Auditoría de Gestión y su incidencia en la rentabilidad de la empresa Avícola Virgen del Cisne S.A.C. de la ciudad de Trujillo Año 2015

La investigación realizada tiene como propósito y objetivo en Determinar de qué manera la auditoria de gestión incide en la rentabilidad de la empresa Avícola Virgen del Cisne S.A.C. de la ciudad de Trujillo año 2015., teniendo por población y muestra a la empresa Avícola , para ello se hizo una investigación de las tareas que ejecuta para llevar a cabo el manejo de la empresa Avícola Virgen del Cisne S.A.C., una vez identificadas las actividades de cada trabajador del área de ventas y distribución , se identificó si la propuesta y la investigación es factible en la empresa. En seguida se Identifico las deficiencias actuales de cómo se llevan a cabo las operaciones en la empresa Avícola. Es preciso mencionar que la información se obtuvo a través de la aplicación de la entrevista y a través de la observación directa y análisis documental, herramientas que fueron útiles para la recolección de información, ordenamiento y procesamiento. Por último, la Propuesta de una Auditoria de Gestión incide positivamente en la empresa Avícola en un incremento del 1% en su rentabilidad a comparación del periodo 2014 ya que sería una forma de mantener en orden y llevar un buen control en la empresa para de esta manera mejorar la rentabilidad y generar valor para la empresa en el futuro

Pathologist Concordance for Ovarian Carcinoma Subtype Classification and Identification of Relevant Histologic Features Using Microscope and Whole Slide Imaging.

CONTEXT.—: Despite several studies focusing on the validation of whole slide imaging (WSI) across organ systems or subspecialties, the use of WSI for specific primary diagnosis tasks has been underexamined. OBJECTIVE.—: To assess pathologist performance for the histologic subtyping of individual sections of ovarian carcinomas using a light microscope and WSI. DESIGN.—: A panel of 3 experienced gynecologic pathologists provided reference subtype diagnoses for 212 histologic sections from 109 ovarian carcinomas based on optical microscopy review. Two additional attending pathologists provided diagnoses and also identified the presence of a set of 8 histologic features important for ovarian tumor subtyping. Two experienced gynecologic pathologists and 2 fellows reviewed the corresponding WSI images for subtype classification and feature identification. RESULTS.—: Across pathologists specialized in gynecologic pathology, concordance with the reference diagnosis for the 5 major ovarian carcinoma subtypes was significantly higher for a pathologist reading on a microscope than each of 2 pathologists reading on WSI. Differences were primarily due to more frequent classification of mucinous carcinomas as endometrioid with WSI. Pathologists had generally low agreement in identifying histologic features important to ovarian tumor subtype classification with either an optical microscopy or WSI. This result suggests the need for refined histologic criteria for identifying such features. Interobserver agreement was particularly low for identifying intracytoplasmic mucin with WSI. Inconsistencies in evaluating nuclear atypia and mitoses with WSI were also observed. CONCLUSIONS.—: Further research is needed to specify the reasons for these diagnostic challenges and to inform users and manufacturers of WSI technology

Assessment of Pattern Recognition Using Lasers with CMOS Imaging Arrays

Using CMOS camera arrays and multiple colors of lasers we determined the ability of CMOS imaging arrays to collect images and the feasibility of accurately determining the laser beam strike point through software pattern recognition. The laser and sensor arrays were tested in varying scenarios with variability of distance, angle of incidence, background color, and target regularity used as variables. Initial testing occurred with three different colored lasers on a black and white gridline target to identify the accuracy of the pattern recognition. Once baseline accuracy had been established under near perfect conditions the variables listed above were systematically added and evaluated as to their impact on the ability to accurately locate the laser do on the target. It was anticipated that targets with non-perpendicular angles of incidence would cause the most difficulty with their resulting laser splash that had to be factored into the pattern recognition

Auditoría de Gestión y su incidencia en la rentabilidad de la empresa Avícola Virgen del Cisne S.A.C. de la ciudad de Trujillo Año 2015

La investigación realizada tiene como propósito y objetivo en Determinar de qué manera la auditoria de gestión incide en la rentabilidad de la empresa Avícola Virgen del Cisne S.A.C. de la ciudad de Trujillo año 2015., teniendo por población y muestra a la empresa Avícola , para ello se hizo una investigación de las tareas que ejecuta para llevar a cabo el manejo de la empresa Avícola Virgen del Cisne S.A.C., una vez identificadas las actividades de cada trabajador del área de ventas y distribución , se identificó si la propuesta y la investigación es factible en la empresa. En seguida se Identifico las deficiencias actuales de cómo se llevan a cabo las operaciones en la empresa Avícola. Es preciso mencionar que la información se obtuvo a través de la aplicación de la entrevista y a través de la observación directa y análisis documental, herramientas que fueron útiles para la recolección de información, ordenamiento y procesamiento. Por último, la Propuesta de una Auditoria de Gestión incide positivamente en la empresa Avícola en un incremento del 1% en su rentabilidad a comparación del periodo 2014 ya que sería una forma de mantener en orden y llevar un buen control en la empresa para de esta manera mejorar la rentabilidad y generar valor para la empresa en el futuro

Diagnosis of Necrotizing Fasciitis with Bedside Ultrasound: the STAFF Exam

The early diagnosis of necrotizing fasciitis is often ambiguous. Computed tomography and magnetic resonance imaging, while sensitive and specific modalities, are often time consuming or unavailable. We present a case of necrotizing fasciitis that was rapidly diagnosed using bedside ultrasound evaluating for subcutaneous thickening, air, and fascial fluid (STAFF). We propose the STAFF ultrasound exam may be beneficial in the rapid evaluation of unstable patients with consideration of necrotizing fasciitis, in a similar fashion to the current use of a focused assessment with sonography for trauma exam in the setting of trauma. [West J Emerg Med. 2014;15(1):111–113.

