Plan estratégico de marketing para captar nuevos clientes en una empresa cuya actividad principal es el outsourcings financieros

El proceso de tercerización en las organizaciones data desde hace algún tiempo atrás sin tener una fecha fija, pero la época que se aproxima más a explicar el aparecimiento de este proceso es el comienzo de la edad moderna (para muchos historiadores a partir del descubrimiento de América). Por lo tanto, este proceso no es nuevo en las organizaciones de Latinoamérica y el mundo: la tercerización se ha constituido en un aspecto clave en las mismas, puesto que el hecho de delegar un proceso a terceras personas o entidades..

Problemática de la clasificación arancelaria de los productos tecnológicos: Especial referencia al Dictamen de 16 de agosto de 2010 de la OMC relativo al ATI

The innovation of the technological products is a fact that cannot be discussed, and can be easily reviewed by all of us, since we can clearly determine how our working and free time habits have been affected due to the introduction of tablets, mobile phones, or other type of instruments. In addition, in several cases the products are combined in order to obtained a new or improved product that may suit better the requirements of our society. This phenomenon, jointly with the globalization of the production and distribution of this type of products, oblige the custom authorities to address the classification of technological devices from a systematic scope. Nevertheless, the custom regulation is not actualized at the same speed as the technology, generating the corresponding problems in order to classify this type of devices. In this paper we analyze the applicable regulation as well as the criteria to be used in order to carry out the necessary classification of the technological products. Finally, we will examine the special importance of the report issued on August 16, 010 issued by the OMC regarding the ATI.La innovación de los productos tecnológicos es un hecho incontestable, fácilmente comprobable por todos nosotros, que podemos observar como nuestros hábitos de ocio y de trabajo resultan afectados por la introducción de tablets, dispositivos de telefonía móvil multiservicio o aparatos de reproducción o almacenaje de forma constante. Adicionalmente, en muchas ocasiones, los productos se combinan para dar lugar a nuevos o mejorados aparatos que satisfacen la potencial demanda de nuestras sociedades. Este fenómeno, unido a la globalización en la producción y distribución de bienes, determina que las autoridades aduaneras tengan que enfrentarse a la clasificación de productos novedosos de forma sistemática. Lamentablemente, la normativa aduanera no se actualiza a la misma velocidad que los productos tecnológicos, generando una lógica dificultad para la clasificación de estos productos novedosos. En el presente artículo trataremos de exponer la normativa aplicable así como los criterios que deben utilizarse para realizar una adecuada clasificación arancelaria de los productos tecnológicos. Finalmente, examinaremos la importancia que el Dictamen de 16 de agosto de 2010 de la Organización Mundial del Comercio relativo al Acuerdo Internacional sobre Tecnología de la Información tiene a este respecto

SIDM on FIRE: Hydrodynamical Self-Interacting Dark Matter simulations of low-mass dwarf galaxies

We compare a suite of four simulated dwarf galaxies formed in 10$^{10} M_{\odot}$ haloes of collisionless Cold Dark Matter (CDM) with galaxies simulated in the same haloes with an identical galaxy formation model but a non-zero cross-section for dark matter self-interactions. These cosmological zoom-in simulations are part of the Feedback In Realistic Environments (FIRE) project and utilize the FIRE-2 model for hydrodynamics and galaxy formation physics. We find the stellar masses of the galaxies formed in Self-Interacting Dark Matter (SIDM) with $\sigma/m= 1\, cm^2/g$ are very similar to those in CDM (spanning $M_{\star} \approx 10^{5.7 - 7.0} M_{\odot}$) and all runs lie on a similar stellar mass -- size relation. The logarithmic dark matter density slope ($\alpha=d\log \rho / d\log r$) in the central $250-500$ pc remains steeper than $\alpha= -0.8$ for the CDM-Hydro simulations with stellar mass $M_{\star} \sim 10^{6.6} M_{\odot}$ and core-like in the most massive galaxy. In contrast, every SIDM hydrodynamic simulation yields a flatter profile, with $\alpha >-0.4$. Moreover, the central density profiles predicted in SIDM runs without baryons are similar to the SIDM runs that include FIRE-2 baryonic physics. Thus, SIDM appears to be much more robust to the inclusion of (potentially uncertain) baryonic physics than CDM on this mass scale, suggesting SIDM will be easier to falsify than CDM using low-mass galaxies. Our FIRE simulations predict that galaxies less massive than $M_{\star} < 3 \times 10^6 M_{\odot}$ provide potentially ideal targets for discriminating models, with SIDM producing substantial cores in such tiny galaxies and CDM producing cusps.Comment: 10 Pages, 7 figures, submitted to MNRA

