Características y trascendencia comercial de los Baby Boomers en el marketing digital

El presente trabajo tiene como tema a investigar las características y trascendencia comercial de los Baby Boomers en el Marketing Digital, teniendo como principal objetivo describir los factores que intervienen en la conducta de compra de los Baby Boomers a través de medios online. Para esto, la metodología empleada fue realizada a través de una muestra arbitraria. La investigación es de carácter descriptiva explicativa no experimental, puesto que, no se manipularon los datos, teniendo un enfoque cualitativo. En conclusión, resaltamos que, en cuanto a la cultura de consumo de los Baby Boomers, esta generación no se encuentra muy familiarizada con las compras en linea, a diferencia de posteriores generaciones. Las principales características y trascendencia de este grupo en el Marketing digital es que el 60% de ellos, mantiene presencia en redes sociales, principalmente los del NSE A y B, ya que están más familiarizados a la tecnología, mientras que el sector C y D necesita de apoyo de terceros. Una referencia concisa de esta generación en el boom digital, es que, en Europa esta generación tiene el 70% de la riqueza, en EE.UU. este sector representa el 40% de población activa, y en el Perú alrededor del 40.5% están familiarizados con el ecommerce. Por otro lado, un factor tecnológico que permiten su adaptación, es la experiencia del consumidor en plataformas sencillas, siendo los aspectos psicológicos y motivadores como la misma necesidad de evolucionar y adaptarse a estos medios para obtener información de productos o servicios referidos a salud, familia y economía.Trabajo de investigaciónCampus Lima Centr

Experiencia con Telaprevir en una corte de pacientes monoinfectados y coinfectados en un hospital de tercer nivel

Objetivos: avaluar tasas de respuestas y seguridad, a las 24 semanas del inicio de tratamiento, en pacientes monoinfectados por VHC y coinfectados VIH/VHC con Telaprevir.Objectius: avaluar taxes de respostes i seguretat, a les 24 setmanes de l'inici de tractament, en pacients monoinfectados per VHC i coinfectados VIH/VHC amb Telaprevir. Mètodes: estudi descriptiu transversal dels malalts mono i coinfectados (tant "naive", recaedores, no respondedores i respondedores parcials), tractats amb Telaprevir en una Unitat de Malalties Infeccioses. Es van arreplegar les dades demogràfiques de cada malalt, dades analítiques, immunològics i virológicos així com la determinació de polimorfisme IL B28. S'arrepleguen dades basals i a les 4, 8, 12 i 24 setmanes. Resultats: un total de 43 malalts analitzats que van iniciar tractament amb Telaprevir. Completen tractament fins 12 setmanes els 43, i fins a la setmana 24 amb Peginterferon i Rivabirina un total de 35 malalts. Un 48% eren malalts monoinfectados i un 51% coinfectados VIH-VHC. Un 80% eren hòmens i un 20% dones, amb una edat mitjana de 52 +/- 8'7 anys. A les 12 setmanes, un 76% dels pacients monoinfectados i un 86% dels coinfectados tenien indetectable VHC, i a les 24 setmanes un 86% dels monoinfectados i un 90% dels coinfectados,Experiencia con Telaprevir en una corte de pacientes monoinfectados y coinfectados en unhospital de tercer nivel mantenien resposta viral en tractament, sense ser estes diferències estadísticament significatives. De la mateixa manera no es van trobar diferències estadísticament significatives en les proporcions d'efectes secundaris. Conclusions: l'efectivitat i la seguretat del tractament amb triple teràpia que inclou Teleprevir en la infecció crònica de VHC, són semblants en malalts monoinfectados i coinfectados

Estudio sobre el aprendizaje basado en problemas y su contribución al desarrollo de habilidades para el uso de las pruebas de hipótesis en los estudiantes del curso de Estadística Inferencial de las carreras de ingeniería de una universidad privada de lima, durante el periodo 2020-I

