Plan de Negocios."Proyecto tienda BABY BOOM".

BABY BOOM, empresa que hace referencia al término de la maternidad y bienestar de su bebé,enfocada en la etapa de embarazo y niños de 0 meses a 5 años logrando crear un espacio que ofrezca todo lo necesario para los futuros padres ;innovaran con servicios personalizados creando recuerdos memorables para la mamá y papá integrando al resto de la familia

Natural pasture in Salto (Uruguay): relationship with climate variability and analysis in the context of future climate change

En este trabajo se evaluó objetivamente la relación entre la variabilidad del rendimiento de la pastura en el departamento de Salto (Uruguay) y la variabilidad climática. Se analizaron también las posibles implicancias del cambio climático futuro. Se utilizaron datos diarios y mensuales de la estación meteorológica Salto en el período 1961-1990 y un registro de datos experimentales de crecimiento de pastura en el período 1980-1994. Adicionalmente, se emplearon salidas diarias de reanálisis del NCEP y de los Modelos de Circulación General HadCM3 y CSIRO-Mk2 para los escenarios A2 y B2. Las correlaciones simples entre las variables climáticas y la pastura confirmaron en términos cuantitativos la sensibilidad de la pastura a la variabilidad climática, explicando entre el 20% y 58% de la varianza en los rendimientos. Las mayores asociaciones se encontraron en otoño (principalmente con las variables relacionadas con la precipitación) y verano. En invierno no se observaron asociaciones significativas. El efecto conjunto de las variables climáticas explicó entre el 36% y 86% de la variabilidad en el crecimiento de la pastura. Para los escenarios estudiados, los incrementos proyectados en las temperaturas mínima y máxima permitirían reducir las probabilidades de ocurrencia de temperaturas por debajo del umbral mínimo considerado para la pastura (10°C) y aumentar las probabilidades de estrés térmico durante el verano. La precipitación presentaría incrementos que podrían aumentar la incidencia de excedentes hídricos en invierno. Los incrementos proyectados para el verano no compensarían los aumentos de la demanda hídrica atmosférica por mayores temperaturas.This work aimed to evaluate the relationship between natural pasture yield and climate variability in the district of Salto (Uruguay), and to analyze the possible implications of future climate change. Daily and monthly data from Salto meteorological station for the period 1961-1990 were used together with experimental data of pasture yield for the period 1980-1994. Moreover, NCEP reanalyses of daily data as well as daily outputs from General Circulation Models HadCM3 and CSIRO-Mk2 were analyzed. The simple correlations between the climatic variables and the pasture yield confirm in quantitative terms the sensitivity of pasture yield to climate variability, accounting for 20% up to 58% of the variance. The highest associations were found in fall (mainly with precipitation variables), followed by summer. No significant associations were found in winter. The joint effect of the climatic variables on yield could explain between 36% and 86% of the pasture variability. The increments projected for the minimum and maximum temperatures may, respectivaly, reduce the probabilities of occurrences of temperatures below the minimum threshold considered for pasture (10ºC) and increase the probabilities of thermal stress, mainly in summer, respectively. Modeled increments in precipitation may raise the occurrences of precipitation excess during winter. On the other hand, the modeled precipitation increments during summer would not be enough to compensate the high water demand caused by the greater temperatures.Fil: Bettolli, Maria Laura. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Ciencias de la Atmósfera y los Océanos; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Altamirano del Carmen, Miguel Angel. Instituto Nacional de Ecología; MéxicoFil: Cruz Brasesco, Gabriela. Universidad de la República; UruguayFil: Rudorff, Federico. Instituto de Pesquisa e Prevenção em Desastres Naturais; BrasilFil: Martínez Ortiz, Arlen. Ministerio del Ambiente y los Recursos Naturales; NicaraguaFil: Arroyo, Jacinto. Instituto Geofísico del Perú; PerúFil: Armoa, Jorge. Universidad Nacional de Asuncion; Paragua

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Impact of Adding a Rapid PCR-Based Blood Culture Identification Panel to the Antimicrobial Stewardship Program of Patients with Febrile Neutropenia in a Peruvian Referral Hospital

The addition of Biofire® FilmArray® Blood Culture Identification panel 2 (BCID2) to the antimicrobial stewardship program (ASP) could improve outcomes in bloodstream infections (BSI) of patients with febrile neutropenia (FN). A pre- and post-quasi-experimental single-center study was conducted at a reference hospital in Peru. Three groups were considered: patients with BSI before ASP intervention (control group), patients with BSI after ASP intervention (group 1), and patients with BSI after ASP intervention plus BCID2 PCR Panel implementation (group 2). Overall, 93 patients were identified (32 control, 30 group 1, 31 group 2). The median time to effective therapy was significantly shorter in group 2 compared to group 1 and control group, respectively (3.75 vs. 10 h, p = 0.004; 3.75 vs. 19 h, p p < 0.001). In addition to the lack of local studies documenting the microbiological profile of FN episodes, adding syndromic panels-based testing could allow for the consolidation of ASP strategies

Estudios sociales y administrativos en América Latina

Esta obra contiene la compilación de una serie de investigaciones latinoamericanas en las cuales se presenta los nuevos enfoques investigativos, metodológicos y cientificos. Para la generación de soluciones que contribuyan a la toma de decisiones en variables, sociales, economicas y administrativas en los diferentes contextos organizacionales. Además de estos elementos, en esta obra se presentan nuevas apuestas multidisciplinares cuanti-cualitativas en las cuales se destacan la ingeniería, derecho entre otros.