“The woof” dog store

El objetivo de la investigación es demostrar la viabilidad y factibilidad del proyecto de “The Woof” Dog Store en el mercado peruano, para satisfacer las necesidades de los amantes de las mascotas brindándoles un servicio que satisfaga sus expectativas en cuanto a sus problemas en la compra de accesorios y ropa para sus mascotas en las últimas tendencias para optimizar el tiempo de compra y ofrecer medidas de bioseguridad al cliente en estos tiempos pandémicos. Para ello, la presente investigación detalla el siguiente contenido: (1) aspectos generales del negocio, (2) enfoque estratégico, (3) investigación y validación de mercado, (4) plan de marketing, (5) plan de operaciones, (6) estructura organizativa y recursos humanos. (7) plan económico-financiero y conclusiones. El método de investigación utilizado fue mixto, porque utilizamos el método cuantitativo, que recoge y analiza los datos. Asimismo, se aplicó el método cualitativo, que corresponde a la recolección y análisis de entrevistas en profundidad. Finalmente, la viabilidad del proyecto se ejemplifica a través del análisis de diversos escenarios financieros, los cuales han determinado que el proyecto genera valor para los inversionistas. Como futuros emprendedores, buscamos incentivar el sector económico del país creando fuentes de empleo y aumentando el PIB del país, sin descuidar el cuidado y responsabilidad social hacia el medio ambiente mediante el uso de materiales biodegradables.The objective of the research is to demonstrate the viability and feasibility of the Woof Dog store project in the Peruvian market, to satisfy the needs of pet-lovers by providing them with a service that meets their expectations in terms of their problems in the purchase of accessories and clothing for their pets in the latest trends to optimize the time of purchase and offer biosecurity measures to the customer in these pandemic times. For this purpose, the present research details the following content: (1) general aspects of the business, (2) strategic approach, (3) market research and validation, (4) marketing plan, (5) operations plan, (6) organizational structure and human resources. (7) economic-financial plan and conclusions. The research method used was mixed, because we used the quantitative method, which collects and analyzes data. Also, the qualitative method was applied, which corresponds to the collection and analysis of in-depth interviews. Finally, the feasibility of the project is exemplified through the analysis of various financial scenarios, which have determined that the project generates value for investors. As future entrepreneurs, we seek to encourage the country's economic sector by creating sources of employment and increasing the country's GDP, without neglecting the care and social responsibility towards the environment through the use of biodegradable materials.Trabajo de investigació

Impact of COVID-19 pandemic on cardiometabolic patients without SARS CoV-2 infection in Latin America