Oclusión intestinal completa por bridas y adherencias: reporte de caso

Introducción: La oclusión intestinal, detención persistente del tránsito intestinal, dificulta movimiento hacia tramos distales. Adherencias secundarias a cirugías, causa más frecuente, colaboran formación de hernias internas en 4%. Necesidad de intervención quirúrgica es 6,4-10%. Caso Clínico: Mujer, 76 años, 24 horas de evolución de dolor abdominal generalizado, por crisis. Detención de heces de 4 días y gases, 24 horas. Sigmoidostomía por CA de Colon Sigmoideo. Examen físico: abdomen blando, depresible, dolor difuso, defensa y dolor a la descompresión brusca; RHA presentes. Sonoridad aumentada. Presenta neutrofilia, linfopenia, trombocitopenia. Urea, creatinina, BD, AST, TP, INR, fibrinógeno elevados. Rx. de abdomen: niveles hidroaéreos. Ecografía: meteorismo. TAC simple: obstrucción de asas delgadas con múltiples adherencias yeyunales; no zona de transición. Diagnóstico: Oclusión Intestinal Completa. Laparotomía exploradora consta asas delgadas de coloración violácea, múltiples bridas y adherencias a pared, epiplón e interasas. Constatan hernias internas con acodadura a 150- 230 cm del asa fija. Se liberan y disecan adherencias y bridas con liberación de acodadas. Asas delgadas liberadas responden con mejor coloración y peristaltismo. Discusión: 20% de casos de oclusión intestinal causados por hernia, 1% del total por hernia interna. Adherencias abdominales causadas en 93% por casos postoperatorios, como el cuadro. 95% de casos de bridas y adherencias se localizan en intestino delgado, como la presentación. Dolor tipo crisis coincide como sintomatología del caso. Con clínica compatible, radiografía simple de abdomen y TAC simple (Gold Standard). La cirugía temprana previene estrangulación intestinal, resultando la restitución de la circulación y peristaltismo de las asas

Treatment of Chronic Hepatitis C in HIV-Infected Patients with Interferon α-2b Plus Ribavirin

One hundred six HIV-infected patients with chronic hepatitis C virus (HCV) infection were randomized to receive ribavirin (RBV) 400 mg bid plus interferon α-2b (IFN-α) at two different doses, 3 mU tiw (control arm) or 5 mU daily for the first 6 weeks, followed by 3 mU tiw until completing 6 months of therapy (induction arm). All patients had CD4 counts above 350 cells/μl and 89% were taking antiretroviral therapy. Adverse effects leading to treatment discontinuation occurred in 12.3% of patients, a rate quite similar to that seen in HCV-monoinfected patients. Negative serum HCV-RNA values (<60 IU/ml) were recorded in 24.7% and 35.5% of patients at 3 and 6 months of therapy. However, in the intent-to-treat analysis, sustained response was reached by only 16% of patients (22.4% in the on-treatment analysis). No differences between treatment arms were noticed. Patients with HCV genotypes 2 or 3 had a 7-fold higher response rate than those with HCV genotypes 1 or 4. Therefore, early, end-of-treatment, and sustained response rates are lower in HIV/HCV-coinfected patients treated with RBV/IFN-α combination therapy. Since HCV-related liver disease is currently one of the leading causes of morbidity and mortality among HIV-infected patients, new treatment options are urgently needed for coinfected individuals

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

Hematopoietic recovery and immune reconstitution after axicabtagene ciloleucel in patients with large B-cell lymphoma

Chimeric antigen receptor (CAR) T-cell therapy targeting CD19 may be associated with long-term adverse effects such as cytopenia and immune deficiency. In order to characterize these late events, we analyzed 31 patients with relapsed or refractory large B-cell lymphoma treated with axicabtagene ciloleucel at our institution on two clinical trials, ZUMA-1 (clinicaltrials gov. Identifier: NCT02348216) and ZUMA-9 (clinicaltrials gov. Identifier: NCT03153462). Complete blood counts, lymphocyte subsets, and immunoglobulin levels were measured serially until month 24 or progression. Fifteen (48%) patients had grade 3-4 cytopenia, including anemia (five, 16%), neutropenia (nine, 29%), or thrombocytopenia (13, 42%) at day 30. Cytopenia at day 30 was not significantly associated with later diagnosis of myelodysplasia. Among patients with ongoing remission, grade 3-4 cytopenia was observed in one of nine (11%) at 2 years. While peripheral CD8+ T cells recovered early, CD4+ T-cell recovery was delayed with a count of <200/mL in three of nine (33%) patients at 1 year and two of seven (29%) at 2 years. Immunoglobulin G levels normalized in five of nine (56%) patients at 2 years. Thirteen (42%) patients developed grade 3-4 infectious complications, including herpes zoster and Pneumocystis jiroveci pneumonia. These results suggest the need for prolonged monitoring and prophylaxis against opportunistic infections in these patients, to improve the longterm safety of axicabtagene ciloleucel therapy

