Desarrollo de Propuesta de Modelo de Negocio Digital: APLICACIÓN MÓVIL GUANADELIVERY EL SALVADOR.

El presente modelo de negocio tiene como base el desarrollo de una aplicación móvil para las empresas dedicadas a la venta de comida rápida en el Área Metropolitana de San Salvador (en el municipio de Mejicanos y San Salvador). Hoy en día, debido a la emergencia mundial del Covid 19, suscitada a finales del año 2019 y declarada como pandemia en marzo de 2020 (Organización Mundial de la Salud), muchas empresas han utilizado en mayor proporción, los recursos tecnológicos y digitales para poder ofertar sus bienes y servicios a los consumidores. Debido a ello, se diseñó Guanadelivery que, al igual que otras aplicaciones que ya existen en nuestro país, contribuirá a agilizar los procesos de ventas de una manera más rápida y sencilla. En dicho Modelo de Negocio, se enlistan todas y cada una de las características que definirán a la empresa. Entre dichas características se destaca la misión, la visión, los valores a seguir, las metas y los objetivos los cuales se pretende alcanzar. Para considerar la factibilidad y viabilidad del Modelo, se ha tomado como base fundamental, la elaboración de los diferentes planes los cuales se detallan a continuación: Plan Organizacional: En este apartado, se realiza un análisis de la estructura interna de la empresa, detallando todos y cada uno de los procesos (administrativos, con relación al área de Recursos Humanos, Producción y Mercadeo) los cuales son necesarios para llevarse a cabo. No obstante, también se han considerado los recursos disponibles con los que se cuenta, lo cual permitirá optimizar dichos procesos. Plan de Mercadeo: En el cual, se describe el resultado del estudio previo realizado por el equipo de investigación y se analiza de igual forma la situación del entorno actual. Plan de ventas: En él se muestra una proyección de ventas, la cual, permitirá conocer de manera aproximada los ingresos que se estima tener como empresa con base a las posibles ventas realizadas

Scleral Buckling for Primary Retinal Detachment: Outcomes of Scleral Tunnels versus Scleral Sutures

Purpose: There are primarily two techniques for affixing the scleral buckle (SB) to the sclera in the repair of rhegmatogenous retinal detachment (RRD): scleral tunnels or scleral sutures. Methods: This retrospective study examined all patients with primary RRD who were treated with primary SB or SB combined with vitrectomy from January 1, 2015 through December 31, 2015 across six sites. Two cohorts were examined: SB affixed using scleral sutures versus scleral tunnels. Pre- and postoperative variables were evaluated including visual acuity, anatomic success, and postoperative strabismus. Results: The mean preoperative logMAR VA for the belt loop cohort was 1.05 ± 1.06 (Snellen 20/224) and for the scleral suture cohort was 1.03 ± 1.04 (Snellen 20/214, p = 0.846). The respective mean postoperative logMAR VAs were 0.45 ± 0.55 (Snellen 20/56) and 0.46 ± 0.59 (Snellen 20/58, p = 0.574). The single surgery success rate for the tunnel cohort was 87.3% versus 88.6% for the suture cohort (p = 0.601). Three patients (1.0%) in the scleral tunnel cohort developed postoperative strabismus, but only one patient (0.1%) in the suture cohort (p = 0.04, multivariate p = 0.76). All cases of strabismus occurred in eyes that underwent SB combined with PPV (p = 0.02). There were no differences in vision, anatomic success, or strabismus between scleral tunnels versus scleral sutures in eyes that underwent primary SB. Conclusion: Scleral tunnels and scleral sutures had similar postoperative outcomes. Combined PPV/SB in eyes with scleral tunnels might be a risk for strabismus post retinal detachment surgery

Single-Cell Dna Methylome and 3D Multi-Omic Atlas of the Adult Mouse Brain

Cytosine DNA methylation is essential in brain development and is implicated in various neurological disorders. Understanding DNA methylation diversity across the entire brain in a spatial context is fundamental for a complete molecular atlas of brain cell types and their gene regulatory landscapes. Here we used single-nucleus methylome sequencing (snmC-seq3) and multi-omic sequencing (snm3C-seq)1 technologies to generate 301,626 methylomes and 176,003 chromatin conformation–methylome joint profiles from 117 dissected regions throughout the adult mouse brain. Using iterative clustering and integrating with companion whole-brain transcriptome and chromatin accessibility datasets, we constructed a methylation-based cell taxonomy with 4,673 cell groups and 274 cross-modality-annotated subclasses. We identified 2.6 million differentially methylated regions across the genome that represent potential gene regulation elements. Notably, we observed spatial cytosine methylation patterns on both genes and regulatory elements in cell types within and across brain regions. Brain-wide spatial transcriptomics data validated the association of spatial epigenetic diversity with transcription and improved the anatomical mapping of our epigenetic datasets. Furthermore, chromatin conformation diversities occurred in important neuronal genes and were highly associated with DNA methylation and transcription changes. Brain-wide cell-type comparisons enabled the construction of regulatory networks that incorporate transcription factors, regulatory elements and their potential downstream gene targets. Finally, intragenic DNA methylation and chromatin conformation patterns predicted alternative gene isoform expression observed in a whole-brain SMART-seq2 dataset. Our study establishes a brain-wide, single-cell DNA methylome and 3D multi-omic atlas and provides a valuable resource for comprehending the cellular–spatial and regulatory genome diversity of the mouse brain