A cross-sectional survey including 38 questions about demography, clinical condition, changes in health habits, and medical treatments for cardiometabolic patients in outpatient follow-up was conducted. From June 15 to July 15, 2020, a total of 13 Latin-American countries participated in enrolling patients. These countries were divided into 3 geographic regions: Region 1 including North, Central, and Caribbean Regions (NCCR), Region 2 including the Andean Region (AR), and Region 3 including the Southern Cone Region (SCR). 4.216 patients were analyzed, resulting in a coefficient of 33.82%, 32.23%, and 33.94% for NCCR, AR, and SCR, respectively. Significant differences were found between the AR, SCR, and NCCR regions. The analysis of habitual medication usage showed that discontinued use of medication was more present in AR, reaching almost 30% (p < 0.001). The main finding of this study was the negative impact that restrictive measures have on adherence to medications and physical activity: Rs = 0.84 (p = 0.0003) and Rs = 0.61 (p = 0.0032), respectively. AR was the most vulnerable region. Restrictive quarantine measures imposed by the different countries showed a positive correlation with medication discontinuation and a negative correlation with physical activity levels in patients analyzed. These findings characterize the impact of the consequences left by this pandemic. Undoubtedly, restrictive measures have been and will continue to have reverberating negative effects in most Latin-American countries.Fil: Camiletti, Jorge. Hospital Italiano de La Plata; ArgentinaFil: Renna, Nicolas Federico. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto de Medicina y Biología Experimental de Cuyo; Argentina. Universidad Nacional de Cuyo. Facultad de Ciencias Médicas. Cátedra de Fisiología Patológica; Argentina. Hospital Español de Mendoza; ArgentinaFil: López Santi, Ricardo. Hospital Italiano de La Plata; ArgentinaFil: Erriest, Juan. Hospital Italiano de La Plata; ArgentinaFil: García-Bello, Eliomar. Centro de Diagnóstico Medicina Avanzada y Telemedicina; República DominicanaFil: Araujo, John. Centro Cardiovascular Somer Incare; ColombiaFil: Varleta-Olivares, Paola. Hospital Dipreca; ChileFil: Gómez-Díaz, Eduardo. Hospital Metropolitano del Norte; VenezuelaFil: Ramírez, Gisselle. Medicina Cardiovascular Asociada; República DominicanaFil: Berni Betancourt, Ana. Sociedad interamericana de Cardiología; México. Consejo Interamericano de Electrocardiográfica y Arritmias; México. Hospital Ángeles Pedregal; MéxicoFil: Escalada Lesme, Gustavo. Centro Médico Nacional-Hospital Nacional Itaguá; ParaguayFil: Campos Alcántara, Lourdes V.. Consultorio de Lourdes Victoria Campos Alcántara; PerúFil: Moya Loor, Leonardo. Hospital Santa Margarita; EcuadorFil: Rey Benavente, Claudio. Hospital Arroyabe Pichanal; ArgentinaFil: Almonte, Claudia. Medicina Cardiovascular Asociada; República DominicanaFil: Cortez Sandoval, Maicol. Hospital Nacional Edgardo Rebagliti Martins; PerúFil: Alvarado Cuadros, María. Department of Cardiology, Institution; EcuadorFil: Rosario, Monica I.. Centro de Diagnóstico Medicina Avanzada y Telemedicina; República DominicanaFil: Gupta, Shyla. Queen’s University; CanadáFil: Ibarrola, Martin. Cardiovascular Center BV; ArgentinaFil: Baranchuk, Adrián. Kingston Health Sciences Centre; Canad

Rare Genetic Syndromes and Oral Anomalies: A Review of the Literature and Case Series with a New Classification Proposal

Rare genetic syndromes, conditions with a global average prevalence of 40 cases/100,000 people, are associated with anatomical, physiological, and neurological anomalies that may affect different body districts, including the oral district. So far, no classification of oral abnormalities in rare genetic syndromes is present in the literature. The aim of this narrative review is to analyze literature on rare genetic syndromes affecting dento-oro-maxillofacial structures (teeth, maxillary bones, oral soft tissues, or mixed) and to propose a classification according to the detected oral abnormalities. In addition, five significant cases of rare genetic syndromes are presented. The Scale for the Assessment of Narrative Review Articles (SANRA) was followed for this review. From 674 papers obtained through PubMed search, 351 were selected. Sixty-two rare genetic syndromes involving oral manifestations were found and classified. The proposed classification aims to help the clinician to easily understand which dento-oro-maxillofacial findings might be expected in the presence of each rare genetic syndrome. This immediate framework may both help in the diagnosis of dento-oro-maxillofacial anomalies related to the underlying pathology as well as facilitate the drafting of treatment plans with the involvement of a multidisciplinary team

Latin American Consensus for Pediatric Cardiopulmonary Resuscitation 2017

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.Objectives: To develop a Latin American Consensus about Pediatric Cardiopulmonary Resuscitation. To clarify, reinforce, and adapt some specific recommendations for pediatric patients and to stimulate the implementation of these recommendations in clinical practice. Design: Expert consensus recommendations with Delphi methodology. Setting: Latin American countries. Subjects: Experts in pediatric cardiopulmonary resuscitation from 19 Latin American countries. Interventions: Delphi methodology for expert consensus. Measurements and Main Results: The goal was to reach consensus with all the participating experts for every recommendation. An agreement of at least 80% of the participating experts had to exist in order to deliver a recommendation. Two Delphi voting rounds were sent out electronically. The experts were asked to score between 1 and 9 their level of agreement for each recommendation. The score was then classified into three groups: strong agreement (score 7–9), moderate agreement (score 4–6), and disagreement (score 1–3). Nineteen experts from 19 countries participated in both voting rounds and in the whole process of drafting the recommendations. Sixteen recommendations about organization of cardiopulmonary resuscitation, prevention, basic resuscitation, advanced resuscitation, and postresuscitation measures were approved. Ten of them had a consensus of 100%. Four of them were agreed by all the participants except one (94.7% consensus). One recommendation was agreed by all except two experts (89.4%), and finally, one was agreed by all except three experts (84.2%). All the recommendations reached a level of agreement. Conclusions: This consensus adapts 16 international recommendations to Latin America in order to improve the practice of cardiopulmonary resuscitation in children. Studies should be conducted to analyze the effectiveness of the implementation of these recommendations.Revisión por pare

Factors associated with high-risk human papillomavirus infection and high-grade cervical neoplasia: A population-based study in Paraguay.