El presente estudio tiene como objetivo explicar la contribución del aprendizaje basado en problemas en el desarrollo de las habilidades para el uso de las pruebas de hipótesis en los estudiantes del curso de estadística inferencial de las carreras de ingeniería de una Universidad Privada de Lima, durante el periodo 2020-I. El presente trabajo de investigación fundamenta su relevancia para clases presenciales y no presenciales brindando resultados positivos de la aplicación de la misma, aportando a la sociedad una herramienta adicional de comunicació efectiva para la transmisión de información importante. La presente investigación se inició el 2019, antes de la crisis ocasionada por Covid-19. A inicios del año 2020 culminamos la elaboración del planteamiento del problema, marco teórico y la metodología, es decir los tres primeros capítulos del trabajo de investigación. La aplicación de los instrumentos se realizó en el mes de julio del 2020 en una universidad privada de Lima, en el marco del estado de emergencia decretado por el ejecutivo, por lo que fue necesario recopilar la información a través de una plataforma virtual, en una clase del curso de estadística inferencial de las carreras de ingeniería, en la que se aplicó la metodología del ABP. La muestra por conveniencia está conformada por diez estudiantes varones y mujeres, con edades entre veintitrés y veintiocho años, la mayoría de ellos; otro grupo de 31 a 34 años y un alumno de 47 años, matriculados en el turno noche en el curso de estadística inferencial. La metodología empleada desarrolla el enfoque cualitativo porque se centra en hechos, análisis lógicos y procesos inductivos. La recolección de la información es no estandarizada, debido a que no sigue un patrón o guía, si no que consiste en recopilar experiencias y opiniones de los estudiantes. El alcance es explicativo porque analiza y sintetiza los fenómenos. El diseño es fenomenológico porque se describe y explica un fenómeno, a partir de las experiencias y percepciones de los estudiantes. Los resultados mostraron que el aprendizaje basado en problemas sí contribuye al desarrollo de las habilidades para el uso de las pruebas de hipótesis de una media, una proporción y dos proporciones. Se concluye que la aplicación de la estrategia del ABP, mejoró el nivel de conocimiento sobre el contraste estadístico de hipótesis.The present study is to explain how problem-based learning contributes to the development of skills for the use of hypothesis tests in students of the IV cycle of engineering careers of a private university in Lima, during the period 2020-I. This research work bases its relevance for face-to-face and non-face-to-face classes by providing positive results from its application, providing society with an additional effective communication tool for the transmission of important information. This investigation began in 2019, before the crisis caused by Covid-19. At the beginning of 2020, we completed the elaboration of the problem statement, theoretical framework, and methodology. The application of the instruments was carried out in July 2020 at a private university in Lima, during the State of Emergency decreed by the government, it was necessary to collect the information through a virtual platform, in a class in the Inferential statistics course for engineering careers, in which the ABP methodology was applied. The convenience sample is made up of ten students, some are male, and others are female. Most of them are between twenty-three and twenty-eight years. But one of the students is forty-seven years. Everybody is registered in the night shift in the IV cycle Inferential Statistics course. The methodology used develops the qualitative approach because it focuses on facts, logical analysis, and inductive processes. The data collection is not standardized, this means that it does not follow a pattern or guide, but rather that it consists of obtaining the students points of view. The scope is explanatory because it analyzes and synthesizes the phenomena. The design is phenomenological because a phenomenon is described and explained, based on the experiences and perceptions of the students. The results showed that problem-based learning does contribute to the development of skills for the use of hypothesis tests of one mean, one proportion and two proportions. It is concluded that the application of the ABP strategy improved the level of knowledge about the statistical contrast of hypotheses.Escuela de Postgrad

