The aim is to compare the resistance to torsion between 2 implant systems with internal hexagon connection: one using screw-retained abutments (Titanium Fix) and the other using cementable abutments (ITEC) under a tangential load. An in vitro experimental study was carried out. Fourteen implants, 7 implants from each system, were included in this study. The implants were placed at a 45° angle into metal blocks to simulate their position in the maxilla. Then, implants were subjected to a resistance test on a CMT5L universal testing machine, and the maximum load was applied to each sample. The maximum force with which the torsion was achieved in each sample was analyzed. The data were tested using the Shapiro-Wilk test and showed normal distribution. Student t test was used to examine statistical significance between the two groups, and the P value was set at P < .05. There was a statistically significant difference between the two groups (P = .001). ITEC implants with a cementable abutment showed greater flexural strength compared to the Titanium Fix with a screwed abutment implant system. The cemented abutment showed more resistance to torsion against a tangential load compared with the screwed abutment.

Abstract Introduction: Obesity is a global epidemic affecting millions of people worldwide. Its diagnosis and treatment are crucial for the prevention of associated chronic diseases. Objectives: To assess the prevalence of obesity according to different diagnostic criteria, analyze the concordance between various diagnostic methods, and identify associated factors. Methods: Peru's Demographic and Family Health Survey (ENDES) from 2014 to 2022 was utilized. The cut-off points for defining obesity were ≥ 30 for body mass index (BMI), the ATPIII criteria for waist circumference (WC-ATPIII), and 0.56 for the waist-to-height ratio (WHtR). Concordance analyses were performed to compare diagnostic methods and regression analyses were conducted to identify associated factors. Results: The prevalence of obesity according to BMI, WC-ATPIII, and WHtR was 25.65%, 42.04%, and 46.49%, respectively. The concordance between the three criteria was evaluated through the Kappa index. The concordance between obesity by BMI and WC-ATPIII was 0.5141. The concordance between BMI and WHtR was 0.5099. Finally, the concordance between WC-ATPIII and WHtR was 0.7514. Men showed a lower prevalence of obesity compared to women. The obesity trend increased overall during the study period, with marked differences in prevalence according to the obesity measure used. Conclusions: The findings reveal differences in obesity prevalence according to the diagnostic method employed and underscore the need to consider multiple approaches to assess obesity. The results significantly affect public health and provide a foundation for future interventions and policies to combat obesity in Peru.

Abstract Background Toxoplasmosis is a chronic protozoan parasitic infection that affects nearly one-third of the global population. During the COVID-19 pandemic, cases were observed in patients with COVID-19 and toxoplasmosis. Therefore, this systematic review and meta-analysis aimed to determine the frequency of Toxoplasma gondii exposure in patients with COVID-19. Methods A literature search was conducted in six databases (PubMed, Scopus, Embase, Web of Science, ScienceDirect, and Google Scholar) until March 3, 2024. Study selection, quality assessment, and data extraction were performed independently by three investigators. Statistical analysis was performed using R version 4.3, applying a random-effects model. The quality of the included observational studies was assessed using the "JBI-MAStARI". Results A total of 5,936 studies were retrieved, 13 of which were included in the final meta-analysis. The sample included a total of 2,947 patients with COVID-19 from four countries, of whom approximately 43.26% were men and 49.41% were women. Among the patients, 1,323 showed evidence of exposure to T. gondii through IgG detection, while 1,302 COVID-19 patients were specifically examined for the presence of T. gondii by IgM detection, and 36 positive cases were identified. The frequency of exposure to T. gondii, determined by the presence of IgG in patients with COVID-19, reached 49% (95% CI: 34-63%; 2,947 participants; 13 studies; I2 = 98%, p &lt; 0.01). In addition, the frequency of exposure to T. gondii, evaluated by IgM presence in patients with COVID-19, was 2% (95% CI: 0-6%; 1,302 participants; 6 studies; I2 = 94%, p &lt; 0.01). Conclusion It was shown that almost half of COVID-19 patients had previous exposure to T. gondii through the presence of IgG, and a small percentage, 2%, showed active infection through IgM detection.

Abstract The worldwide prevalence of individuals living with dementia is on the rise and expected to reach 152.8 million people by 2050. This increase will affect disproportionately Low- and Middle Income Countries, which is already home to 60% of individuals living with dementia. Screening tools for early detection of mild cognitive impairment are crucial to provide patients with adequate diagnosis, timely interventions, and access to disease-modifying therapies. The Montreal Cognitive Assessment (MoCA) is one of the most widely used tests for cognitive assessment of first line, but its uniform application across Latin American and Caribbean (LAC) countries is questionable due to cultural and linguistic differences, a higher prevalence of low educational achievement and socioeconomical disparities. This systematic review for validation of the MoCA in Spanish-speaking LAC countries identified fourteen studies but only included twelve based on inclusion and exclusion criteria. We assessed the articles for cultural adaptation and translation reports using the Manchester Cultural Adaptation Questionnaire and the Manchester Translation Reporting Questionnaire. Only two studies reported significant adaptations to the original MoCA, with one study providing detailed cultural and lexical rationale. The adaptation process assessment revealed limited reporting on the translation steps involved, with few studies detailing the original author's involvement, professional translation, pilot testing, or healthcare professional input. This systematic review suggests the use of suitable cutoff scores, educational level-based scoring adjustments, and cultural awareness are key for adequate screening using the MoCA in LAC Spanish-speaking countries. PROSPERO Study registration number: CRD42023465794.

