Service Pet 360

El presente proyecto consiste en un modelo de negocio para la creación de una empresa llamada Service Pet 360 que unifica los servicios principales para atender a perros y gatos, los cuales abarcan servicios de salud, alimentación, entretenimiento, etc. que llegará al cliente mediante una página web donde se podrán encontrar diferentes empresas reconocidas que trabajan con calidad y compromiso para la total seguridad de nuestros clientes (perros y gatos), de esta forma le otorgamos a nuestros usuarios (dueños de mascotas) la posibilidad de escoger entre una cartera de opciones de atención, productos de la más alta calidad y que se encuentren cerca de su ubicación. Como hemos visto en la actualidad este rubro del cuidado personalizado a las mascotas se ha incrementado de manera significativa y ha tenido buena acogida en el mercado, ya que muchas más personas dedican más que su tiempo una inversión en sus mascotas. Ante ello nace la oportunidad de que Service Pet 360 pueda satisfacer las diferentes necesidades de estas personas y que ayuden a que otros negocios que son nuestros socios estratégicos se den a conocer en el mercado. Este proyecto de investigación tiene como objetivo demostrar la sostenibilidad y rentabilidad de Service Pet 360 con diferentes estudios de mercado que se realizarán a nuestro público objetivo y desarrollando diferentes estrategias de marketing que logre un mejor posicionamiento en el mercado y ofrecer servicios y productos diferenciados. La empresa conforma un grupo de trabajo óptimo y profesionales calificados para lograr los objetivos propuestos.The project consists of a business model for the creation of a company called Service Pet 360, which provides the main services towards dogs and cats. It includes: health services, food, entertainment, etc. that will reach the customer through the webpage where you can find different companies that work with quality and commitment for the total safety of our clients (their pets). In this way we give our users (dog or cat owners) the possibility of choosing among a range of care options and products of the highest quality, that are close to your location. As you can read on this work, this type of product (personalized pet care) has increased significantly and has been well received in the market, since more people spend more of their time investing in their pets. Thus, the opportunity arises for Service Pet 360 to satisfy the different needs of these people and help other businesses (our strategic partners) become known in the market. This research project aims to demonstrate the sustainability and profitability of Service Pet 360, with different market studies that will be carried out on our target audience, while developing different marketing strategies with the purpose of achieving a better positioning in the market and offer a variety of services and products. The company is formed of optimal teamwork and qualified professionals to achieve the proposed objective: Helping pet owners find the best quality products and services for their dogs or cats, throughout a modern, aesthetically pleasing, helpful and easy-to-use webpage.Trabajo de investigació

Desafíos de las metrópolis: Efectos ambientales y sociales. Tendencias geográficas II

El libro está conformado de estudios realizados por profesores-investigadores de la Universidad Autónoma del Estado de México, de la Universidad de Varsovia, así como de la Universidad Pedagógica Comisión de Educación Nacional de Cracovia. En esta obra se exponen algunas investigaciones sobre los cambios en los factores sociales, naturales, económicos y ambientales como principales desafios que presentan las zonas de México, Polonia y de contextos de Sudamérica, tales como Sao Paulo, Quito y Bogotá y ciudades medias y pequeñas.Universidad Autónoma del Estado de Méxic

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

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

Tax Planning and its impact on the profitability of the advertising company PDV Latin Group Lima 2021

La empresa PDV Latin Group S.A.C. cuenta con más de 15 años en el mercado de la publicidad de medios en los puntos de venta en la ciudad de Lima. Además, cuenta con contratos de exclusividad con diferentes marcas comerciales de consumo masivo. Asimismo, cuenta con diferentes homologaciones y certificaciones necesarias para poder competir en el mercado de servicios publicitarios. Luego de analizar los estados financieros de la empresa, documentos referidos al cierre del ejercicio, cálculo de impuesto y las comunicaciones generadas por contingencias fiscales, se establece que la empresa carece de planificación tributaria en su gestión empresarial. La empresa refleja una inadecuada estrategia fiscal para poder pagar en justa medida los tributos establecidos por ley; esto último ocasiona pérdidas y falta de previsión en el flujo de efectivo empresarial afectando su rentabilidad. Por lo expuesto anteriormente, se toma como conclusión que PDV Latin Group S.A.C. necesita una adecuada planificación tributaria que pueda proyectar el devengo de impuestos y anticipar los flujos necesarios para el pago de los mismos evitando contingencias con la administración tributaria; asimismo, como consecuencia de lo anterior se podrá ampliar la rentabilidad de la compañía con el ahorro y planificación tributaria.The company PDV Latin Group S.A.C. It has more than 9 years in the advertising market in Peru. In addition, it has contracts with different mass consumption commercial brands. Likewise, it has different approvals and certifications necessary to be able to compete in the advertising services market. After analyzing the company's financial statements, documents referring to the year-end, the tax calculation and the communications generated by tax contingencies, it is established that the company lacks tax planning in its business management. The company reflects an inadequate fiscal strategy to be able to fairly pay the taxes established by law; The latter causes losses and lack of forecast in business cash flow, affecting its profitability. Based on the above, it is concluded that PDV Latin Group S.A.C. needs adequate tax planning that can project the accrual of taxes and anticipate the flows necessary for their payment, avoiding contingencies with the tax administration; Likewise, as a consequence of the above, the company's profitability can be expanded with tax savings and planning.Trabajo de Suficiencia Profesiona