BACKGROUND:Cervical cancer (CC) is one of the leading causes of cancer mortality among women from Paraguay, with high incidence and mortality rates (31.2 and 16 per 100 000 women, respectively). Although the risk factors associated with high-risk human papillomavirus (hrHPV) infection and preneoplastic cervical lesions are widely studied, population-based characteristics of particular settings may influence the feasibility of HPV-based CC screening implementation. This study aimed to explore factors associated with hrHPV infection and high-grade cervical neoplasia in hrHPV-positive (hrHPV+) women from Paraguay. METHODS:A total of 5677 women aged 30-64 years from the Central Department of Paraguay were screened with HPV test (Hybrid Capture 2) and Pap smear. Sociodemographic and risk factor interviews were conducted. hrHPV+ women were referred to colposcopy and women with an abnormal colposcopy had a biopsy taken. The outcomes recorded were the hrHPV status and the presence of high-grade cervical intraepithelial neoplasia or worse (CIN2+) among hrHPV+ women. Associations were investigated using multivariate logistic regressions. RESULTS:hrHPV prevalence was 13.8% (95%CI 13.0-14.8). This value decreased with the age of women (p-trend<0.001) and increased with the lifetime number of sexual partners (p-trend<0.001) and number of previous female partners of their current male partner if women had had one lifetime sexual partner (p-trend<0.001), increasing from 3.06 (95%CI 0.073-20.9) if partners had had one previous female partner to 9.19 (95%CI 2.36-61.1) if they had had eight or more. In hrHPV+ women, CIN2+ prevalence was 10.7% (95%CI 8.58-13.2) and increased with time since the last Pap smear (p-trend<0.001) and with the increasing number of pregnancies (p-trend = 0.05). CONCLUSION:In these settings, the sexual behavior of women and their male partners is associated with hrHPV infection. In hrHPV+ women, underscreening practices and multiple pregnancies are associated with CIN2+. This knowledge can contribute to public health policies for CC prevention and control in Paraguay

Impacto de la pandemia COVID-19 en pacientes cardiometabólicos sin infección por SARS-CoV-2 en Latinoamérica

Antecedentes y Objetivos: Se realizó una encuesta transversal que incluyó 38 preguntas sobre demografía, estado clínico, cambio de hábitos de salud, tratamientos médicos a pacientes cardiometabólicos en seguimiento ambulatorio. Un total de 13 países latinoamericanos inscribieron pacientes del 15 de junio al 15 de julio de 2020. Método: Los países se dividieron en 3 regiones geográficas Región 1 (NCCR): Región Norte, Centro y Caribe; Región 2 (AR): Región Andina; Región 3 (SCR): Región Cono Sur. Las medidas de aislamiento se estimaron a partir de informes nacionales y se correlacionaron utilizando el coeficiente R de Spearman. Se analizaron 4.216 pacientes, NCCR (33.82%); AR (32.23%) SCR (33.94%). Resultados: Se encontraron diferencias significativas entre regiones. Este análisis de la medicación habitual mostró que la discontinuación de la medicación fue mayor en RA, llegando a casi el 30% (p < 0.001). El principal hallazgo de este estudio fue el impacto negativo que tienen las medidas restrictivas sobre la adherencia a la medicación y la actividad física, Rs = 0.84 (p = 0.0003) y Rs = 0.61 (p = 0.0032), respectivamente. Se encontraron diferencias significativas entre regiones. AR es la región más vulnerable. Conclusiones: Las medidas restrictivas impuestas por los diferentes países (cuarentena) mostraron una correlación positiva con la interrupción de la medicación y una correlación negativa con la cantidad de actividad física. El impacto de las consecuencias que deja esta pandemia será muy profundo en la mayoría de los países latinoamericanos

