Proyecto Freya

El presente proyecto “Freya Perú” fue diseñado a partir de la necesidad que tiene el público femenino respecto al cuidado de su cabello y el daño que ocasionan los shampoos líquidos con una formulación a base de químicos, sulfatos y tensioactivos dañinos para el cuero cabelludo. A partir de esta necesidad se formula la presente idea de negocio, un shampoo en barra a base de insumos peruanos y naturales; elaborados de manera artesanal, que busca cuidar, y proteger la belleza de las mujeres peruanas.   La finalidad de esta tesis es desarrollar un modelo de negocio innovador que permita contribuir de manera sostenible a la sociedad, de tal manera que se pueda hacer frente a los competidores potenciales del mercado peruano; a través, de diferentes estrategias enfocadas en optimizar nuestros procesos logrando posicionar a la empresa, así como aumentar su participación de mercado y captar clientes de manera efectiva. De tal manera, se han desarrollado los siguientes planes: Estratégico, Operativo, Marketing, Recursos Humanos, Responsabilidad Social, Plan Financiero y de Financiamiento. Para desarrollar y mantener este emprendimiento se necesita de una inversión inicial de S/. 57,167.71; no obstante, según las proyecciones financieras este proyecto genera valor para los inversionistas logrando un VAN de S/. 37,239.59, con flujos de caja libre descontados en el primer año de - S/. 14,823.19, S/. 13,920.62, S/. 15,457.26 para el segundo y tercer año, finalmente se logra obtener S/. 24,609 y S/. 37,757.39 para el cuarto y quinto año.This project, named “Freya Peru”, was designed based on the necessity to repair the damage caused by liquid shampoos. More specifically, those with chemical formulation, sulfates and surfactants which are harmful to the scalp. It is this need that is the basis of this business idea. A Shampoo Bar based on natural Peruvian inputs whose formula is handcrafted, which seeks to take care of and protect the beauty of Peruvian women.     The purpose of this thesis is to develop an innovative business model that will make a sustainable contribution to society, in such a way that potential competitors in the Peruvian Market can be faced. We will do as much through different strategies focused on optimizing our processes, managing company position in the marketplace, as well as increasing market share by attracting customers effectively. In this way, the following plans have been developed: Strategic, Operational, Marketing, Human Resources, Social Responsibility, Financial and Financing Plan.   To develop and maintain this entrepreneurship, needs an initial investment of S/. 57,167.71; however, according to the financial projections, this project generates value for investors by achieving an NPV of S/. 37,239.59, with free cash flows discounted in the first year of - S/. 14,823.19, S/. 13,920.62, S/. 15,457.26 for the second and third years, it finally achieves S/. 24,609 and S/. 37,757.39 for the fourth and fifth years.Trabajo de investigació

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

Teamwork and the relationship with job performance of employees of banking companies in Lima Metropolitana, 2021

A través del tiempo, se ha evidenciado la importancia del desempeño laboral en una organización, ya que es fundamental para evaluar a los empleados en su funcionamiento y rendimiento en la empresa; asimismo, en la actualidad, son cada vez más las organizaciones que consideran al trabajo en equipo importante para el logro de los objetivos. Por ello, la presente investigación pretende determinar la relación del trabajo en equipo con el desempeño laboral de los empleados de las empresas bancarias en Lima Metropolitana, año 2021. La presente investigación está compuesta por cinco capítulos; en primer lugar, en el Capítulo I, se desarrolló el marco teórico de las variables Trabajo en Equipo y Desempeño Laboral. En el Capítulo II, se exploró la evolución de la literatura de nuestras variables y se expuso los principales hallazgos. En el Capítulo III, se desarrolló la metodología de investigación, así como el instrumento y la muestra a utilizar para la obtención de la información. En el Capítulo IV, se desarrolló y analizó los resultados obtenidos de las respuestas de los empleados de las empresas bancarias a los cuestionarios, en donde se obtuvo una correlación positiva media de 0.284 entre el Trabajo en Equipo y el Desempeño Laboral. En el Capítulo V, se expresó las conclusiones y recomendaciones de la presente investigación; siendo la principal conclusión que se determina la existencia de una relación positiva del Trabajo en Equipo con el Desempeño Laboral de los empleados de las empresas bancarias en Lima Metropolitana, año 2021.Over time, the importance of job performance in an organization has become evident, since it is fundamental to evaluate employees in their functioning and performance in the company; likewise, nowadays, there are more and an increasing number of organizations that consider teamwork important for the achievement of objectives. Therefore, this research aims to determine the relationship between teamwork and job performance of employees of banking companies in Lima Metropolitana, 2021. The present research is composed of five chapters; first, in Chapter I, the theoretical framework of the variables Teamwork and Job Performance was developed. In Chapter II, the literature evolution of our variables was explored, and the main findings were presented. In Chapter III, the research methodology was developed, as well as the instrument and the sample to be used to obtain the information. In Chapter IV, the results obtained from the answers of the employees of the banking companies to the questionnaires were developed and analyzed, where a positive medium correlation of 0.284 was obtained between Teamwork and Job Performance. In Chapter V, the conclusions and recommendations of this research were expressed; the main conclusion being that there is a positive relationship between Teamwork and Job Performance of the employees of the banking companies in Lima Metropolitana, 2021.Tesi

