Dise?o, procura y construcci?n del CENCUL RURICANCHO ? SJL en el distrito de San Juan de Lurigancho, provincia de Lima - Per?

El proyecto Dise?o, procura y construcci?n del CENCUL RURICANCHO ? SJL en el distrito de San Juan de Lurigancho, provincia de Lima ? Per?, es un proyecto de inversi?n p?blica patrocinado por la municipalidad distrital de San Juan de Lurigancho, cuyo desarrollo y ejecuci?n se realizar? bajo el sistema de inversi?n p?blica INVIERTE.PE y la Ley de Contrataciones con el Estado por la empresa GALGON S.A.C. adjudicado mediante concurso p?blico de m?ritos. El centro cultural CENCUL RURICANCHO ?SJL es una infraestructura de car?cter social y cultural mediante el cual se cubrir? la deficiencia existente de espacios de socializaci?n y reuni?n comunitarios bajo condiciones ?ptimas de seguridad, confort, funcionalidad, calidad arquitect?nica y constructiva. El alcance de la tesis abarca el inicio y planificaci?n bajo el enfoque de los lineamientos de direcci?n de proyectos del PMBOK? 5ta edici?n, de las fases de dise?o y desarrollo del expediente t?cnico, la procura, construcci?n y puesta en marcha del CENCUL RURICANCHO ? SJL, cuya ejecuci?n generar? un gran impacto permitiendo el reordenamiento urbano y revalorizaci?n de la zona, el impulso para la creaci?n de nuevas oportunidades de negocio y ser el nuevo referente de la identidad e imagen del distrito y sus pobladores

Propuesta de un plan de negocio, basado en tecnolog?a, para atenci?n de consultas e incidentes relacionados a dispositivos electr?nicos

El servicio de soporte t?cnico se ha venido prestando de manera tradicional a lo largo del tiempo. Sin embargo, no se ha evidenciado la existencia de alg?n proveedor, que brinde este servicio de manera integral, siendo independiente del dispositivo, marca y plataforma. En ese sentido, la presente tesis, propone un modelo de negocio que, fundament?ndose en tecnolog?a como elemento diferenciador, busca atender las consultas e incidentes de los usuarios de manera integral, eliminando la complejidad de buscar al proveedor que compete un determinado incidente. Asimismo, el uso de tecnolog?a, permitir? brindar un primer nivel de servicio totalmente gratuito, y otro pagado, que ser? el que generar?a ingresos a la empresa. En ambos casos, se buscar? maximizar la eficiencia en cuanto a operaciones y calidad del servicio. Finalmente, se ha contemplado tambi?n el uso de tecnolog?a anal?tica, que permita mejorar las operaciones de la empresa a lo largo del tiempo. Por ejemplo, mediante la consulta a bases de datos de conocimiento, lo cual permitir? una mayor eficiencia en la soluci?n de incidentes

Characterization of pulmonary function in 10â18 year old patients with Duchenne muscular dystrophy

Pulmonary function loss in patients with Duchenne muscular dystrophy (DMD) is progressive and leads to pulmonary insufficiency. The purpose of this study in 10â18 year old patients with DMD is the assessment of the inter-correlation between pulmonary function tests (PFTs), their reliability and the association with the general disease stage measured by the Brooke score. Dynamic PFTs (peak expiratory flow [PEF], forced vital capacity [FVC], forced expiratory volume in one second [FEV1]) and maximum static airway pressures (MIP, MEP) were prospectively collected from 64 DMD patients enrolled in the DELOS trial (ClinicalTrials.gov, number NCT01027884). Baseline PEF percent predicted (PEF%p) was <80% and patients had stopped taking glucocorticoids at least 12 months prior to study start. At baseline PEF%p, FVC%p and FEV1%p correlated well with each other (Spearman's rho: PEF%pâFVC%p: 0.54; PEF%pâFEV1%p: 0.72; FVC%pâFEV1%p: 0.91). MIP%p and MEP%p correlated well with one another (MIP%pâMEP%p: 0.71) but less well with PEF%p (MIP%pâPEF%p: 0.40; MEP%pâPEF%p: 0.41) and slightly better with FVC%p (MIP%pâFVC%p: 0.59; MEP%pâFVC%p: 0.74). The within-subject coefficients of variation (CV) for successive measures were 6.97% for PEF%p, 6.69% for FVC%p and 11.11% for FEV1%p, indicating that these parameters could be more reliably assessed compared to maximum static airway pressures (CV for MIP%p: 18.00%; MEP%p: 15.73%). Yearly rates of PFT decline (placebo group) were larger in dynamic parameters (PEF%p: â8.9% [SD 2.0]; FVC%p: â8.7% [SD 1.1]; FEV1%p: â10.2% [SD 2.0]) than static airway pressures (MIP%p: â4.5 [SD 1.3]; MEP%p: â2.8 [SD 1.1]). A considerable drop in dynamic pulmonary function parameters was associated with loss of upper limb function (transition from Brooke score category 4 to category 5). In conclusion, these findings expand the understanding of the reliability, correlation and evolution of different pulmonary function measures in DMD patients who are in the pulmonary function decline phase

Association between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials.

Funder: laura and john arnold foundationBACKGROUND: Convalescent plasma has been widely used to treat COVID-19 and is under investigation in numerous randomized clinical trials, but results are publicly available only for a small number of trials. The objective of this study was to assess the benefits of convalescent plasma treatment compared to placebo or no treatment and all-cause mortality in patients with COVID-19, using data from all available randomized clinical trials, including unpublished and ongoing trials (Open Science Framework, https://doi.org/10.17605/OSF.IO/GEHFX ). METHODS: In this collaborative systematic review and meta-analysis, clinical trial registries (ClinicalTrials.gov, WHO International Clinical Trials Registry Platform), the Cochrane COVID-19 register, the LOVE database, and PubMed were searched until April 8, 2021. Investigators of trials registered by March 1, 2021, without published results were contacted via email. Eligible were ongoing, discontinued and completed randomized clinical trials that compared convalescent plasma with placebo or no treatment in COVID-19 patients, regardless of setting or treatment schedule. Aggregated mortality data were extracted from publications or provided by investigators of unpublished trials and combined using the Hartung-Knapp-Sidik-Jonkman random effects model. We investigated the contribution of unpublished trials to the overall evidence. RESULTS: A total of 16,477 patients were included in 33 trials (20 unpublished with 3190 patients, 13 published with 13,287 patients). 32 trials enrolled only hospitalized patients (including 3 with only intensive care unit patients). Risk of bias was low for 29/33 trials. Of 8495 patients who received convalescent plasma, 1997 died (23%), and of 7982 control patients, 1952 died (24%). The combined risk ratio for all-cause mortality was 0.97 (95% confidence interval: 0.92; 1.02) with between-study heterogeneity not beyond chance (I2 = 0%). The RECOVERY trial had 69.8% and the unpublished evidence 25.3% of the weight in the meta-analysis. CONCLUSIONS: Convalescent plasma treatment of patients with COVID-19 did not reduce all-cause mortality. These results provide strong evidence that convalescent plasma treatment for patients with COVID-19 should not be used outside of randomized trials. Evidence synthesis from collaborations among trial investigators can inform both evidence generation and evidence application in patient care