Procesos de sostenibilidad del medio ambiente en un Centro comercial

Como estudiantes de economía se busca que dentro en cada industria ya sea grande o pequeña se desarrolle un proceso de sostenibilidad en donde no solo se hace referencia a un crecimiento o desarrollo económico sino a aquellas practicas sociales y ambientales que deben de desarrollar cada una de las empresas, establecimientos, negocios y entidades que impulsan la economía de Colombia. En esta investigación la atención se centró a los centros comerciales como aquellos puntos de grana fluencia de personas, debido a la variedad de productos y servicios que estos ofrecen, lo que hace que sea grandes focos de contaminación y desecho de residuos debido a su actividad económica. Dentro de esta investigación se incorpora lo que es la economía circular como aquella estrategia que busca la reducción de desechos, impulsa el reciclaje, el aprovechamiento eficaz de los recursos naturales, y a su vez ser una gran fuente de empleo. Los centros comerciales además de proporcionar a sus clientes o visitantes variedad en productos y servicios, son responsables de educar a la población sobre el adecuado desecho de los residuos a fin de utilizar al máximo la vida útil de cada uno de estos. La investigación se centra en nueve centros comerciales ubicados en la ciudad de Bogotá y sus alrededores como centro mayor, gran estación, Plaza de las Américas, Centro Suba, Galerías, Palatino, Fontanar y centro Chía, quienes han compartido como sus estrategias de sostenibilidad ambiental, para marcar un impacto positivo en el desarrollo, económico, social y ambiental de Colombia.As economics students, it is sought that within each industry, whether large or small, a sustainability process is developed where reference is not only made to economic growth or development but also to those social and environmental practices that each of the companies must develop. companies, establishments, businesses and entities that promote the economy of Colombia. In this research, attention was focused on shopping centers as those points of great influx of people, due to the variety of products and services that they offer, which makes them large sources of pollution and waste disposal due to their economic activity. Within this research, what is the circular economy is incorporated as a strategy that seeks to reduce waste, promotes recycling, the effective use of natural resources, and in turn be a great source of employment. The shopping centers, in addition to providing their customers or visitors with a variety of products and services, are responsible for educating the population on the proper disposal of waste in order to make the most of the useful life of each of these. The research focuses on nine shopping centers located in the city of Bogotá and its surroundings such as the main center, the large station, Plaza de las Americas, Centro Suba, Gallerias, Palatino, Fontana and Centro Chía, who have shared their environmental sustainability strategies, to mark a positive impact on the development, economic, social and environmental of Colombi

Family Pet : supermercado para mascotas.

El objetivo principal de la presente tesis, es desarrollar una propuesta diferente ante una necesidad presente en muchas familias que cuentan con una mascota en casa, logrando superar de esta manera sus expectativas dentro de un mercado aún poco desarrollado. La mascota es considerada hoy en día un miembro importante dentro de cada familia, que está siempre brindando amor, cariño y buenos momentos; razón suficiente para que quienes comparten con ella deseen retribuirle en algo todo lo que les da. En la actualidad existen centros veterinarios y pet shops que ofrecen una gama limitada de productos y servicios, los mismos que no se encuentran integrados en un solo lugar; motivo por el cual se plantea una visionaria idea de negocio que es la de crear un supermercado para mascotas llamado “Family Pet”, que buscará ingresar al mercado limeño ofreciendo además de integración de productos y servicios, una gran variedad y calidad. El enfoque comercial del presente proyecto se centrará en el análisis del estudio de mercado realizado tanto para conocer al público objetivo, como para desarrollar estrategias promocionales y acciones post – venta, adecuadas. Para tal fin, se realizaron 584 encuestas a diferentes personas de los seis distritos considerados de nuestra zona geográfica objetiva: Miraflores, San Isidro, Magdalena, San Borja, Surco y La Molina; a partir de los resultados se obtuvo que un 97 % de los encuestados corrobora la necesidad de crear un lugar como Family Pet, lo que fortalece la propuesta de negocio planteada. Dentro del plan de operaciones del negocio, se graficarán los flujos de los procesos claves como comercialización de productos, servicio de baños y cortes, atención veterinaria, servicio de delivery y servicios de información. Asimismo se estructurará un sistema de reabastecimiento como apoyo a las actividades operacionales del negocio. Concluyendo el plan operativo, se validará el costeo del proyecto mediante la evaluación de cotizaciones provenientes de diferentes proveedores. Finalmente, la evaluación económica del proyecto permitirá conocer la viabilidad del negocio, de esta manera la elaboración del Balance General preliminar, brindará información acerca del nivel de inversión del capital de trabajo y activo fijo necesario para ejecutar el proyecto. Adicionalmente, se realizará un análisis financiero, comenzando con la elaboración del Estado de Ganancias y Pérdidas, el flujo de caja y por último, la elaboración de un análisis de sensibilización. Con toda esta información analizada se logrará obtener un diagnostico sincerado de la viabilidad del proyecto.Tesi