Effect of SGLT2 Inhibitors on Stroke and Atrial Fibrillation in Diabetic Kidney Disease: Results From the CREDENCE Trial and Meta-Analysis

BACKGROUND AND PURPOSE: Chronic kidney disease with reduced estimated glomerular filtration rate or elevated albuminuria increases risk for ischemic and hemorrhagic stroke. This study assessed the effects of sodium glucose cotransporter 2 inhibitors (SGLT2i) on stroke and atrial fibrillation/flutter (AF/AFL) from CREDENCE (Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation) and a meta-analysis of large cardiovascular outcome trials (CVOTs) of SGLT2i in type 2 diabetes mellitus.METHODS: CREDENCE randomized 4401 participants with type 2 diabetes mellitus and chronic kidney disease to canagliflozin or placebo. Post hoc, we estimated effects on fatal or nonfatal stroke, stroke subtypes, and intermediate markers of stroke risk including AF/AFL. Stroke and AF/AFL data from 3 other completed large CVOTs and CREDENCE were pooled using random-effects meta-analysis.RESULTS: In CREDENCE, 142 participants experienced a stroke during follow-up (10.9/1000 patient-years with canagliflozin, 14.2/1000 patient-years with placebo; hazard ratio [HR], 0.77 [95% CI, 0.55-1.08]). Effects by stroke subtypes were: ischemic (HR, 0.88 [95% CI, 0.61-1.28]; n=111), hemorrhagic (HR, 0.50 [95% CI, 0.19-1.32]; n=18), and undetermined (HR, 0.54 [95% CI, 0.20-1.46]; n=17). There was no clear effect on AF/AFL (HR, 0.76 [95% CI, 0.53-1.10]; n=115). The overall effects in the 4 CVOTs combined were: total stroke (HRpooled, 0.96 [95% CI, 0.82-1.12]), ischemic stroke (HRpooled, 1.01 [95% CI, 0.89-1.14]), hemorrhagic stroke (HRpooled, 0.50 [95% CI, 0.30-0.83]), undetermined stroke (HRpooled, 0.86 [95% CI, 0.49-1.51]), and AF/AFL (HRpooled, 0.81 [95% CI, 0.71-0.93]). There was evidence that SGLT2i effects on total stroke varied by baseline estimated glomerular filtration rate (P=0.01), with protection in the lowest estimated glomerular filtration rate (&lt;45 mL/min/1.73 m2]) subgroup (HRpooled, 0.50 [95% CI, 0.31-0.79]).CONCLUSIONS: Although we found no clear effect of SGLT2i on total stroke in CREDENCE or across trials combined, there was some evidence of benefit in preventing hemorrhagic stroke and AF/AFL, as well as total stroke for those with lowest estimated glomerular filtration rate. Future research should focus on confirming these data and exploring potential mechanisms. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02065791

Kidney and Cardiovascular Effects of Canagliflozin According to Age and Sex: A Post Hoc Analysis of the CREDENCE Randomized Clinical Trial

Rationale &amp; Objective: It is unclear whether the effect of canagliflozin on adverse kidney and cardiovascular events in those with diabetic kid-ney disease varies by age and sex. We assessed the effects of canagliflozin among age group categories and between sexes in the Canagli-flozin and Renal Endpoints in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE) study.Study Design: Secondary analysis of a random-ized controlled trial. Setting &amp; Participants: Participants in the CREDENCE trial. Intervention: Participants were randomly assigned to receive canagliflozin 100 mg/d or placebo.Outcomes: Primary composite outcome of kid-ney failure, doubling of serum creatinine con-centration, or death due to kidney or cardiovascular disease. Prespecified secondary and safety outcomes were also analyzed. Out-comes were evaluated by age at baseline (&lt;60, 60-69, and &gt;_70 years) and sex in the intention-to-treat population using Cox regression models.Results: The mean age of the cohort was 63.0 &amp; PLUSMN; 9.2 years, and 34% were female. Older age and female sex were independently associ-ated with a lower risk of the composite of adverse kidney outcomes. There was no evidence that the effect of canagliflozin on the primary outcome (acomposite of kidney failure, a doubling of serum creatinine concentration, or death from kidney or cardiovascular causes) differed between age groups (HRs, 0.67 [95% CI, 0.52-0.87], 0.63 [0.4 8-0.82], and 0.89 [0.61-1.29] for ages &lt;60, 60-69, and &gt;_70 years, respectively; P = 0.3 for interaction) or sexes (HRs, 0.71 [95% CI, 0.5 4-0.95] and 0.69 [0.56-0.8 4] in women and men, respectively; P = 0.8 for interaction). No differences in safety outcomes by age group or sex were observed.Limitations: This was a post hoc analysis with multiple comparisons.Conclusions: Canagliflozin consistently reduced the relative risk of kidney events in people with diabetic kidney disease in both sexes and across age subgroups. As a result of greater background risk, the absolute reduction in adverse kidney outcomes was greater in younger participants.Funding: This post hoc analysis of the CREDENCE trial was not funded. The CREDENCE study was sponsored by Janssen Research and Development and was conducted collaboratively by the sponsor, an academic-led steering committee, and an academic research organization, George Clinical.Trial Registration: The original CREDENCE trial was registered at ClinicalTrials.gov with study number NCT02065791