Plan de negocios en turismo rural comunitario para la comunidad de Viacha en la regi?n de Cusco

El sector turismo, es uno de los sectores que m?s ha crecido en los ?ltimos a?os en el pa?s, por lo que la presente tesis muestra un plan de negocios en Turismo Rural Comunitario para la comunidad de Viacha en la Regi?n de Cusco, como una oportunidad de desarrollo econ?mico y social, para la comunidad, la cual no ha sido beneficiada por la gran actividad tur?stica que se desarrolla cerca de su territorio, donde en el estudio se puede mostrar todos los procesos de trabajo que se ir?n realizando para poder desarrollar productos tur?sticos aprovechando las costumbres que siguen intactas en la comunidad, bajo actividades tur?sticas vivenciales reflejadas en paquetes tur?sticos desde 1 d?a, hasta 3 d?as, donde los actores ser?n los miembros de la comunidad, d?ndole un valor agregado y diferencial a los clientes en este casos las agencia de viajes y a trav?s de ellos los turistas finales. Para evaluar la rentabilidad del proyecto se realiz? un an?lisis financiero el cual dio un resultado positivo, demostrando que este plan de negocio resultar? beneficioso para la comunidad

Sex Differences in Nociceptin/Orphanin FQ Peptide Receptor-Mediated Pain and Anxiety Symptoms in a Preclinical Model of Post-traumatic Stress Disorder

Nociceptin/Orphanin FQ (N/OFQ) is a neuropeptide that modulates pain transmission, learning/memory, stress, anxiety, and fear responses via activation of the N/OFQ peptide (NOP or ORL1) receptor. Post-traumatic stress disorder (PTSD) is an anxiety disorder that may arise after exposure to a traumatic or fearful event, and often is co-morbid with chronic pain. Using an established animal model of PTSD, single-prolonged stress (SPS), we were the first to report that NOP receptor antagonist treatment reversed traumatic stress-induced allodynia, thermal hyperalgesia, and anxiety-like behaviors in male Sprague-Dawley rats. NOP antagonist treatment also reversed SPS-induced serum and CSF N/OFQ increase and circulating corticosterone decrease. The objective of this study was to examine the role of the NOP receptor in male and female rats subjected to traumatic stress using Wistar wild type (WT) and NOP receptor knockout (KO) rats. The severity of co-morbid allodynia was assessed as change in paw withdrawal threshold (PWT) to von Frey and paw withdrawal latency (PWL) to radiant heat stimuli, respectively. PWT and PWL decreased in male and female WT rats within 7 days after SPS, and remained decreased through day 28. Baseline sensitivity did not differ between genotypes. However, while male NOP receptor KO rats were protected from SPS-induced allodynia and thermal hypersensitivity, female NOP receptor KO rats exhibited tactile allodynia and thermal hypersensitivity to the same extent as WT rats. Male NOP receptor KO rats had a lower anxiety index (AI) than WT, but SPS did not increase AI in WT males. In contrast, SPS significantly increased AI in WT and NOP receptor KO female rats. SPS increased circulating N/OFQ levels in male WT, but not in male NOP receptor KO, or WT or KO female rats. These results indicate that the absence of the NOP receptor protects males from traumatic-stress-induced allodynia and hyperalgesia, consistent with our previous findings utilizing a NOP receptor antagonist. However, female NOP receptor KO rats experience allodynia, hyperalgesia and anxiety-like symptoms to the same extent as WT females following SPS. This suggests that endogenous N/OFQ-NOP receptor signaling plays an important, but distinct, role in males and females following exposure to traumatic stress

Propuesta de redistribución de planta del área de confección de una empresa de tejido plano

