Proyecto de desarrollo para la elaboración de un estudio de mercado y plan de marketing para la empresa eficensa s.a

El presente trabajo analiza la situación actual de la empresa EFICENSA S.A., para lo cual se desarrolló un estudio de mercado mediante el modelo SERVQUAL, cuyos resultados son favorables respecto a la ventaja diferenciadora que tiene la empresa que es la calidad y el buen servicio. Es necesario reforzar esta imagen mediante estrategias y un adecuado plan de marketing, con el fin de dar a conocer a sus usuarios la principal característica que posee la empresa, que es la de brindar atención oportuna y eficiente

the case of ischemic heart disease in Portugal, 2002–2015

The magnitude of the impact of technological innovations on healthcare expenditure is unclear. This paper estimated the impact of high-technology procedures on public healthcare expenditure for patients with ischemic heart disease (IHD) in Portugal. The Blinder–Oaxaca decomposition method was applied to Portuguese NHS administrative data for IHD discharges during two periods, 2008–2015 vs. 2002–2007 (N = 434,870). We modelled per episode healthcare expenditures on the introduction of new technologies, adjusting for GDP, patient age, and comorbidities. The per episode healthcare expenditure was significantly higher in 2008–2015 compared to 2002–2007 for IHD discharges. The increase in the use of high-technology procedures contributed to 28.6% of this growth among all IHD patients, and to 18.4%, 6.8%, 11.1%, and 29.2% for acute myocardial infarction, unstable angina, stable angina, and other IHDs, respectively. Changes in the use of stents and embolic protection and/or coronary brachytherapy devices were the largest contributors to expenditure growth. High-technology procedures were confirmed as a key driver of public healthcare expenditure growth in Portugal, contributing to more than a quarter of this growth.publishersversionpublishe

Large diversity of nonstandard genes and dynamic evolution of chloroplast genomes in siphonous green algae (Bryopsidales, Chlorophyta)

Chloroplast genomes have undergone tremendous alterations through the evolutionary history of the green algae (Chloroplastida). This study focuses on the evolution of chloroplast genomes in the siphonous green algae (order Bryopsidales). We present five new chloroplast genomes, which along with existing sequences, yield a data set representing all but one families of the order. Using comparative phylogenetic methods, we investigated the evolutionary dynamics of genomic features in the order. Our results show extensive variation in chloroplast genome architecture and intron content. Variation in genome size is accounted for by the amount of intergenic space and freestanding open reading frames that do not show significant homology to standard plastid genes. We show the diversity of these nonstandard genes based on their conserved protein domains, which are often associated with mobile functions (reverse transcriptase/intron maturase, integrases, phage- or plasmid-DNA primases, transposases, integrases, ligases). Investigation of the introns showed proliferation of group II introns in the early evolution of the order and their subsequent loss in the core Halimedineae, possibly through RT-mediated intron loss

Identificacao das necessidades de apoio em pessoas com doenca mental grave utilizando a Escala de Intensidade de Apoios

OBJECTIVE: to characterize the intensity of the support needs of individuals with severe mental illness. METHODS: quantitative and descriptive study that applied the Supports Intensity Scale to a sample comprising 182 individuals. RESULTS: the supports intensity profile identifies groups, individuals, and areas with different needs of support relative to the domains of home living, health, community living, learning, employment, and social living. As a whole, the intensity level of support needs found was low, and the domains with greater needs were employment and social. CONCLUSIONS: identification of the intensity of support needs is helpful in planning integral care and detecting professional training needs. The support provision-centered approach, associated with the person-related outcomes perspective, has been sparsely applied to individuals with mental illness, and this represents the main contribution of the present study. In addition, this study introduces novel approaches to assessment that are both concordant and an innovation in nursing because they might provide a tool for understanding other disabilities.OBJETIVO: caracterizar el perfil de intensidad de necesidades de apoyo de personas con enfermedad mental severa. METODOLOGÍA: cuantitativa desarrollando un estudio descriptivo, utilizando como instrumento la escala de intensidad de apoyos que se aplicó a una muestra de 182 personas. RESULTADOS: el perfil de intensidad de apoyos identifica grupos, personas y áreas con diferentes niveles de necesidades de apoyo en las áreas de vida en el hogar, salud, comunidad, aprendizaje, empleo y vida social. De forma global, el perfil identificado es bajo, mostrando necesidades más elevadas en las áreas de empleo y vida social. CONCLUSIONES: esta identificación ayuda a planificar el cuidado de forma integral permitiendo además identificar necesidades en la formación profesional. Este enfoque centrado en la proporción de apoyos, y relacionado con la perspectiva de resultados referidos a la persona ha sido poco utilizado en personas con enfermedad mental, es ahí donde radica la aportación de este estudio. Además posibilita contar con nuevas formas de valoración que son concordantes y novedosas para la Enfermería porque pueden constituir una herramienta para comprender otras discapacidades.OBJETIVO: caracterizar o perfil da intensidade das necessidades de apoio em indivíduos com doença mental grave. METODOLOGIA: quantitativa, no contexto de um estudo descritivo que utilizou a escala de intensidade de apoios como instrumento, sendo aplicada a amostra constituída por 182 pessoas. RESULTADOS: o perfil de intensidade de apoio identifica grupos, pessoas e áreas com diferentes níveis de necessidades de apoio na vida no lar, saúde, comunidade, aprendizagem, emprego e vida social. De modo geral, o perfil identificado foi de baixa intensidade, sendo que as áreas que apresentaram as maiores necessidades foram aquelas correspondentes a emprego e vida social. CONCLUSÕES: essa identificação contribui para o planejamento do cuidado de modo integral e, além disso, permite a identificação de necessidades na formação profissional. Essa abordagem, centrada na proporção de apoios combinada com a perspectiva de resultados referidos à pessoa, tem sido pouco utilizada no caso de indivíduos com doença mental e nisso consiste a contribuição singular do presente estudo. Além disso, este estudo possibilita a inclusão de novas formas de avaliação que são consistentes e inovadoras na área de enfermagem, porque podem representar uma ferramenta para a compreensão de outras deficiências

