Jeel Moya-Salazar

The digital transformation of medical research has outpaced the ethical frameworks designed to govern it, creating systemic vulnerabilities that legacy governance models cannot adequately address. Drawing on the Peruvian experience, we examine the convergence of metric-driven research evaluation, regulatory gaps, and digital disruption, and we argue for hybrid governance as an operational necessity for preserving scientific integrity. Our analysis reveals three interconnected findings. First, regulatory codification alone is insufficient to prevent misconduct. Peru’s National Code and RENACyT system proved vulnerable to large-scale authorship trafficking, exemplified by the “La Granja de Científicos Bamba” scandal involving over USD 53 million in state incentives. Second, institutional risk, assessed via SCImago IRIS, is not linked to the performance of university publications. Most of Peru’s top 20 universities fall into medium or significant risk categories, though low-risk cases indicate that maintaining integrity is possible at the institutional level. Third, the digital era compounds these vulnerabilities through challenges that legacy frameworks cannot address. We propose a reorientation of medical research ethics along five axes: from privacy to data justice, from consent to continuous engagement, from individual to systemic accountability, from voluntary RRI to mandatory Ethics by Design, and from national codes to global hybrid governance. The Peruvian case offers distinctive lessons for the international community: rapidly expanding research output, a regulatory framework that appears robust yet is operationally weak, and organized fraud at scale. This combination exposes the universal vulnerability of metric-driven systems to gaming when oversight lags behind digital realities.

This study aims to understand the uses, consumption, and cultivation practices of guayusa in indigenous populations of Ecuador. A qualitative design was employed, conducting semi-structured face-to-face interviews with three indigenous women over the age of 18 from the Napo community. Participants were invited during the 4th American Meeting of Professional Experts in Phytocannabinoids CANNAMERICA 2023. The findings revealed that guayusa consumption is deeply rooted and passed down through generations, associated with spiritual rituals seeking permission from Pachamama. Participants highlighted the importance of guayusa in obtaining energy and protection, and mentioned various ways of preparing and consuming the plant. Regarding cultivation, each family maintains their own guayusa crops, believing that the plant possesses consciousness and must be respected. The significance of the full moon in the planting process was emphasized. Guayusa is also used as a natural medicine to treat various health issues. In conclusion, guayusa holds great cultural and spiritual meaning for indigenous communities in Ecuador, consumed daily and transmitted from one generation to another. Its use as a traditional beverage and natural medicine highlights these communities’ connection with nature and respect for Pachamama.

Background Confinement by COVID-19 forced university students to adapt to virtual education, altering their daily routines. This led to increased consumption of processed foods and modified their perception of their body. The aim was to determine the relationship between processed foods and being overweight among Peruvian university students during the COVID-19 lockdown. Methods An observational study was conducted in 82 university students of both genders, aged 17 to 28, who had experienced both in-person and remote classes. A questionnaire based on the Questionnaire of Highly Processed Food Consumption (sQ-HPF) was developed to determine processed food consumption, and the Thompson and Gray C Scale was used to measure body image perception. Results The study included a sample of 84 university students. The majority of students were female (63.4%) with an average age of 21 ± 2.8 years. Regarding body image, 68.3% perceived themselves as being overweight and 14.6% as obese. The five most frequently consumed foods were refined cereals (76.4%), additives (75%), sweets (69.1%), fried foods (60.3%), and snacks (58.8%). Additionally, females more frequently perceived themselves as being overweight and had higher consumption of processed foods. Finally, a relationship was found between processed food consumption (processed meats, sweets, fats, fast food) and overweight/obesity. Conclusion The majority of university students frequently consumed processed foods, particularly those who perceived themselves as being overweight or obese, with sweets and refined cereals consumption being particularly noteworthy. It is necessary to emphasize the promotion of healthy eating, as well as frequent physical activity, to promote long-term healthy habits.

Liver fibrosis is a chronic disease diagnosed through invasive methods that can worsen patients’ health. Moreover, this disease is diagnosed in terminal stages, when the damage is already widespread and irreversible, which makes it necessary to have minimally invasive diagnostic methods with high performance. The aim was to compare research on non-invasive methods, respiratory footprint, and volatile organic compounds for the diagnosis of liver fibrosis through patient exhalation. Following the PRISMA guidelines, systematic searches were conducted in 13 databases. We could identify 17,454 documents between 2009 and 2022. Inclusion criteria comprised original investigations using Gas Chromatography–Mass Spectrometry (GC-MS), Ion Mobility–Mass Spectrometer (IMR-MS), and e-nose for liver fibrosis diagnosis. We considered the precision, specificity, and sensitivity of each test and the methodological quality of each study according to the PEDro guideline. Seven investigations were included. Four (57%) studies used GC-MS, and two (28.6%) used e-nose. The most commonly used gold standard was liver biopsy, and all studies were of European origin, with only adult populations. Three (42%) studies had a specificity >90%, and five (71.4%) had a sensitivity between 85 and 100%. Isoprene is the most significant and distinguishable biomarker for liver fibrosis diagnosis. Five (71.4%) studies had high methodological quality. GC-MS is the most used technique for detecting liver fibrosis, and isoprene is the most frequent volatile organic compound (VOC) found in the exhalation of patients with liver fibrosis. More studies are needed in areas with high risk and prevalence of hepatic fibrosis.