COMPARAÇÃO DO USO DE IECA E BRA EM PACIENTES COM INSUFICIÊNCIA CARDÍACA – REVISÃO INTEGRATIVA

This study compared the efficacy of Angiotensin Converting Enzyme Inhibitors (ACEI) and Angiotensin Receptor Blockers in heart failure for clinical stability outcomes, hospital admissions and deaths. Randomized clinical trials were searched in the Cochrane, PubMed and LILACS databases. A total of 1,789 references were collected and 8 were fully analyzed, totaling 9,447 patients. The results found were: enalapril reduced deaths and hospitalizations at low and target doses; perindopril reduced hospitalization (HR 0.628; 95% CI 0.408–0.966; P=0.033), mortality (HR 0.98; CI (0.63; 1.53) P=0.928) and functional class (P 0.030); candesartana reduced mortality and recurrent hospitalizations. ACE inhibitors reduced the number of deaths, in percentage and according to the therapeutic follow-up: 14% (full), 57% (discontinuation) and 35% (placebo). Thus, the results demonstrate therapeutic equivalence between the pharmacological groups analyzed in HF.  Esse estudo comparou a eficácia dos Inibidores da Enzima Conversora de Angiotensina (IECA) e Bloqueadores dos Receptores de Angiotensina, na Insuficiência Cardíaca para os desfechos estabilidade clínica, internações hospitalares e óbitos. Realizou-se buscas de ensaios clínicos randomizados nas bases de dados Cochrane, PubMed e LILACS. Foram coletadas 1.789 referências e 8 foram analisadas na íntegra, totalizando 9.447 pacientes. Os resultados encontrados foram: enalapril reduziu óbitos e internações em doses baixas e alvo; perindopril reduziu hospitalização (HR 0,628; IC 95% 0,408–0,966; P=0,033), mortalidade (HR 0,98; IC (0,63; 1,53) P=0,928) e classe funcional (P 0,030); candesartana reduziu mortalidade e internações recorrentes. Os IECA reduziram o número de óbitos, em percentagem e de acordo com o seguimento terapêutico: 14%(plena), 57%(descontinuação) e 35%(placebo). Assim, os resultados demonstram equivalência terapêutica entre os grupos farmacológicos analisados na IC. &nbsp

Sophisticated viral quasispecies with a genotype-related pattern of mutations in the hepatitis B X gene of HBeAg-ve chronically infected patients

Haplotipos; Enfermedades infecciosas; MutaciónHaplotips; Enfermetats infeccioses; MutacióHaplotypes; Infectious diseases; MutationPatients with HBeAg-negative chronic infection (CI) have not been extensively studied because of low viremia. The HBx protein, encoded by HBX, has a key role in viral replication. Here, we analyzed the viral quasispecies at the 5′ end of HBX in CI patients and compared it with that of patients in other clinical stages. Fifty-eight HBeAg-negative patients were included: 16 CI, 19 chronic hepatitis B, 16 hepatocellular carcinoma and 6 liver cirrhosis. Quasispecies complexity and conservation were determined in the region between nucleotides 1255 and 1611. Amino acid changes detected were tested in vitro. CI patients showed higher complexity in terms of mutation frequency and nucleotide diversity and higher quasispecies conservation (p < 0.05). A genotype D-specific pattern of mutations (A12S/P33S/P46S/T36D-G) was identified in CI (median frequency, 81.7%), which determined a reduction in HBV DNA release of up to 1.5 log in vitro. CI patients showed a more complex and conserved viral quasispecies than the other groups. The genotype-specific pattern of mutations could partially explain the low viremia observed in these patients.This study was supported by grants from the Institute of Health Carlos III (grant PI15/00856 and PI18/01436) and co-financed by the European Regional Development Fund (ERDF)