Abstract Background Positive thinking skills are fundamentally important in various fields, including mental health, education, and medicine. Within the context of medical education, where stress and pressure are prevalent, positive thinking can be a transformative force in enhancing resilience and empathy. However, careful validation of measurement tools is required to ensure their applicability in different cultural contexts. Objective The aim of this study was to adapt and validate the Positive Thinking Skills Scale (PTSS) among Peruvian medical students. Methods An instrumental study was conducted. A total of 408 Peruvian medical students aged between 18 to 35 years (M = 19, SD = 2.55) participated. The Positive Thinking Skills Scale (PTSS), academic self-efficacy, and burnout were used. A confirmatory factor analysis (CFA) was performed to assess the factorial structure of the PTSS. Additionally, a sequence of hierarchical variance models was used to evaluate measurement invariance by gender. For the reliability assessment, Cronbach's alpha (α) and omega (ω) coefficients were used. Results The CFA supported the unifactorial structure of 8 items with adequate goodness-of-fit indices: χ2 (20) = 69.860, CFI = 0.95, TLI = 0.93, RMSEA = 0.08 (90% CI: 0.06–0.09), SRMR = 0.04. Reliability using Cronbach's Alpha (α = 91) and McDonald's Omega (ω = 91) was excellent. Likewise, convergent and discriminant validity between the PTSS and measures of academic self-efficacy and burnout was demonstrated. Conclusions The Peruvian version of the PTSS is effective in measuring positive thinking skills. The PTSS represents a valid, reliable, and invariant tool for assessing and promoting positive thinking, which has profound implications on the mental health and overall well-being of future doctors.

Abstract Background Peru’s Rural and Marginal Urban Health Service (SERUMS) aims to improve healthcare in rural and marginal areas. Despite its objectives, a gap exists between training General Practitioners (GPs) and the competencies required for SERUMS. This study assesses GPs' self-perceived competencies and training needs for SERUMS. Methods A cross-sectional analytical study was conducted involving GPs who enrolled in SERUMS between 2020 and 2022. A questionnaire was developed based on the Ministry of Health's competency framework, assessing 21 minimal achievement conditions. The survey was distributed via Google Forms and included sections on sociodemographic information, SERUMS characteristics, self-perceived competencies, and training needs. Results Out of 190 GPs who participated, most were female, over 27 years old, and graduates from private universities with mixed-setting internships. The highest self-perceived competencies were in low-complexity problem management, communication, and professionalism. However, competencies in research, leadership, and health system management were rated lowest. The primary resource for training was self-study, with a preference for active learning methods for future training. Perceived training needs were in therapeutic competencies, the Peruvian health system, diagnostic competencies, administrative tasks, and interprofessional competencies. Conclusions This study reveals significant gaps in the training and competencies of Peruvian GPs for SERUMS. It emphasizes the need for a tailored curriculum incorporating active learning and focusing on clinical reasoning, leadership, and interprofessional competencies. This approach would better prepare GPs for SERUMS and enhance their self-efficacy and effectiveness in primary care. Leading to a better quality of care for these neglected populations.

Abstract Introduction: Obesity is a global epidemic affecting millions of people worldwide. Its diagnosis and treatment are crucial for the prevention of associated chronic diseases. Objectives: To assess the prevalence of obesity according to different diagnostic criteria, analyze the concordance between various diagnostic methods, and identify associated factors. Methods: Peru's Demographic and Family Health Survey (ENDES) from 2019 to 2022 was utilized. The cut-off points for defining obesity were ≥ 30 for body mass index (BMI), the ATPIII criteria for waist circumference (WC-ATPIII), and 0.56 for the waist-to-height ratio (WHtR). Concordance analyses were performed to compare diagnostic methods and regression analyses were conducted to identify associated factors. Results: The prevalence of obesity according to BMI, WC-ATPIII, and WHtR was 25.65%, 42.04%, and 46.49%, respectively. The concordance between the three criteria was evaluated through the Kappa index. The concordance between obesity by BMI and WC-ATPIII was 0.5141. The concordance between BMI and WHtR was 0.5099. Finally, the concordance between WC-ATPIII and WHtR was 0.7514. Men showed a lower prevalence of obesity compared to women. The obesity trend increased overall during the study period, with marked differences in prevalence according to the obesity measure used. Conclusions: The findings reveal differences in obesity prevalence according to the diagnostic method employed and underscore the need to consider multiple approaches to assess obesity. The results significantly affect public health and provide a foundation for future interventions and policies to combat obesity in Peru.

Abstract Objectives: to estimate the role of maternal overweight and obesity before pregnancy as predictors of childhood asthma in a population of Peruvian children under five years. Methods: we carried out a retrospective cohort study of children aged five years or less and their mothers from the Regional Hospital of Ayacucho and the María Auxiliadora Hospital in Lima, Peru. We included children who were born between 2013 and 2014 and follow them up until 2018 and 2019, respectively. The diagnosis of overweight and obesity of the mother before pregnancy and asthma in the child were registered in their clinical histories. Crude (cRR) and adjusted relative risks (aRR) and 95% confidence intervals (CI95%) were obtained using a generalized lineal model of the Poisson family with link log and robust variances. Results: we evaluated 431 medical records and found that 20.9% of the children had asthma, 26.7% of the mothers were overweight, and 20.2% were obese before pregnancy. In the adjusted regression model, overweight (aRR=2.94; CI95%= 1.54-5.60) and maternal obesity (aRR=5.10; CI95%= 2.73-9.51) were predictors of an increased risk of childhood asthma. Conclusions: maternal overweight and maternal obesity increased the risk of her children developing asthma threeand five-fold, respectively.