Incidencia de las aplicaciones para infocentros en la gestión de ventas de las empresas TIC. Caso: Nova Devices S.A.

En el Ecuador, la tecnología es un factor cada vez más influyente en la vida cotidiana de las personas, es por esto que las empresas, así como los gobiernos buscan una mayor incorporación y difusión en la sociedad, por el impacto que esta puede tener. El gobierno ecuatoriano ha invertido muchos recursos en los denominados Infocentros, que son espacios disponibles para que todas las personas puedan hacer uso de las tecnologías de la información y comunicación de manera gratuita, inclusive brindando diferentes cursos y capacitaciones, procesos que pueden ser revolucionarios en la economía social. Para poder tener la mejor herramienta al servicio de los ciudadanos, la empresa privada ha sido parte importante en el diseño e implementación de los Infocentros, inclusive desarrollando productos y servicios únicos y exclusivos. Esta customización solicitada por el Estado, ha tenido que ser desarrollada tanto en el software como en el hardware para poder brindar una opción adecuada a las necesidades y requerimientos de la población, propios y específicos. Estas aplicaciones propietarias buscan la maximización de los costos no solo financieros sino también operativos, para que todo este gran proyecto pueda ser sostenido en el tiempo. Es por esto que se ha buscado una incidencia mucho más relevante que el impacto en la gestión de ventas, y esta es la valoración del impacto social y económico, no desde el ámbito comercial sino desde el punto de vista de la implementación de un proyecto. En este sentido, el direccionamiento que brinda una política pública puede ser trascendental para la implementación de proyectos públicos, privados o de cooperación interinstitucional y que faciliten o motiven su gestión, pero sobre todo promuevan el desarrollo económico y social. Se ha llegado a determinar el gran impacto social y se ha podido valorar el mismo desde el punto de vista económico, para poder entender, comprender y considerar los grandes beneficios y aportes que brinda a la sociedad el proyecto de los Infocentros, sobre todo a los sectores menos favorecidos tecnológicamente

Ingresos Digitales - Impuestos Análogos

In mid-2019 in Japan, the G20 agreed to create a digital tax (the draft of which will be debated in the first months of 2020, and even from this date it is already intended to start changing the legislation in some countries), aimed at large companies our operations rely mainly on the internet, to generate income such as Facebook, Amazon, Google, Netflix, Uber, Spotify, Airbnb, among others. This digital rate is aimed at: large network companies pay taxes not based on their geographical location (tax residence) as it is currently done, but based on the users of each of the countries in which they provide the service, to avoid in this way the existing legal loopholes, due to the lack of updating of the laws. Pretending to be fairer when collecting taxes for all the actors: without tax havens, subsidiaries, among others. This work seeks to contribute to the debate generated in relation to the imposition of this digital rate. This article is divided into the first instance in the review of Ecuador’s tax regulations, and in the second instance the implication of a digital rate in the Ecuador’s tax coffers.A mediados de 2019 en Japón, el G20 acordó crear un impuesto digital (cuyo borrador sería debatido los primeros meses de 2020, e inclusive desde esta fecha ya se pretende empezar a cambiar la legislación en algunos países), dirigido a las grandes empresas cuyas operaciones se basan principalmente en el internet para generar enormes ingresos como Facebook, Amazon, Google, Netflix, Uber, Spotify, Airbnb, entre otros. Esta tasa digital está orientada a que: las grandes empresas de la red paguen impuestos no por su ubicación geográfica (residencia fiscal) como se lo hace actualmente, sino con base en el número de usuarios de cada uno de los países en los que brindan el servicio, para evitar de esta forma los vacíos legales existentes, por la falta de actualización de las leyes, o la elusión fiscal. Pretendiendo ser más justos al momento de recaudar tributos para todos los actores sin paraísos fiscales, filiales, entre otros. Este trabajo busca contribuir al debate generado en relación a la imposición de esta tasa digital. Este artículo se divide en primera instancia en la revisión de la normativa tributaria del Ecuador, y en segunda instancia la implicación de una tasa digital en las arcas fiscales de nuestro país

Characteristics of patients with type 2 diabetes mellitus newly treated with GLP-1 receptor agonists (CHADIG Study): a cross-sectional multicentre study in Spain