Ciencias de la Biología y Agronomía

Este volumen I contiene 17 capítulos arbitrados que se ocupan de estos asuntos en Tópicos Selectos de Ciencias de la Biología y Agronomía, elegidos de entre las contribuciones, reunimos algunos investigadores y estudiantes. Se presenta un Estudio Comparativo de los Recursos Hidrológico-Forestales de la Microcuenca de la Laguna de Epatlan, Pue. (1993 a 2014); la Situación Actual de la Mancha de Asfalto en Maíz (Zea mays L.) en los Municipios de Jiquipilas y Ocozocoautla, Chiapas, México; las poblaciones sobresalientes de maíz de la raza Zapalote Chico, en la Región Istmeña de Oaxaca; Se indica el índice de área foliar de cultivo de Chile Poblano mediante dos métodos en condiciones protegidas; Esquivel, Urzúa y Ramírez exploran el efecto de la biofertilización con Azospirillum en el crecimiento y producción de Jitomate; esbozan su artículo sobre la determinación del nivel de Heterosis en híbridos de Maíz para la Comarca Lagunera; una investigación sobre la estabilización de semilla de Solanum lycopersicum durante el almacenamiento y estimulación de la germinación; acotan sobre el CTAB como una nueva opción para la detección de Huanglongbing en cítricos, plantean su evaluación sobre el aluminio y cómo afecta la vida de florero de Heliconia psittacorum; indican sobre el impacto del H-564C, como un híbrido de maíz con alta calidad de proteina para el trópico húmedo de México; presetan su investigación sobre la producción de Piña Cayena Lisa y MD2 (Ananas comosus L.) en condiciones de Loma Bonita, en Oaxaca; acotan sobre el efecto de coberteras como control biológico por conservación contra áfidos en Nogal Pecanero; esbozan sobre la caracterización de cuatro genotipos de Frijol Negro en Martínez de la Torre, Veracruz, México; presentan una caracterización hidroecológica de la microcuenca de Arroyo Prieto, Yuriría, Gto., y alternativas para su restauración ambiental; presentan su investigación sobre el efecto del hongo Beauveria bassiana sobre solubilización de fosfatos y la disponibilidad de fósforo en el suelo; plantean su investigación sobre la Germinación y regeneración in vitro de Epidendrum falcatum LINDL; esbozan su artículo sobre genotipos de frijol negro y su tolerancia a sequía terminal en Veracruz, México

Hepatitis D double reflex testing of all hepatitis B carriers in low-HBV- and high-HBV/HDV-prevalence countries

Hepatitis D virus (HDV) infection occurs as a coinfection with hepatitis B and increases the risk of hepatocellular carcinoma, decompensated cirrhosis, and mortality compared to hepatitis B virus (HBV) monoinfection. Reliable estimates of the prevalence of HDV infection and disease burden are essential to formulate strategies to find coinfected individuals more effectively and efficiently. The global prevalence of HBV infections was estimated to be 262,240,000 in 2021. Only 1,994,000 of the HBV infections were newly diagnosed in 2021, with more than half of the new diagnoses made in China. Our initial estimates indicated a much lower prevalence of HDV antibody (anti-HDV) and HDV RNA positivity than previously reported in published studies. Accurate estimates of HDV prevalence are needed. The most effective method to generate estimates of the prevalence of anti-HDV and HDV RNA positivity and to find undiagnosed individuals at the national level is to implement double reflex testing. This requires anti-HDV testing of all hepatitis B surface antigen-positive individuals and HDV RNA testing of all anti-HDV-positive individuals. This strategy is manageable for healthcare systems since the number of newly diagnosed HBV cases is low. At the global level, a comprehensive HDV screening strategy would require only 1,994,000 HDV antibody tests and less than 89,000 HDV PCR tests. Double reflex testing is the preferred strategy in countries with a low prevalence of HBV and those with a high prevalence of both HBV and HDV. For example, in the European Union and North America only 35,000 and 22,000 cases, respectively, will require anti-HDV testing annually

Global prevalence and genotype distribution of hepatitis C virus infection in 2015 : A modelling study

Publisher Copyright: © 2017 Elsevier LtdBackground The 69th World Health Assembly approved the Global Health Sector Strategy to eliminate hepatitis C virus (HCV) infection by 2030, which can become a reality with the recent launch of direct acting antiviral therapies. Reliable disease burden estimates are required for national strategies. This analysis estimates the global prevalence of viraemic HCV at the end of 2015, an update of—and expansion on—the 2014 analysis, which reported 80 million (95% CI 64–103) viraemic infections in 2013. Methods We developed country-level disease burden models following a systematic review of HCV prevalence (number of studies, n=6754) and genotype (n=11 342) studies published after 2013. A Delphi process was used to gain country expert consensus and validate inputs. Published estimates alone were used for countries where expert panel meetings could not be scheduled. Global prevalence was estimated using regional averages for countries without data. Findings Models were built for 100 countries, 59 of which were approved by country experts, with the remaining 41 estimated using published data alone. The remaining countries had insufficient data to create a model. The global prevalence of viraemic HCV is estimated to be 1·0% (95% uncertainty interval 0·8–1·1) in 2015, corresponding to 71·1 million (62·5–79·4) viraemic infections. Genotypes 1 and 3 were the most common cause of infections (44% and 25%, respectively). Interpretation The global estimate of viraemic infections is lower than previous estimates, largely due to more recent (lower) prevalence estimates in Africa. Additionally, increased mortality due to liver-related causes and an ageing population may have contributed to a reduction in infections. Funding John C Martin Foundation.publishersversionPeer reviewe