El presente proyecto se llevó a cabo en una empresa de confecciones de tejido plano, en el área de confecciones específicamente. Tiene como objeto el desarrollar una propuesta de redistribución de planta que permita la organización eficaz de las máquinas, el recurso humano y los materiales; a través de herramientas de distribución de planta y estudio de tiempos. Con la finalidad de elevar los niveles de productividad de la empresa y lograr reducir el tiempo de recorrido de los materiales, entre las estaciones o puestos de trabajo. Para llevar a cabo el proyecto de tesis, el trabajo se dividió en cuatro capítulos. El primero es el marco teórico del proyecto, donde se define la distribución de planta; así como, también, se detalla los tipos de distribución que existen y se emplean actualmente. Además, se menciona los factores que influyen en una distribución de planta y los métodos o herramientas de solución que existen en la actualidad para poder desarrollar o llevar a cabo diseños de planta. Como segundo capítulo se tiene el diagnóstico de la situación actual del área de la empresa donde se lleva a cabo el proyecto. En este capítulo se describe un poco a la empresa para poder comprender mejor su proceso de fabricación y poder realizar algunos estudios; con la finalidad de poder determinar el problema principal del área y hallar las posibles pérdidas que puede estar causando en la empresa. Es en el tercer capítulo donde se desarrollan las propuestas de solución al problema encontrado en el capitulo anterior, empleando una de las herramientas de distribución de planta, la herramienta SLP. Asimismo, se realiza un análisis de cada una de ellas para poder escoger la mejor propuesta de solución y realizar un análisis de costos de la mejor propuesta. Finalmente, en el capítulo cuatro se detallan las conclusiones más importantes del proyecto; además, se detallan una serie de recomendaciones al momento de aplicar un proyecto de diseño de distribución de planta.Tesi

Satisfacción laboral y clima organizacional en trabajadores de una compañía de radiadores del Distrito de Ate, 2021

El presente estudio tiene por título “Satisfacción laboral y clima organizacional en trabajadores de una compañía de radiadores del Distrito de Ate, 2021”, La investigación fue de tipo cuantitativo, de diseño no experimental, transversal de alcance correlacional. La muestra se conformó por 83 colaboradores de ambos sexos. Para dicho estudio el objetivo fue determinar la relación entre satisfacción laboral y el clima organizacional en los trabajadores de una compañía de radiadores del Distrito de Ate. Los instrumentos que se emplearon fueron: Escala de Comportamiento Organizacional (ECO-50) y Escala de Clima Organizacional (EMCO 10) ambos adaptados por Mg. José Luis Pereyra Quiñones. Los resultados obtenidos indicaron que existe una correlación directa y significativa entre satisfacción laboral y clima organizacional en trabajadores de una compañía de Radiadores del distrito de Ate, con Rho=, 742, mostrando un nivel de significancia igual a 0,000 y un tamaño de efecto de 0.55

Pulmonary Function in Extremely Low Birth Weight Infants with Bronchopulmonary Dysplasia Before Hospital Discharge.

Objective To compare pulmonary function in extremely low birth weight (ELBW) infants with bronchopulmonary dysplasia (BPD) studied at 34–36 weeks postmenstrual age (PMA) with a reference group of “healthy” infants born at 34–36 weeks. We hypothesized that ELBW infants have decreased functional residual capacity (FRC) and respiratory compliance (Crs). Study design Pulmonary function testing was performed at 34–36 weeks PMA in infants with BPD and within 96 h of age in infants delivered at 34–36 weeks. Results Twenty BPD patients and 20 healthy infants were studied. FRC (18.9 versus 26.2 mL/kg; adjusted 95% CI 5.0, 10.9; P \u3c 0.001) and Crs (0.80 versus 1.29-mL/cm H2O/kg; 95% CI 0.31, 0.71; P \u3c 0.001) were decreased in BPD patients. Respiratory resistance was increased in BPD patients. Conclusions ELBW infants with BPD have decreased pulmonary function compared to healthy infants delivered at 34–36 weeks. This suggests that infants with BPD have smaller lung volumes

Pharmacodynamic monitoring of the conversion from mycophenolate mofetil to enteric-coated mycophenolate sodium in stable kidney-allograft recipients.

International audienceBACKGROUND: The formulations of mycophenolic acid, i.e., mycophenolate mofetil (MMF) and enteric-coated mycophenolate sodium (EC-MPS), seem to have different pharmacokinetic profiles. The aim of this study was to compare the effects MMF and EC-MPS on T-cell proliferation, T-cell activation, T-cell function, and lymphocyte subsets. CLINICAL STUDY AND METHODS: Ten stable kidney-transplant patients on standard maintenance therapy of tacrolimus and MMF (1 g/d), with or without steroids, were converted from MMF to EC-MPS at equivalent dose (720 mg/d). Tacrolimus and steroid doses remained unchanged before, and at 1, 2, 3, and 6 months (M) after conversion. Intra T-lymphocyte cytokines IL-2 and TNF-alpha, lymphocyte-activation surface markers (CD25 and CD71), T-cell proliferation (PCNA+ PI(high)), total lymphocyte count, as well as lymphocytes subsets (CD2, CD3, CD4, CD8, CD19, NK cells) were measured by flow cytometry before conversion and at M1, M2, M3, and M6. RESULTS: We found no significant differences of MMF versus EC-MPS on lymphocyte function. T-cell proliferation and T-cell activation (CD25 and CD71 expression), but not cytokine expression (TNF-alpha and IL-2), showed a trend to increase after conversion from MMF to EC-MPS. Total lymphocyte, CD2, CD3, CD4, CD8, and NK cells counts were not significantly modified. CONCLUSION: This study revealed a trend to a lower immunosuppression with EC-MPS as compared to MMF in stable renal transplant patients