Objective: Several glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1Ra) have been made recently available in Spain for type 2 diabetes mellitus (DM2) treatment. There are no published data on the clinical and sociodemographic profile of patients initiating treatment with GLP-1Ra in Spain. Our objective was to understand these patients' characteristics in a real-world clinical practice setting. Design: Cross-sectional observational study. Setting: Spanish specialist outpatient clinics. Participants: 403 adults with DM2 initiating GLP-1Ra treatment were included. Primary and secondary outcome measures: Sociodemographic and DM2-related clinical data, including treatment at and after GLP-1Ra initiation and comorbidities, were collected. Results: Evaluable patients (n=403; 50.9% female) were included ( July 2013 to March 2014) at 24 centres by 53 specialists (47 endocrinology, 6 internal medicine), with the following profile (value±SD): age (58.3±10.4 years), diabetes duration (9.9±7 years), body mass index (BMI; 36.2±5.5) and glycated haemoglobin (HbA1c; 8.4±1.4%); 14% had HbA1c≤7%. Previous antidiabetic treatment: 53.8% only oral antidiabetic drugs (OADs), 5.2% insulin and 40% insulin and OAD; of those receiving OAD, 35% single drug, 38.2% 2 drugs and 24% 3 drugs. Concomitant to GLP-1Ra, 55.3% were only on OAD, 36.2% on insulin and OAD, and 7.2% only on insulin. Of those receiving OAD, the GLP-1Ra was mainly associated with 1 drug (65%) or 2 drugs (31.8%). GLP-1Ra are frequently added to existing antidiabetic drugs, with dipeptidyl peptidase-4 inhibitors being the OAD most frequently switched (45% receiving 1 before starting GLP-1Ra, only 2.7% receiving it concomitantly). Conclusions: In Spain, GLP-1Ra therapy is usually started in combination with OADs or OADs and insulin. These drugs are used in relatively young patients often not reaching therapeutic goals with other treatment combinations, roughly a decade after diagnosis and with a relatively high BMI. The latter could be explaine

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p&lt;0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (&lt;1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (&lt;1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline

Expansión de un negocio de telecomunicación con nuevas fuentes de financiamiento

El presente trabajo está enfocado a determinar la mejor fuente de financiamiento para la expansión de un negocio de telecomunicación, tomando en cuenta los diferentes parámetros, características y oportunidades tanto de la empresa como de las diferentes formas y fuentes de financiamiento existentes. La investigación se compone de cuatro grandes capítulos, donde la primera parte hace referencia a los antecedentes, características, productos y servicios de la empresa de telecomunicación, así como tambien a su estructura inicial, balances, operaciones, riesgos e índices para comprender y entender la situación inicial del negocio....

Switching TNF antagonists in patients with chronic arthritis: An observational study of 488 patients over a four-year period

The objective of this work is to analyze the survival of infliximab, etanercept and adalimumab in patients who have switched among tumor necrosis factor (TNF) antagonists for the treatment of chronic arthritis. BIOBADASER is a national registry of patients with different forms of chronic arthritis who are treated with biologics. Using this registry, we have analyzed patient switching of TNF antagonists. The cumulative discontinuation rate was calculated using the actuarial method. The log-rank test was used to compare survival curves, and Cox regression models were used to assess independent factors associated with discontinuing medication. Between February 2000 and September 2004, 4,706 patients were registered in BIOBADASER, of whom 68% had rheumatoid arthritis, 11% ankylosing spondylitis, 10% psoriatic arthritis, and 11% other forms of chronic arthritis. One- and two-year drug survival rates of the TNF antagonist were 0.83 and 0.75, respectively. There were 488 patients treated with more than one TNF antagonist. In this situation, survival of the second TNF antagonist decreased to 0.68 and 0.60 at 1 and 2 years, respectively. Survival was better in patients replacing the first TNF antagonist because of adverse events (hazard ratio (HR) for discontinuation 0.55 (95% confidence interval (CI), 0.34-0.84)), and worse in patients older than 60 years (HR 1.10 (95% CI 0.97-2.49)) or who were treated with infliximab (HR 3.22 (95% CI 2.13-4.87)). In summary, in patients who require continuous therapy and have failed to respond to a TNF antagonist, replacement with a different TNF antagonist may be of use under certain situations. This issue will deserve continuous reassessment with the arrival of new medications. © 2006 Gomez-Reino and Loreto Carmona; licensee BioMed Central Ltd

Compilación de Proyectos de Investigacion de 1984-2002

Instituto Politecnico Nacional. UPIICS