Utilización de los ingresos y su efecto en la liquidez de la empresa Conagas S.A.C., Santiago de Surco, Lima, 2017

RESUMEN El presente trabajo de investigación “Utilización de los ingresos y su efecto en la liquidez de la empresa Conagas S.A.C, Santiago de Surco, Lima, 2017”; está orientado a comprender que la variable liquidez es la capacidad de pago que tiene la empresa a corto plazo y tratar de generar dinero líquido en caja. El objetivo general busca determinar “El manejo de los ingresos y su efecto en la liquidez de la empresa Conagas S.A.C, Santiago de Surco, Lima, 2017”, un problema detectado que consideramos relevante para investigar la causa y efecto de las variables en estudio. Mediante la investigación se pretende aportar recomendaciones que permita contrarrestar el problema que se viene suscitando en forma mensual debido al inadecuado mecanismo del manejo de sus ingresos y que le permita mantener un nivel adecuado de liquidez mensual. Este proyecto se apoya en el marco teórico, logrando así una síntesis de cada una de las variables que ayuda a una mejor comprensión de la parte teórica de la investigación. Para la elaboración de este proyecto de investigación hemos aplicado el tipo de investigación aplicada, la población está constituida por la liquidez de la empresa, ya que esto nos ayudará a responder a las preguntas de investigación, el diseño es no experimental de corte transversal y con un enfoque cuantitativo. PALABRAS CLAVES: Liquidez, ingresos, indicadores financieros.ABSTRACT The present research paper "Use of income and its effect on the liquidity of the company Conagas S.A.C, Santiago de Surco, Lima, 2017"; is oriented to understand that the variable liquidity is the capacity of payment that the company has in the short term and try to generate liquid cash. The general objective is to determine "The management of income and its effect on the liquidity of the company Conagas S.A.C, Santiago de Surco, Lima, 2017", a detected problem that we consider relevant to investigate the cause and effect of the variables under study. The research is intended to provide recommendations to offset the problem that is arising on a monthly basis due to the inadequate mechanism of managing their income and to maintain an adequate level of monthly liquidity. This project is based on the theoretical framework, thus achieving a synthesis of each of the variables that helps a better understanding of the theoretical part of the research. For the elaboration of this research project we have applied the type of applied research, the population is constituted by the liquidity of the company, since this will help us to answer the research questions, the design is non-experimental of transversal cut and with a quantitative approach. KEYWORDS: Liquidity, revenues, financial indicators

Integrative Clinical, Molecular, and Computational Analysis Identify Novel Biomarkers and Differential Profiles of Anti-TNF Response in Rheumatoid Arthritis

Background: This prospective multicenter study developed an integrative clinical and molecular longitudinal study in Rheumatoid Arthritis (RA) patients to explore changes in serologic parameters following anti-TNF therapy (TNF inhibitors, TNFi) and built on machine-learning algorithms aimed at the prediction of TNFi response, based on clinical and molecular profiles of RA patients. Methods: A total of 104 RA patients from two independent cohorts undergoing TNFi and 29 healthy donors (HD) were enrolled for the discovery and validation of prediction biomarkers. Serum samples were obtained at baseline and 6 months after treatment, and therapeutic efficacy was evaluated. Serum inflammatory profile, oxidative stress markers and NETosis-derived bioproducts were quantified and miRNomes were recognized by next-generation sequencing. Then, clinical and molecular changes induced by TNFi were delineated. Clinical and molecular signatures predictors of clinical response were assessed with supervised machine learning methods, using regularized logistic regressions. Results: Altered inflammatory, oxidative and NETosis-derived biomolecules were found in RA patients vs. HD, closely interconnected and associated with specific miRNA profiles. This altered molecular profile allowed the unsupervised division of three clusters of RA patients, showing distinctive clinical phenotypes, further linked to the TNFi effectiveness. Moreover, TNFi treatment reversed the molecular alterations in parallel to the clinical outcome. Machine-learning algorithms in the discovery cohort identified both, clinical and molecular signatures as potential predictors of response to TNFi treatment with high accuracy, which was further increased when both features were integrated in a mixed model (AUC: 0.91). These results were confirmed in the validation cohort. Conclusions: Our overall data suggest that: 1. RA patients undergoing anti-TNF-therapy conform distinctive clusters based on altered molecular profiles, which are directly linked to their clinical status at baseline. 2. Clinical effectiveness of anti-TNF therapy was divergent among these molecular clusters and associated with a specific modulation of the inflammatory response, the reestablishment of the altered oxidative status, the reduction of NETosis, and the reversion of related altered miRNAs. 3. The integrative analysis of the clinical and molecular profiles using machine learning allows the identification of novel signatures as potential predictors of therapeutic response to TNFi therapy.This study was supported by grants from the Instituto de Salud Carlos III (PI18/00837), cofinanciado por el Fondo Europeo de Desarrollo Regional de la Unión Europea Una manera de hacer Europa, Spain, the Spanish Inflammatory and Rheumatic Diseases Network (RIER), Instituto de Salud Carlos III (RD16/0012/0015) and the Andalusian Regional Health System (ref. PI-0285-2017). CL-P was supported by a contract from the Spanish Junta de Andalucía (Nicolas Monardes program).Ye

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)