Bioética. El final de la vida y las voluntades anticipadas

Esta obra contiene textos elaborados por investigadores de diferentes áreas del conocimiento: medicina, filosofía, derecho, entre otras especialidades, pertenecientes a distintos países: España, Chile y México. El objetivo principal de este libro es servir de referente teórico a otros investigadores de bioética, y especialmente a los que son o desean estar especializados en la comprensión del final de la vida y las voluntades anticipadas en el ámbito sanitario en cualquier país del mundo

Safety and immediate humoral response of COVID-19 vaccines in chronic kidney disease patients:the SENCOVAC study

BACKGROUND: Chronic kidney disease (CKD) patients are at high-risk for severe Covid-19. The multicentric, observational and prospective SENCOVAC study aims to describe the humoral response and safety of SARS-CoV-2 vaccines in CKD patients. Safety and immediate humoral response results are reported here. METHODS: Four cohorts of patients were included: kidney transplant (KT) recipients, haemodialysis (HD), peritoneal dialysis (PD) and non-dialysis CKD patients from 50 Spanish centres. Adverse events after vaccine doses were recorded. At baseline and on day 28 after the last vaccine dose, anti-Spike antibodies were measured and compared between cohorts. Factors associated with development of anti-Spike antibodies were analyzed. RESULTS: 1746 participants were recruited: 1116 HD, 171 PD, 176 non-dialysis CKD patients and 283 KT recipients. Most patients (98%) received mRNA vaccines. At least one vaccine reaction developed after the first dose in 763 (53.5%) and after the second dose in 741 (54.5%) of patients. Anti-Spike antibodies were measured in the first 301 patients. At 28 days, 95% of patients had developed antibodies: 79% of KT, 98% of HD, 99% of PD and 100% of non-dialysis CKD patients (p<0.001). In a multivariate adjusted analysis, absence of an antibody response was independently associated to KT (OR 20.56, p = 0.001) and to BNT162b2 vaccine (OR 6.03, p = 0.023). CONCLUSION: The rate of anti-Spike antibody development after vaccination in KT patients was low but in other CKD patients it approached 100%; suggesting that KT patients require persistent isolation measures and booster doses of a Covid-19 vaccine. Potential differences between Covid-19 vaccines should be explored in prospective controlled studies

Dietary Iron, Anemia Markers, Cognition, and Quality of Life in Older Community-Dwelling Subjects at High Cardiovascular Risk

Anemia causes hypo-oxygenation in the brain, which could lead to cognitive disorders. We examined dietary iron intake as well as anemia markers (i.e., hemoglobin, hematocrit, mean corpuscular volume) and diabetes coexistence in relation to neuropsychological function and quality of life. In this study, 6117 community-dwelling adults aged 55-75 years (men) and 60-75 years (women) with overweight/obesity and metabolic syndrome were involved. We performed the Mini-Mental State Examination (MMSE), the Trail Making Test parts A and B (TMT-A/B), Semantic Verbal Fluency of animals (VFT-a), Phonological Verbal Fluency of letter P (VFT-p), Digit Span Test (DST), the Clock Drawing Test (CDT), and the Short Form-36 Health Survey (SF36-HRQL test). Dietary iron intake did not influence neuropsychological function or quality of life. However, anemia and lower levels of anemia markers were associated with worse scores in all neurophysiological and SF36-HRQL tests overall, but were especially clear in the MMSE, TMT-B (cognitive flexibility), and the physical component of the SF36-HRQL test. The relationships between anemia and diminished performance in the TMT-A/B and VFT tasks were notably pronounced and statistically significant solely among participants with diabetes. In brief, anemia and reduced levels of anemia markers were linked to inferior cognitive function, worse scores in different domains of executive function, as well as a poorer physical, but not mental, component of quality of life. It was also suggested that the coexistence of diabetes in anemic patients may exacerbate this negative impact on cognition. Nevertheless, dietary iron intake showed no correlation with any of the outcomes. To make conclusive recommendations for clinical practice, our findings need to be thoroughly tested through methodologically rigorous studies that minimize the risk of reverse causality