Conditional Temporal Attention Networks for Neonatal Cortical Surface Reconstruction

Cortical surface reconstruction plays a fundamental role in modeling the rapid brain development during the perinatal period. In this work, we propose Conditional Temporal Attention Network (CoTAN), a fast end-to-end framework for diffeomorphic neonatal cortical surface reconstruction. CoTAN predicts multi-resolution stationary velocity fields (SVF) from neonatal brain magnetic resonance images (MRI). Instead of integrating multiple SVFs, CoTAN introduces attention mechanisms to learn a conditional time-varying velocity field (CTVF) by computing the weighted sum of all SVFs at each integration step. The importance of each SVF, which is estimated by learned attention maps, is conditioned on the age of the neonates and varies with the time step of integration. The proposed CTVF defines a diffeomorphic surface deformation, which reduces mesh self-intersection errors effectively. It only requires 0.21 seconds to deform an initial template mesh to cortical white matter and pial surfaces for each brain hemisphere. CoTAN is validated on the Developing Human Connectome Project (dHCP) dataset with 877 3D brain MR images acquired from preterm and term born neonates. Compared to state-of-the-art baselines, CoTAN achieves superior performance with only 0.12mm geometric error and 0.07% self-intersecting faces. The visualization of our attention maps illustrates that CoTAN indeed learns coarse-to-fine surface deformations automatically without intermediate supervision.Comment: Accepted by the 26th International Conference on Medical Image Computing and Computer Assisted Intervention, MICCAI 202

Microwave-Assisted Synthesis of Substituted Pyrrolo[2,3-d]pyrimidines

A new synthetic routes to the triaryl pyrrolo[2,3-d]pyrimidines from common 4,6-dichloropyrimidine have been developed. The triarylated compounds are synthesized by three cross-coupling reactions using three different catalysts. The introduction of C-6-aryl was allowed in two step process using Sonogashira conditions followed by intramolecular cyclization and the Suzuki-Miyaura conditions led the C-4 and C-5 diarylation. This sequence allows a flexible approach to the highly arylated pyrrolopyrimidines containing different aryl group

A Systematic Review on the Efficacy of Common Antacid Components

Gastroesophageal Reflux Disease (GERD) is a common health issue worldwide that utilizes antacids to mitigate its symptoms such as chest pains and burning sensations. However, the most common component used in antacids, Aluminum Hydroxide, has a high toxicity level as it builds up in the body. Thus, this study aims to determine whether Alginate, an organic compound, and Calcium Carbonate, which is considered an age-friendly component, are suitable antacid component alternatives to Aluminum Hydroxide in terms of their corresponding Acid Neutralization Capacity (ANC) and adverse effects. The researchers utilized a systematic review approach, guided by the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P), to accomplish the study objectives. The study results suggest that Calcium Carbonate has the highest ANC while Alginate has the second-highest ANC and has fewer adverse effects than placebo. These results support the claim that Alginate and Calcium Carbonate are suitable alternatives to Aluminum Hydroxide

Grape epicatechin conjugates prevent erythrocyte membrane protein oxidation

Epicatechin conjugates obtained from grape have shown antioxidant activity in various systems. However, how these conjugates exert their antioxidant benefits has not been widely studied. We assessed the activity of epicatechin and epicatechin conjugates on the erythrocyte membrane in the presence and absence of a peroxyl radical initiator, to increase our understanding of their mechanisms. Thus, we studied cell membrane fluidity by fluorescence anisotropy measurements, morphology of erythrocytes by scanning electron microscopy, and finally, red cell membrane proteins by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Our data showed that incubation of red cells in the presence of epicatechin derivatives altered membrane fluidity and erythrocyte morphology but not the membrane protein pattern. The presence in the medium of the peroxyl radical initiator 2,2′-azobis(amidinopropane) dihydrochloride (AAPH) resulted in membrane disruptions at all levels analyzed, causing changes in membrane fluidity, cell morphology, and protein degradation. The presence of antioxidants avoided protein oxidation, indicating that the interaction of epicatechin conjugates with the lipid bilayer might reduce the accessibility of AAPH to membranes, which could explain in part the inhibitory ability of these compounds against hemolysis induced by peroxidative insult