Plan de negocio car place aplicativo móvil

En la actualidad, la pandemia del Covid-19 ha sido un acelerador para la transformación digital en el Perú. Más aún desde la perspectiva empresarial, debido a que todo tipo de organización, desde una corporación hasta una pequeña empresa, se ha visto en la necesidad de enfocar sus estrategias al plano digital, entre ellas incorporar tecnología informática y comunicación a sus productos y/o servicios. No solo con la finalidad de reducir costos sino también, con el objetivo de mantener a sus clientes y atraer a nuevos, ya que el perfil del consumidor final está cambiando. A raíz del crecimiento de la tecnología, ha dado pie a nuevos términos como la economía colaborativa, la cual tiene como principal objetivo el intercambio de bienes o servicios a cambio de una compensación. Según (Diez Canseco. R, 2020) “debido a la pandemia la economía colaborativa ha dado un salto cuantitativo y cualitativo al punto que la industria tecnológica se encuentra en pleno crecimiento y desarrollo a nivel global como nunca antes”. En base a los conceptos señalados líneas previas, el presente trabajo de investigación, tiene como principal objetivo mitigar uno de los principales problemas que tienen los conductores en Lima Metropolitana y Callao, que es contar con una cochera disponible para guardar su vehículo, a fin de evitar la inseguridad en las calles y ahorrar tiempo. Asimismo, ayudar a los propietarios de cocheras a publicar y alquilar su garaje y todo ello, mediante un aplicativo móvil.Currently, the Covid-19 pandemic has been an accelerator for digital transformation in Peru. Even more from the business perspective, because all types of organizations, from a corporation to a small company, have seen the need to focus their strategies on the digital plane, including incorporating information technology and communication into their products and / or services. Not only in order to reduce costs but also in order to keep its customers and attract new ones, since the profile of the end consumer is changing. As a result of the growth of technology, it has given rise to new terms such as the collaborative economy, which has as its main objective the exchange of goods or services in exchange for compensation. According to (Diez Canseco. R, 2020) “due to the pandemic, the collaborative economy has taken a quantitative and qualitative leap to the point that the technology industry is in full growth and development at a global level like never before”. Based on the concepts indicated in the previous lines, the main objective of this research work is to mitigate one of the main problems that drivers have in Metropolitan Lima and Callao, which is to have a garage available to store their vehicle, in order to avoid insecurity on the streets and save time. Also, help garage owners to publish and rent their garage and all this, through a mobile application.Trabajo de investigació

Anti-tumour necrosis factor discontinuation in inflammatory bowel disease patients in remission: study protocol of a prospective, multicentre, randomized clinical trial

Background: Patients with inflammatory bowel disease who achieve remission with anti-tumour necrosis factor (anti-TNF) drugs may have treatment withdrawn due to safety concerns and cost considerations, but there is a lack of prospective, controlled data investigating this strategy. The primary study aim is to compare the rates of clinical remission at 1?year in patients who discontinue anti-TNF treatment versus those who continue treatment. Methods: This is an ongoing, prospective, double-blind, multicentre, randomized, placebo-controlled study in patients with Crohn?s disease or ulcerative colitis who have achieved clinical remission for ?6?months with an anti-TNF treatment and an immunosuppressant. Patients are being randomized 1:1 to discontinue anti-TNF therapy or continue therapy. Randomization stratifies patients by the type of inflammatory bowel disease and drug (infliximab versus adalimumab) at study inclusion. The primary endpoint of the study is sustained clinical remission at 1?year. Other endpoints include endoscopic and radiological activity, patient-reported outcomes (quality of life, work productivity), safety and predictive factors for relapse. The required sample size is 194 patients. In addition to the main analysis (discontinuation versus continuation), subanalyses will include stratification by type of inflammatory bowel disease, phenotype and previous treatment. Biological samples will be obtained to identify factors predictive of relapse after treatment withdrawal. Results: Enrolment began in 2016, and the study is expected to end in 2020. Conclusions: This study will contribute prospective, controlled data on outcomes and predictors of relapse in patients with inflammatory bowel disease after withdrawal of anti-TNF agents following achievement of clinical remission. Clinical trial reference number: EudraCT 2015-001410-1

Quality of Colonoscopy Is Associated With Adenoma Detection and Postcolonoscopy Colorectal Cancer Prevention in Lynch Syndrome

Background & Aims: Colonoscopy reduces colorectal cancer (CRC) incidence and mortality in Lynch syndrome (LS) carriers. However, a high incidence of postcolonoscopy CRC (PCCRC) has been reported. Colonoscopy is highly dependent on endoscopist skill and is subject to quality variability. We aimed to evaluate the impact of key colonoscopy quality indicators on adenoma detection and prevention of PCCRC in LS. Methods: We conducted a multicenter study focused on LS carriers without previous CRC undergoing colonoscopy surveillance (n = 893). Incident colorectal neoplasia during surveillance and quality indicators of all colonoscopies were analyzed. We performed an emulated target trial comparing the results from the first and second surveillance colonoscopies to assess the effect of colonoscopy quality indicators on adenoma detection and PCCRC incidence. Risk analyses were conducted using a multivariable logistic regression model. Results: The 10-year cumulative incidence of adenoma and PCCRC was 60.6% (95% CI, 55.5%–65.2%) and 7.9% (95% CI, 5.2%–10.6%), respectively. Adequate bowel preparation (odds ratio [OR], 2.07; 95% CI, 1.06–4.3), complete colonoscopies (20% vs 0%; P =.01), and pan-chromoendoscopy use (OR, 2.14; 95% CI, 1.15–3.95) were associated with significant improvement in adenoma detection. PCCRC risk was significantly lower when colonoscopies were performed during a time interval of less than every 3 years (OR, 0.35; 95% CI, 0.14–0.97). We observed a consistent but not significant reduction in PCCRC risk for a previous complete examination (OR, 0.16; 95% CI, 0.03–1.28), adequate bowel preparation (OR, 0.64; 95% CI, 0.17–3.24), or previous use of high-definition colonoscopy (OR, 0.37; 95% CI, 0.02–2.33). Conclusions: Complete colonoscopies with adequate bowel preparation and chromoendoscopy use are associated with improved adenoma detection, while surveillance intervals of less than 3 years are associated with a reduction of PCCRC incidence. In LS, high-quality colonoscopy surveillance is of utmost importance for CRC prevention