Evaluation of the Xpert MTB Host Response assay for the triage of patients with presumed pulmonary tuberculosis: a prospective diagnostic accuracy study in Viet Nam, India, the Philippines, Uganda, and South Africa

BackgroundNon-sputum-based triage tests for tuberculosis are a priority for ending tuberculosis. We aimed to evaluate the diagnostic accuracy of the late-prototype Xpert MTB Host Response (Xpert HR) blood-based assay.MethodsWe conducted a prospective diagnostic accuracy study among outpatients with presumed tuberculosis in outpatient clinics in Viet Nam, India, the Philippines, Uganda, and South Africa. Eligible participants were aged 18 years or older and reported cough lasting at least 2 weeks. We excluded those receiving tuberculosis treatment in the preceding 12 months and those who were unwilling to consent. Xpert HR was performed on capillary or venous blood. Reference standard testing included sputum Xpert MTB/RIF Ultra and mycobacterial culture. We performed receiver operating characteristic (ROC) analysis to identify the optimal cutoff value for the Xpert HR to achieve the target sensitivity of 90% or more while maximising specificity, then calculated diagnostic accuracy using this cutoff value. This study was prospectively registered with ClinicalTrials.gov, NCT04923958.FindingsBetween July 13, 2021, and Aug 15, 2022, 2046 adults with at least 2 weeks of cough were identified, of whom 1499 adults (686 [45·8%] females and 813 [54·2%] males) had valid Xpert HR and reference standard results. 329 (21·9%) had microbiologically confirmed tuberculosis. Xpert HR had an area under the ROC curve of 0·89 (95% CI 0·86-0·91). The optimal cutoff value was less than or equal to -1·25, giving a sensitivity of 90·3% (95% CI 86·5-93·3; 297 of 329) and a specificity of 62·6% (95% CI 59·7-65·3; 732 of 1170). Sensitivity was similar across countries, by sex, and by subgroups, although specificity was lower in people living with HIV (45·1%, 95% CI 37·8-52·6) than in those not living with HIV (65·9%, 62·8-68·8; difference of 20·8%, 95% CI 13·0-28·6; p&lt;0·0001). Xpert HR had high negative predictive value (95·8%, 95% CI 94·1-97·1), but positive predictive value was only 40·1% (95% CI 36·8-44·1). Using the Xpert HR as a triage test would have reduced confirmatory sputum testing by 57·3% (95% CI 54·2-60·4).InterpretationXpert HR did not meet WHO minimum specificity targets for a non-sputum-based triage test for pulmonary tuberculosis. Despite promise as a rule-out test that could reduce confirmatory sputum testing, further cost-effectiveness modelling and data on acceptability and usability are needed to inform policy recommendations.FundingNational Institute of Allergy and Infectious Diseases of the US National Institutes of Health.TranslationsFor the Vietnamese and Tagalog translations of the abstract see Supplementary Materials section

HPV-FASTER: broadening the scope for prevention of HPV-related cancer

&lt;p&gt;Human papillomavirus (HPV)-related screening technologies and HPV vaccination offer enormous potential for cancer prevention, notably prevention of cervical cancer. The effectiveness of these approaches is, however, suboptimal owing to limited implementation of screening programmes and restricted indications for HPV vaccination. Trials of HPV vaccination in women aged up to 55 years have shown almost 90% protection from cervical precancer caused by HPV16/18 among HPV16/18-DNA-negative women. We propose extending routine vaccination programmes to women of up to 30 years of age (and to the 45-50-year age groups in some settings), paired with at least one HPV-screening test at age 30 years or older. Expanding the indications for HPV vaccination and much greater use of HPV testing in screening programmes has the potential to accelerate the decline in cervical cancer incidence. Such a combined protocol would represent an attractive approach for many health-care systems, in particular, countries in Central and Eastern Europe, Latin America, Asia, and some more-developed parts of Africa. The role of vaccination in women aged &gt;30 years and the optimal number of HPV-screening tests required in vaccinated women remain important research issues. Cost-effectiveness models will help determine the optimal combination of HPV vaccination and screening in public health programmes, and to estimate the effects of such approaches in different populations.&lt;/p&gt;</p