Brain-Wide Correspondence of Neuronal Epigenomics and Distant Projections

Single-cell analyses parse the brain’s billions of neurons into thousands of ‘cell-type’ clusters residing in different brain structures1. Many cell types mediate their functions through targeted long-distance projections allowing interactions between specific cell types. Here we used epi-retro-seq2 to link single-cell epigenomes and cell types to long-distance projections for 33,034 neurons dissected from 32 different regions projecting to 24 different targets (225 source-to-target combinations) across the whole mouse brain. We highlight uses of these data for interrogating principles relating projection types to transcriptomics and epigenomics, and for addressing hypotheses about cell types and connections related to genetics. We provide an overall synthesis with 926 statistical comparisons of discriminability of neurons projecting to each target for every source. We integrate this dataset into the larger BRAIN Initiative Cell Census Network atlas, composed of millions of neurons, to link projection cell types to consensus clusters. Integration with spatial transcriptomics further assigns projection-enriched clusters to smaller source regions than the original dissections. We exemplify this by presenting in-depth analyses of projection neurons from the hypothalamus, thalamus, hindbrain, amygdala and midbrain to provide insights into properties of those cell types, including differentially expressed genes, their associated cis-regulatory elements and transcription-factor-binding motifs, and neurotransmitter use

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Diagnóstico e estudo da dinâmica socioambiental do Parque Ambiental Bernardo Berneck em Várzea Grande, Região Metropolitana vale do rio Cuiaba

In space-time in which the stone jungles are a reflection of idealizations of the human mind, and that technology an extension of their relationship, nature becomes an escape, not only physical but psychological around the toxic environment of cities. The human being transforms the medium according to your needs, and the same distance from the natural that contributed to the evolution, motivated the existence of urban parks, both for the construction of environmental knowledge, as for leisure. Soon this Article result of theoretical and methodological research and field, tries to reflect the role of Bernardo Berneck Environmental Park in the municipality of Várzea Grande, located in the metropolitan area Vale do Rio Cuiabá, Mato Grosso, Brazil, both as a field of study environmental as organizing agent from space showcasing strengths and weaknesses that should be used so that the government promote the sustainability of this area.En el espacio-tiempo en el que las selvas de piedra son un reflejo de las idealizaciones de la mente humana, y que la tecnología es una extensión de sus relaciones, la naturaleza se convierte en un escape, no solo físico, sino psicológico de todo el contexto tóxico de las ciudades. El ser humano transforma el entorno según sus necesidades, y la misma distancia de lo natural que contribuyó a la evolución, motivó la existencia de parques urbanos, tanto para la construcción del conocimiento ambiental como para el ocio. Por lo tanto, el presente artículo, resultado de una investigación teórico-metodológica y de campo, intenta reflejar el papel del Parque Ambiental Bernardo Berneck en el municipio de Várzea Grande, ubicado en la región metropolitana de Vale do Rio Cuiabá, en Mato Grosso, Brasil, tanto como área de estudio, ambiental como agente organizador del espacio que presenta potencialidades y debilidades que deben ser aprovechadas para que el poder público promueva la sustentabilidad de esta área.  No espazo-tempo no que as selvas de pedra son un reflexo das idealizacións da mente humana e que a tecnoloxía é unha extensión das súas relacións, a natureza convértese nunha fuxida, non só física, senón psicolóxica de todo o contexto tóxico das cidades. O ser humano transforma o ambiente segundo as súas necesidades e a mesma distancia do natural que contribuíu á evolución motivou a existencia de parques urbanos, tanto para a construción de coñecemento ambiental como para o lecer. Polo tanto, o presente artigo, froito de investigacións teórico-metodolóxicas e de campo, intenta reflectir o papel do parque ambiental Bernardo Berneck no concello de Várzea Grande, situado na rexión metropolitana de Vale do Rio Cuiabá, en Mato Grosso, Brasil, como área de estudo ambiental  e como axente organizador do espazo que presenta potenciais e debilidades que se deben empregar para que o poder público promova a sustentabilidade desta área.Em No espaço-tempo no qual as selvas de pedra são o reflexo das idealizações da mente humana, e que a tecnologia uma extensão de suas relações, a natureza se torna uma fuga, não somente física, mas psicológica de todo o contexto tóxicos das cidades. O ser humano transforma o meio de acordo com suas necessidades, e o mesmo distanciamento do natural que contribuiu para a evolução, motivou a existência dos parques urbanos, tanto para a construção do conhecimento ambiental, quanto para o lazer. Logo o presente artigo, resultado de pesquisas teórico-metodológicas e de campo, tenta refletir o papel do Parque Ambiental Bernardo Berneck no município de Várzea Grande, localizado na região metropolitana Vale do Rio Cuiabá, em Mato Grosso, Brasil, tanto como área de estudo ambiental como agente organizador do espaço que apresenta potencialidades e fragilidades que devem ser utilizadas para que o poder público promova a sustentabilidade desta área