Combining scales to assess suicide risk

Authors posting Accepted Author Manuscript online should later add a citation for the Published Journal Article indicating that the Article was subsequently published, and may mention the journal title provided they add the following text at the beginning of the document: “NOTICE: this is the author’s version of a work that was accepted for publication in Journal of Cardiovascular Echography. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Psychiatric Research, [VOL#, ISSUE#, (DATE)] DOI#”A major interest in the assessment of suicide risk is to develop an accurate instrument, which could be easily adopted by clinicians. This article aims at identifying the most discriminative items from a collection of scales usually employed in the assessment of suicidal behavior. Methods: The answers to the Barrat Impulsiveness Scale, International Personality Disorder Evaluation Screening Questionnaire, BrowneGoodwin Lifetime History of Aggression, and Holmes & Rahe Social Readjustment Rating Scale provided by a group of 687 subjects (249 suicide attempters, 81 non-suicidal psychiatric inpatients, and 357 healthy controls) were used by the Lars-en algorithm to select the most discriminative items. Results: We achieved an average accuracy of 86.4%, a specificity of 89.6%, and a sensitivity of 80.8% in classifying suicide attempters using 27 out of the 154 items from the original scales. Conclusions: The 27 items reported here should be considered a preliminary step in the development of a new scale evaluating suicidal risk in settings where time is scarce.This article was supported by the National Alliance for Research on Schizophrenia and Affective Disorders (NARSAD), Fondo de Investigacion Sanitaria (FIS) PI060092, Fondo de Investigacion Sanitaria FIS RD06/0011/0016, ETES (PI07/90207), the Conchita Rabago Foundation, and the Spanish Ministry of Health, Instituto de Salud Carlos III, CIBERSAM (Intramural 521 Project, P91B; SCO/3410/2004)

Embryonic Pig Pancreatic Tissue Transplantation for the Treatment of Diabetes

BACKGROUND: Transplantation of embryonic pig pancreatic tissue as a source of insulin has been suggested for the cure of diabetes. However, previous limited clinical trials failed in their attempts to treat diabetic patients by transplantation of advanced gestational age porcine embryonic pancreas. In the present study we examined growth potential, functionality, and immunogenicity of pig embryonic pancreatic tissue harvested at different gestational ages. METHODS AND FINDINGS: Implantation of embryonic pig pancreatic tissues of different gestational ages in SCID mice reveals that embryonic day 42 (E42) pig pancreas can enable a massive growth of pig islets for prolonged periods and restore normoglycemia in diabetic mice. Furthermore, both direct and indirect T cell rejection responses to the xenogeneic tissue demonstrated that E42 tissue, in comparison to E56 or later embryonic tissues, exhibits markedly reduced immunogenicity. Finally, fully immunocompetent diabetic mice grafted with the E42 pig pancreatic tissue and treated with an immunosuppression protocol comprising CTLA4-Ig and anti–CD40 ligand (anti-CD40L) attained normal blood glucose levels, eliminating the need for insulin. CONCLUSIONS: These results emphasize the importance of selecting embryonic tissue of the correct gestational age for optimal growth and function and for reduced immunogenicity, and provide a proof of principle for the therapeutic potential of E42 embryonic pig pancreatic tissue transplantation in diabetes

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

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Thoracoscopic sympathectomy ganglia ablation in the management of palmer hyperhidrosis: A decade experience in a single institution

Background: Hyperhidrosis can cause significant professional and social handicaps. Surgery is the preferred treatment modality for hyperhidrosis. There has been evolution in the surgical management of hyperhidrosis. This study evaluated the place of minimally invasive surgical approach and its long-term outcome in the management of hyperhidrosis. Patients and Methods: A 10-year prospective study of all children and adolescents who underwent thorascopic sympathectomy at the Schneider Children′s Hospital of Israel. Data were validated for the procedure and analysed for outcome of procedure. Results: There were 148 patients, 66 were males and 82 were females, with a median age of 13.8 SD ± 4.0 years. Two hundred and ninety-six thoracopic sympathectomies were performed with no conversion to open procedure. The mean operation time was 18 min. Ninety-five per cent of the patients were discharged the next day with a mean hospital stay of 1.2 days. Postoperative complications included segmental atelectasis in seven (4.72%) patients, pneumothorax in two (1.35%) and transient unilateral Horner′s syndrome in one (0.67%). Seventy-one (38.8%) experienced some form of compensatory hyperhidrosis. Complete relief of palmer hyperdidrosis was achieved in all patients (mean follow-up = 5.03 ± 1.76 years). The outcome was very satisfactory in 91 (61.5%) and satisfactory in 48 (32.4%). Only nine (6.1%) were not satisfied with the outcome. Conclusion: Thorascopic sympathectomy provides effective and satisfactory cure for palmer hyperhidrosis with acceptable complication rate and excellent satisfactory outcome. There is a possibility of compensatory sweating in some individuals