Primer caso de Thelaziosis ocular (Thelazia rhodesi) en toro de lidia en la Península Ibérica

Bovine thelaziosis is caused by Thelazia rhodesi, T. skrjabini and T. gulosa, although the most prevalent species in Europe is the first of them. Thelazia rhodesi is a nematode (order Spirurida, family Thelaziidae) para- sitizing the eye of cattle, buffalo, zebu, and bison and, less frequently, horses and small ruminants. It is located on the corneal surface, under the lids and nictitating membrane and in the conjunctival sac. Thelazia spp. has an indirect life cycle, acting diptera of the family Muscidae as intermediate hosts. This study presents a case of thelaziosis in a fighting bull (Bos taurus), dealt in the bullring of Murcia in September 2014, coming from a farmer located in the Southwest of the Iberian Peninsula. During the first and second veterinary examinations of the animal, abundant tearing was observed, but despite this, the animal reacted positively to visual stimuli made in the visual field of both eyes, jointly and independently. The fighting bull was considered useful during the mentioned veterinary examinations, although it presented constant epiphora. During the fight, no abnormality was observed in the behavior of the bull in relation to the sense of sight. The post mortem ocular inspection in the pit of the square revealed the presence of nematodes 8-20 mm length in both the conjunctival sac and the surface of the cornea, which were extracted using tweezers and preserved in 70% ethanol. The specimens were identified as T. rhodesi according to the morphometric criteria described by Gupta and Kalia (1978) and Naem (2007a, b). This is a nematode species with ocular tropism that can appear in the fighting bull, farms exploited in extensive regime in temperate or warm areas, whose environmental conditions will favor the proliferation of intermediate hosts and the development of parasitosis. Therefore, thelaziosis must be considered in the differential diagnosis of ocular pathologies of fighting bull whose signs include restlessness, decreased visual acuity, epiphora and pruritus in the periocular area. To the knowledge of the authors, no case of Thelazia rho- desi infection has been reported in fighting bull.La thelaziosis bovina está causada por Thelazia rhodesi, T. skrjabini y T. gulosa, aunque la especie más prevalente en Europa es la primera de ellas. Thelazia rhodesi es un nematodo (orden Spirurida, familia The- laziidae) que parasita el globo ocular del ganado vacuno, búfalos, cebúes, bisontes y, con menor frecuencia, caballos y pequeños rumiantes. Se localiza en la superficie corneal, sobre la membrana nictitante y en el saco conjuntival. Tiene un ciclo biológico indirecto, actuando como hospedadores intermediarios dípteros de la familia Muscidae. En este estudio se describe un caso de thelaziosis ocular en un toro de lidia (Bos taurus), muerto en la plaza de toros de Murcia en septiembre de 2014, procedente de una ganadería localizada en el su- roeste de la Península Ibérica. Durante el primer y segundo reconocimiento veterinario del animal en la plaza de toros, se observó la existencia de lagrimeo abundante, pero a pesar de ello el animal reaccionaba positivamente a estímulos visuales realizados en el campo visual de ambos ojos, conjunta e independientemente. A pesar del lagrimeo constante, el animal fue considerado apto para la lidia. Durante esta no se observó anormalidad alguna en el comportamiento del toro en relación con el sentido de la vista. La inspección ocular post mortem realizada en el desolladero de la plaza permitió detectar la presencia de nematodos de 8-20 mm de longitud tanto en el saco conjuntival como en la superficie de la córnea, que fueron extraídos con ayuda de pinzas y conservados en etanol al 70%. La identificación microscópica específica de los ejemplares encontrados se realizó en base a los criterios morfométricos descritos por Gupta y Kalia (1978) y Naem (2007a,b), siendo identificados como Thelazia rhodesi. Se trata de un nematodo con tropismo ocular que puede aparecer en el toro de lidia, gana- derías explotadas en régimen extensivo en zonas templadas o cálidas, cuyos condicionantes ambientales van a favorecer la proliferación de los hospedadores intermediarios y el desarrollo de la parasitosis. Por ello, la thelaziosis ha de considerarse en el diagnóstico diferencial de patologías oculares del toro de lidia cuyo cuadro sintomático incluya intranquilidad, agudeza visual disminuida, epífora y prurito en la zona periocular. En el conocimiento de los autores, esta es la primera vez que se publica un caso de parasitación por Thelazia rhodesi en el bovino de lidia