A Digital Solution for an Advanced Breast Tumor Board: Pilot Application Cocreation and Implementation Study

BackgroundCancer treatment is constantly evolving toward a more personalized approach based on clinical features, imaging, and genomic pathology information. To ensure the best care for patients, multidisciplinary teams (MDTs) meet regularly to review cases. Notwithstanding, the conduction of MDT meetings is challenged by medical time restrictions, the unavailability of critical MDT members, and the additional administrative work required. These issues may result in members missing information during MDT meetings and postponed treatment. To explore and facilitate improved approaches for MDT meetings in France, using advanced breast cancers (ABCs) as a model, Centre Léon Bérard (CLB) and ROCHE Diagnostics cocreated an MDT application prototype based on structured data. ObjectiveIn this paper, we want to describe how an application prototype was implemented for ABC MDT meetings at CLB to support clinical decisions. MethodsPrior to the initiation of cocreation activities, an organizational audit of ABC MDT meetings identified the following four key phases for the MDT: the instigation, preparation, execution, and follow-up phases. For each phase, challenges and opportunities were identified that informed the new cocreation activities. The MDT application prototype became software that integrated structured data from medical files for the visualization of the neoplastic history of a patient. The digital solution was assessed via a before-and-after audit and a survey questionnaire that was administered to health care professionals involved in the MDT. ResultsThe ABC MDT meeting audit was carried out during 3 MDT meetings, including 70 discussions of clinical cases before and 58 such discussions after the implementation of the MDT application prototype. We identified 33 pain points related to the preparation, execution, and follow-up phases. No issues were identified related to the instigation phase. Difficulties were grouped as follows: process challenges (n=18), technological limitations (n=9), and the lack of available resources (n=6). The preparation of MDT meetings was the phase in which the most issues (n=16) were seen. A repeat audit, which was undertaken after the implementation of the MDT application, demonstrated that (1) the discussion times per case remained comparable (2 min and 22 s vs 2 min and 14 s), (2) the capture of MDT decisions improved (all cases included a therapeutic proposal), (3) there was no postponement of treatment decisions, and (4) the mean confidence of medical oncologists in decision-making increased. ConclusionsThe introduction of the MDT application prototype at CLB to support the ABC MDT seemed to improve the quality of and confidence in clinical decisions. The integration of an MDT application with the local electronic medical record and the utilization of structured data conforming to international terminologies could enable a national network of MDTs to support sustained improvements to patient care

Cytokines correlate with age in healthy volunteers, dialysis patients and kidney-transplant patients.

International audienceT-cell functions are currently used as biomarkers for the pharmacodynamic monitoring of immunosuppressive drugs or as disease biomarkers of inflammation/sepsis and organ rejection. In order to evaluate co-factors potentially influencing the expression of the immunological biomarkers, we explored T-cell proliferation, T-cell activation (CD25 and CD71 expressions) and intra-lymphocyte cytokine production (interleukin (IL)-2 and tumor necrosis factor (TNF)-alpha) in healthy volunteers, dialysis patients and stable kidney-transplant patients treated with standard immunosuppressive therapy, i.e. tacrolimus, mycophenolic acid with or without steroids. Age was positively correlated with TNF-alpha expression in all three patient populations, and with IL-2 expression in healthy volunteers and kidney-transplant patients. Further age was correlated with inhibition of lymphocyte proliferation in healthy volunteers and with the T-cell activation marker CD25 in kidney-transplant patients. In healthy volunteers lymphocyte proliferation was higher in woman as compared to men. Other biomarkers of T-cell function were independent of the gender. In the kidney-transplant patient group a significantly lower expression of all biomarkers of T-cell functions compared to healthy volunteers and dialysis patients. In dialysis patients we found significant increased IL-2 expression compared to healthy volunteers, while the other T-cell functions were not significantly different. Further time on dialysis had no effect on the level of biomarker expression. In conclusion we found decreased T-cell functions in kidney-transplant patients compared to healthy volunteers and dialysis patients, increased IL-2 expression in dialysis patients compared to healthy volunteers and in all three populations we found a correlation of age and intra-T-lymphocyte TNF-alpha expression