeutic guidelines may not always be applicable, necessitating individualized treatment plans. This case highlights the importance of tailored treatment approaches for familial AVM, demonstrating successful outcomes with both embolization and wide excision

By Bima Satriono Purwanto , Mohammad Hardian Basuki, Sjahjenny Mustokoweni, Paulus Rahardjo, Ferdiansyah Mahyudin, Mouli Edward

Rectal neuroendocrine carcinoma, though rare, is experiencing an increase in its incidence, representing approximately 1% of all colorectal cancers. A growth in its incidence has been observed in recent decades, albeit with varying figures geographically. Research studies such as those by Dasari et al. (2017) and Scherübl et al. (2014) have indicated a significant rise in the incidence of these tumors, especially in the United States and Europe. Although it can manifest in different age groups, it is more common in middle-aged or older adults, without a clear gender predilection. Symptoms may include changes in bowel habits, rectal bleeding, abdominal pain, unexplained weight loss, and fatigue, varying according to the degree of tumor differentiation and the presence of metastasis. We present the case of a 65-year-old woman who presented with obstructive symptoms and was subsequently found to have neuroendocrine tumor post-surgery.

By Marcos Lenin Zambrano Avellán, Reina Narváez Fabián Esteban, Rodrigo Hernández Ramírez, Israel Josue Neira Serrano, Carolina Estefania Bayas Azogue, Priscilla Martina Vera Gaibor, Josseline Sofía Solano Zambrano, Flavio Hernan Ante Guanotuña, María José Peña Pibaque, María Lorena Armijos Pazmiño, Villacis Hidalgo Yerlyn Narcisa, Rolando Alberto Castro Cardenas, Pamela Elizabeth Vega Chanalata , Stefhany Tatiana Guerrero Saltos

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: 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

In response to the article “Spirulina applications - marine plant: panoramic review” by Ochoa and Moyano (2022), we would like to point that the word "plant" in the title of the article (since it is a Cyanobacterium or, in more general terms, an alga) might not be appropriate. Additionally, we would like to suggest some formatting observations regarding the nomenclature (italics are not used) and an update on the scientific name of Spirulina (genus Limnospira).

By Isabel Milagros Gavilan-Figari, Graciela Vanessa Peña-Urdániga, Angelica Naka, Miguel Angel Castro-Rosas

Introduction: The research addresses the problem of technical training and qualified labor in civil construction workers in the urban area of the Pichari district, La Convention Cusco 2022.
Objective: Analyze the influence of technical training on the quality of the workforce in this sector.
Method: Adopting a quantitative approach, explanatory level and a non-experimental design, the hypothetical deductive method was applied in a basic type of study. The population consisted of 156 civil construction workers in Pichari, and the selected sample was 120 participants through non-probabilistic convenience sampling.
Results: The results revealed a significant relationship between technical training and skilled labor, supporting the alternative hypothesis. Levels of technical training and skilled labor varied, with most workers located at middle and high levels. The alternative hypothesis, which maintains that technical training significantly influences skilled labor, was supported with a two-sided significance of 0.000, a Log Likelihood of 18.176, a Chi-Square of 34.923 and a Nagelkerke Pseudo Square of 0.292.
Conclusions: In conclusion, the research highlights the importance of technical training to improve the quality of labor in civil construction.

By Jhonatan Huaman-Urbano , Nerio Enriquez-Gavilan, Aydeé Lopez-Curasma , Julio Amarildo Romero-Sandoval, Naara Eunice Medina-Altamirano , Mariano Hamilton Pachas-Niño

Introduction. The diagnosis of type 1 Diabetes (T1D) in a child impacts family dynamics, which is why it is necessary to understand the phenomenon from effective adaptation, an essential reason to have a mid-range theory that allows analyzing family adaptation in the care of children with T1D. Aim. Develop the mid-range theory “Family adaptation in caring for children with type 1 diabetes”. Methods. The theory was developed from Fawcett's methodological proposal in which concepts of interest are identified, the concepts and propositions are classified according to the phenomenon, the propositions are organized hierarchically, and the diagram that addresses the phenomenon is constructed. Results. The mid-range theory “Family adaptation in the care of children with type 1 diabetes” is proposed, which allows us to understand and effectively address the challenges that families face in caring for their children with cancer; which helps to validate and refine the propositions, which in turn will contribute to the growth and advancement of knowledge in this field. Conclusions. The Midrange Theory “Family adaptation in the care of children with T1D” (AFDT1) allows us to understand family functioning in the face of diagnosis and coexistence with T1D due to its theoretical integration with empirical knowledge. It is suggested to test the theory through quasi-experimental or experimental studies.

By Aldo Pelcastre Neri, José Manuel Herrera Paredes

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

Introduction: plant tissue culture is a set of biotechnological methods involving propagation and regeneration of plant cells, tissues, organs by specific control of nutritional factors. The bibliometric study turns out to be a great source of information on the development of a certain area, since it employs methods of measurement and comparison of data on the different sources obtained.
Objective: scientific production was characterized through bibliometric analysis of theses on plant tissue culture in Peruvian universities. We analyzed undergraduate and graduate theses on in vitro plant tissue culture in the period 1997 - 2023 from 143 public and private universities.
Methods: the sample was delimited in 24 universities (22 public and 2 private) with specialties such as Biology, Biotechnology, Agronomic Engineering, Biotechnological Engineering and others.
Results: there are 126 published theses on the subject of plant tissue culture in 24 Peruvian universities. Of the total number of published theses, a higher percentage of undergraduate theses was obtained with 84,13 %, while master's theses represented 11,90 % and doctoral theses 3,97 %. The Universidad Nacional Agraria La Molina (UNALM) has 28 theses (22,22 %), followed by the Universidad Nacional de Trujillo (UNT) with 19 (15,1 %), etc.
Conclusions: this bibliometric study of theses in plant tissue culture has identified that there is a greater concentration of research in this area in public universities, in addition to being linked to Schools of Agricultural Engineering and Biology.

By Mao Yupanqui-Celestino, Brayan Lugo, Giselle Jazmín Aguilar-Balabarca, Allison Esmeralda Lozano-Galindo, Carlos Roberto Pesantes-Rojas, Hermila Belba Díaz-Pillasca