Adolescents are prone to unwanted pregnancies and sexually transmitted infections. It is key that they receive reproductive sexual education during secondary education, which can be important for the prevention of these events. This study aims to compare knowledge of reproductive health between adolescents with and without STI history. A cross-sectional study was carried out on 164 schoolchildren from a national school in Lima (Peru). The AA-20 short questionnaire and the t-test were used to demonstrate differences between students with and without a history of sexually transmitted infections (STIs). Twenty-six (15.9%) students had STIs (mean age 16.6 ± 2.3 years). The average knowledge in students with and without STIs was 15.4 ± 3.7 points and 14.7 ± 3.9 points, respectively (p = 0.417). Among students with and without a previous STI, it was found that the majority used some form of contraception (61.5% vs. 31.9%, p = 0.004) and had received talks on the topic (92.3% vs. 72.5%, p = 0.031). Condom use was the most commonly used method to prevent STIs in both groups. In conclusion, students with a previous STI had slightly better knowledge about pregnancy and infections than students without a history.

* Introduction COVID-19 pandemic has generated changes in work environments and job satisfaction could be affected. We aimed to identify the relationship between job satisfaction and stress among dentists in Lima during the COVID-19 pandemic. Methods This cross-sectional study was conducted with 547 dentists in Lima (Peru). The inclusion criteria were adult dental professionals of both genders who were working during the pandemic. A 23-item Palma Work Climate Scale (SL-SPC) Likert-like questionnaire and the 36-item Marquina & Adriazola stress questionnaire were used. Results The mean age was 38.02±8.5 years, 53.4% were male, 51% were single, 88.3% has housemates and 61.3% were engaged exclusively in private practice. High stress levels were reported by 73.7% of the respondents. Dentists who were dissatisfied with the importance of their tasks, working conditions, economic benefits and lack of job recognition had significantly higher stress levels (p<0.001) in all sociodemographic categories. The regression model showed that task importance (p=0.006), personal recognition (p<0.001) and perceived economic benefits (p<0.001) significantly influenced high stress levels. This pattern was particularly pronounced in males, married, and those who work both in the public and private sector. The adjusted logistic model showed that dentists who were dissatisfied with task importance (OR: 2.22, 95%CI: 1.24-4.00), personal recognition (OR: 5.92, 95%CI: 2.40-14.57), and economic benefits (OR: 10.52, 95%CI: 5.91-18.71) had an increased risk of experiencing high stress levels. Conclusion Our results highlight the significant relationship between job satisfaction and stress levels among dentists during the COVID-19 pandemic. These findings may have important implications for the design of interventions aimed at reducing stress and improving the well-being of dentists.

Poor cleaning practices for healthcare workers’ mobile phones can promote microbial contamination, posing a latent risk of infections for patients. D

Background and Aims: In Peru, disparities in medical services have been reported, but costs have not been assessed based on the different health insurance (HI) available. In this cross‐sectional study, we aimed to determine the differences in the cost of consultations and medicines in Peruvians with different types of HI according to the 2019 National Household Survey (ENAHO), which is a representative dataset of the Peruvian population. Methods: A multivariate‐regression model was used to analyze the relationship between the expenditure on consultations, medicines, dental services, and other expenses and the type of HI. In this case, the type depends on the provider: (1) Social HI called “Seguro Integral de Salud” (SIS) of the Ministry of Health (MINSA); (2) ESSALUD Social Insurance; (3) Armed Forces; and (4) Private sector. Our regressions include demographic controls, and we declared the corresponding survey design to obtain correct standard errors. Results: A total of 15,592,649 (47.7%) and 8,159,941 (25%) people had SIS and ESSALUD, respectively. In the first quartile, 77.6% had access to HI through the SIS and 16.1% were uninsured; in the fourth quartile, only 17.3% had access to the SIS. 80% and 6% of people in rural areas have access to SIS and ESSALUD, respectively. In urban areas, there is a higher percentage of people who do not have HI (24% vs. 14% in rural areas) ( p < 0.05). We found that a SIS affiliate spends an average of USD 22 (80 Soles) on consultations and USD 85 (306 Soles) on medicine. The ESSALUD affiliate spends USD 36 (130 Soles) on consultations and USD 116 (420 Soles) on medicine. Conclusions: Our results showed differences in the expenditures on consultations, availability of medicines, and costs among people presenting different types of HI affiliations according to ENAHO 2019, where the SIS covers a wide range of insured persons generating high disbursements.

Introduction: Online education has experienced significant growth, particularly accelerated by the pandemic and the expansion of Information and Communication Technologies (ICT). In Peru, a country that endured one of the world’s longest COVID-19 lockdowns, the transition has faced challenges such as a lack of devices and connectivity. Objective: To determine the perception of the optimization of pedagogical approaches for online learning and its relationship to the level of digital competence among nursing students at a private university in Lima, Peru, in 2024. Methods: A cross-sectional study assessed the perception of 278 nursing students at a private university via simple random sampling. An online, Likert-scale, 58-item questionnaire was used for data gathering. Both instruments demonstrated high reliability (Cronbach’s α: 0.914–0.922) and validity (Aiken’s V: 0.894–0.995). We used Mann Whitney U and one-way ANOVA with Eta-square (η2) values for comparing the variables Spearman’s Rho for association. Results: Most participants were women aged 18–27 (73.9%). A moderate perception of pedagogical optimization prevailed (56.8%), while 81.4% exhibited high digital competence. Age significantly influenced pedagogical perception (p< 0.001) and digital competence (p= 0.006), with younger students outperforming older peers. Academic semester showed no significant impact. A strong association emerged between pedagogical perception and digital competence (Rho=0.336, p<0.001), with high-competence students exclusively reporting high pedagogical satisfaction. Also, students with high digital competence differed significantly from those with moderate/low competence (U = 6061, p < 0.001). Conclusion: These findings highlight the interdependence of digital proficiency and effective pedagogical design in nursing education. While high digital competence is prevalent, gaps in pedagogical optimization suggest that technological integration alone is insufficient without structured teaching strategies. Addressing age-related disparities and enhancing interactive virtual learning are critical to preparing nurses for technology-driven healthcare environments.