DNA methylation in ductal carcinoma in situ related with future development of invasive breast cancer

Background Ductal carcinoma in situ (DCIS) is a heterogeneous, pre-invasive lesion associated with an increased risk for future invasive ductal carcinoma. However, accurate risk stratification for development of invasive disease and appropriate treatment decisions remain clinical challenges. DNA methylation alterations are early events in the progression of cancer and represent emerging molecular markers that may predict invasive recurrence more accurately than traditional measures of DCIS prognosis. Results We measured DNA methylation using the Illumina HumanMethylation450K array of estrogen-receptor positive DCIS (n = 40) and adjacent-normal (n = 15) tissues from subjects in the New Hampshire Mammography Network longitudinal breast imaging registry. We identified locus-specific methylation differences between DCIS and matched adjacent-normal tissue (95,609 CpGs, Q  0.1) in these cases compared with age-matched subjects without invasive disease. The set of differentially methylated CpG loci associated with disease progression was enriched in homeobox-containing genes (P = 1.3E-09) and genes involved with limb morphogenesis (P = 1.0E-05). In an independent cohort, a subset of genes with progression-related differential methylation between DCIS and invasive breast cancer were confirmed. Further, the functional relevance of these genes’ regulation by methylation was demonstrated in early stage breast cancers from The Cancer Genome Atlas database. Conclusions This work contributes to the understanding of epigenetic alterations that occur in DCIS and illustrates the potential of DNA methylation as markers of DCIS progression

Atypical proliferative (borderline) serous tumor in the brain: A case report

A 59-year-old woman with a remote history of invasive ductal carcinoma of the breast was found on a follow-up computed tomography scan of her brain to have a 1-cm lesion in the right frontal lobe in 2008. In the ensuing years, before her current admission, multiple imaging studies of the brain revealed that the lesion was stable and it was, therefore, interpreted as a small area of encephalomalacia related to a thrombosed cortical vein, a cavernoma, or treated metastatic breast cancer. In 2013, the patient underwent a bilateral salpingo-oophorectomy for ovarian tumors that were diagnosed as bilateral serous cystadenofibromas. A partial omentectomy showed no evidence of implants. In June 2016, the brain lesion was completely excised and diagnosed as an atypical proliferative (borderline) serous tumor. Immunohistochemical staining demonstrated that the tumor cells were immunoreactive for Pax8, WT-1, ER, and CK-7 and negative for Gata-3, PR, TTF-1, CDX-2, Napsin A, and CK-20, which was consistent with that diagnosis. We present a brief review of possible mechanisms to account for this unusual presentation and speculate that the most likely one is exfoliation of fallopian tube epithelial cells into the peritoneal cavity, which then gain access to lymphatics resulting in cells implanting in the brain and subsequently progressing to an atypical proliferative (borderline) serous tumor

Immune checkpoint status and tumor microenvironment in vulvar squamous cell carcinoma

Vulvar squamous cell carcinoma accounts for 5% of cancers of the female genital tract. Current guidelines recommend wide local excision with negative surgical margins as the standard treatment. However, the extent of the tumor-free resection margin after wide local excision is still controversial in many cases. Drugs targeting immune checkpoints such as PD-1 or its ligand PD-L1 have potential clinical utility in these patients. We examined the expression of PD-L1 in tumor cells and immune cells, as well as the proportion of PD-1, CD8, and FOXP3 positive lymphocytes. Twenty-one cases of invasive vulvar squamous cell carcinomas were reviewed. Whole slides of representative formalin-fixed, paraffin-embedded archival material were used for analysis. Odds ratios (OR) and hazard ratios (HR) were used to estimate risk for disease recurrence, overall mortality, and cancer mortality. PD-L1 expression was found in 43% of tumor cells, with higher proportions in intratumoral (67%) and peritumoral (81%) immune cells. OR and HR for disease recurrence and cancer mortality were higher in tumors with higher CD8 expression. OR and HR for overall mortality were also higher in tumors with higher PD-L1 and CD8 expression. In conclusion, nearly half of cases were PD-L1 positive in tumor cells with over two-third of cases demonstrating PD-L1 positivity in immune cells. Immunohistochemical expression of PD-L1 and CD8 could be used to suggest higher risk of disease recurrence, overall mortality, and cancer mortality. Furthermore, our data contributes to the growing evidence that targeting the PD-1/PD-L1 pathway may be beneficial in vulvar squamous cell carcinomas