Level of Knowledge Regarding Mpox among Peruvian Physicians during the 2022 Outbreak: A Cross-Sectional Study

Introduction: Due to the high incidence of mpox in Peru and the poor knowledge about this disease among healthcare workers in non-endemic countries, it is crucial to determine the knowledge status of Peruvian physicians. Methodology: We conducted an analytical cross-sectional study based on an online survey from August to September 2022. Physicians who had a medical license and lived and practiced medicine in Peru were included. To evaluate the factors associated with a higher level of knowledge, we used crude (cPR) and adjusted (aPR) prevalence ratios with 95% confidence intervals (95% CI) using Poisson regression. Results: We included 463 physicians. The mean age was 36.6 (SD: 10.3) years, and most were male (58.1%). Regarding knowledge, the median knowledge score was 14 [IQR: 13 to 15] out of 17 points. In terms of knowledge gaps, only 60.7% of the participants knew that there was an FDA-approved vaccine for mpox, 49.0% of participants knew about mpox proctitis and 33.3% acknowledged that it could be transmitted by the bite of an infected rodent. We found that taking care of patients with mpox (aPR: 1.39; 95% CI: 1.13 to 1.72) was associated with higher knowledge (>p50), while living in the eastern macro-region (aPR: 0.62; 95% CI: 0.42 to 0.93) was associated with lower knowledge (≤p50). Conclusions: Our study showed a high level of knowledge about mpox among Peruvian physicians. However, educational campaigns may be necessary, especially for physicians from the eastern region and those who do not have clinical experience with mpox

Nivel de conocimiento sobre Mpox entre médicos peruanos durante el brote de 2022: un estudio transversal

Introduction: Due to the high incidence of mpox in Peru and the poor knowledge about this disease among healthcare workers in non-endemic countries, it is crucial to determine the knowledge status of Peruvian physicians. Methodology: We conducted an analytical cross-sectional study based on an online survey from August to September 2022. Physicians who had a medical license and lived and practiced medicine in Peru were included. To evaluate the factors associated with a higher level of knowledge, we used crude (cPR) and adjusted (aPR) prevalence ratios with 95% confidence intervals (95% CI) using Poisson regression. Results: We included 463 physicians. The mean age was 36.6 (SD: 10.3) years, and most were male (58.1%). Regarding knowledge, the median knowledge score was 14 [IQR: 13 to 15] out of 17 points. In terms of knowledge gaps, only 60.7% of the participants knew that there was an FDA-approved vaccine for mpox, 49.0% of participants knew about mpox proctitis and 33.3% acknowledged that it could be transmitted by the bite of an infected rodent. We found that taking care of patients with mpox (aPR: 1.39; 95% CI: 1.13 to 1.72) was associated with higher knowledge (>p50), while living in the eastern macro-region (aPR: 0.62; 95% CI: 0.42 to 0.93) was associated with lower knowledge (≤p50). Conclusions: Our study showed a high level of knowledge about mpox among Peruvian physicians. However, educational campaigns may be necessary, especially for physicians from the eastern region and those who do not have clinical experience with mpox.Introducción: Debido a la alta incidencia de la mpox en Perú y al escaso conocimiento sobre esta enfermedad entre los trabajadores de la salud en países no endémicos, es crucial determinar el estado de conocimiento de los médicos peruanos. Metodología: Realizamos un estudio transversal analítico basado en una encuesta en línea de agosto a septiembre de 2022. Se incluyeron médicos que tenían licencia médica y residían y ejercían la medicina en Perú. Para evaluar los factores asociados a un mayor nivel de conocimiento se utilizaron razones de prevalencia crudas (cPR) y ajustadas (aPR) con intervalos de confianza del 95% (IC 95%) mediante regresión de Poisson. Resultados: Se incluyeron 463 médicos. La edad media fue de 36,6 (DE: 10,3) años y la mayoría eran hombres (58,1%). En cuanto a los conocimientos, la mediana de la puntuación de conocimientos fue de 14 [RIC: 13 a 15] sobre 17 puntos. En cuanto a las lagunas de conocimiento, solo el 60,7 % de los participantes sabía que existía una vacuna contra la mpox aprobada por la FDA, el 49,0 % de los participantes conocía la proctitis por mpox y el 33,3 % reconocía que podía transmitirse por la picadura de un roedor infectado. Encontramos que cuidar a pacientes con mpox (RPa: 1,39; IC 95%: 1,13 a 1,72) se asoció con un mayor conocimiento (>p50), mientras vivan en la macrorregión oriental (RPa: 0,62; IC 95%: 0,42 a 0,93) se asoció con un menor conocimiento (≤p50). Conclusiones: Nuestro estudio mostró un alto nivel de conocimiento sobre la mpox entre los médicos peruanos. Sin embargo, pueden ser necesarias campañas educativas, especialmente para los médicos de la región oriental y aquellos que no tienen experiencia clínica con la mpox