Teoría del trade-off para la definición de la estructura de financiación de las pyme's de Bucaramanga

This article presents a diagnostic of frm's debt of small-and-medium-size companies in Bucaramanga, based on the optimal amount of debt that they should have according to a model adjusted for our environment, using trade-off theory concepts. This model that includes tax advantages of debt and costs of maintain it, affected by their associated probabilities, yields the optimal amount of debt. The comparison with current amount of debt for small and medium sized frms by using statistical treatment showed that these kinds of organizations don't keep the right amount and most of them actually have less debt than the optimum suggested by the model. El siguiente artículo muestra un diagnóstico de la situación de endeudamiento de las pequeñas y medianas empresas de Bucaramanga, basado en el punto óptimo de deuda que deberían mantener de acuerdo con un modelo ajustado al entorno, incorporando los conceptos de la teoría del trade-off. El modelo incluye los ahorros fscales por deuda y los costos por mantenerla, afectados por sus probabilidades asociadas, lo que arroja un punto óptimo de endeudamiento que, al contrastarse con los niveles actuales de deuda de las PYME's, mostró mediante tratamiento estadístico que las empresas no mantienen niveles adecuados de deuda; estando la mayoría de ellas en niveles inferiores a los planteados como óptimos por el modelo.&nbsp

Teoría del trade-off para la definición de la estructura de financiación de las pyme's de Bucaramanga

This article presents a diagnostic of frm's debt of small-and-medium-size companies in Bucaramanga, based on the optimal amount of debt that they should have according to a model adjusted for our environment, using trade-off theory concepts. This model that includes tax advantages of debt and costs of maintain it, affected by their associated probabilities, yields the optimal amount of debt. The comparison with current amount of debt for small and medium sized frms by using statistical treatment showed that these kinds of organizations don't keep the right amount and most of them actually have less debt than the optimum suggested by the model. El siguiente artículo muestra un diagnóstico de la situación de endeudamiento de las pequeñas y medianas empresas de Bucaramanga, basado en el punto óptimo de deuda que deberían mantener de acuerdo con un modelo ajustado al entorno, incorporando los conceptos de la teoría del trade-off. El modelo incluye los ahorros fscales por deuda y los costos por mantenerla, afectados por sus probabilidades asociadas, lo que arroja un punto óptimo de endeudamiento que, al contrastarse con los niveles actuales de deuda de las PYME's, mostró mediante tratamiento estadístico que las empresas no mantienen niveles adecuados de deuda; estando la mayoría de ellas en niveles inferiores a los planteados como óptimos por el modelo.&nbsp

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

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

La organización informal y el proceso innovador: caso de una PYME colombiana de manufactura electrónica

El objetivo del presente trabajo es evidenciar la importancia de la organización informal como uno de los componentes que influye en el proceso innovador de las pequeñas empresas. Para ello, se analiza el caso de una empresa colombiana de manufactura electrónica, que ha introducido más de 40 productos innovadores al mercado en los últimos 10 años sin contar con una estructura formal para la gestión de la innovación. El referente teórico, tomado como base para el análisis, corresponde al modelo propuesto por López, Díaz, & Robledo (2013), el cual se sustenta en el modelo conceptual de gestión de la innovación empresarial y los diferentes niveles del comportamiento organizacional. Los resultados obtenidos, permiten resaltar la importancia de la cultura enfocada en la innovación y el liderazgo de la gerencia como los factores de mayor influencia de la organización informal, para el éxito de las innovaciones

Strategic Analysis of collaboration Between National and Multinational Companies of Software in Colombia using Dynamics System

The multinationals software companies are economic agents with the potential of affecting drastically the dynamics of development of the domestic industry in this sector. These effects depend on the type of relationship (competition or cooperation) between the companies. On the relationship of competition, the literature reveals progress in their systemic understanding. However, the analysis of collaborative behavior among national and multinational software companies and their effects on the development of the latter has advanced little, being notable in the literature the absence of simulation models to analyze the phenomenon. The purpose of this work is to make a contribution in this way, using the system dynamics as a methodological approach. The results obtained demonstrate the conditions favorable and unfavorable to the establishment of a relationship of collaboration with multinational, leading to a better understanding of the phenomenon under study and facilitating the formulation and implementation of most successful growth strategies of the industr

Teoría del trade-off para la definición de la estructura de financiación de las pyme's de Bucaramanga

El siguiente artículo muestra un diagnóstico de la situación de endeudamiento de las pequeñas y medianas empresas de Bucaramanga, basado en el punto óptimo de deuda que deberían mantener de acuerdo con un modelo ajustado al entorno, incorporando los conceptos de la teoría del trade-off. El modelo incluye los ahorros fscales por deuda y los costos por mantenerla, afectados por sus probabilidades asociadas, lo que arroja un punto óptimo de endeudamiento que, al contrastarse con los niveles actuales de deuda de las PYME's, mostró mediante tratamiento estadístico que las empresas no mantienen niveles adecuados de deuda; estando la mayoría de ellas en niveles inferiores a los planteados como óptimos por el modelo. This article presents a diagnostic of frm's debt of small-and-medium-size companies in Bucaramanga, based on the optimal amount of debt that they should have according to a model adjusted for our environment, using trade-off theory concepts. This model that includes tax advantages of debt and costs of maintain it, affected by their associated probabilities, yields the optimal amount of debt. The comparison with current amount of debt for small and medium sized frms by using statistical treatment showed that these kinds of organizations don't keep the right amount and most of them actually have less debt than the optimum suggested by the model.

Participación de la sociedad civil en las dinámicas de innovación para el logro de los ODS. Un marco de análisis

Currently, people are beginning to recognize the contribution of innovation in the achievement of the Sustainable Development Goals (SDGs). However, the predominant approach, reduced to the economic dimension, has not focused on solving global problems. A strategy to achieve this is to take advantage of the civil society potential, which can be an active agent in the generation of innovations, which can guide them to the achievement of the SDGs. In this paper, it is proposed a framework of analysis that helps us to understand the role of civil society in the dynamics of innovation and its contribution to the achievement Agenda 2030. For this reason, this work includes an analysis of concepts about civil society, innovation, and the SDGs, which is apply to two case studies, exploring the participation of civil society in the development of innovations and its transformative potential. The results suggest that civil society is a fundamental actor for the fulfilment of the SDGs, but that, in some contexts, state intervention can be decisive for the transformative potential of socially based innovations.Actualmente, se empieza a reconocer el aporte de la innovación en la consecución de los objeti-vos de desarrollo sostenible (ODS); sin embargo, su enfoque predominante, reducido a la dimensión económica, no se ha centrado en solucionar problemas globales. Una estrategia para lograrlo reside en aprovechar el potencial de la sociedad civil, viéndose como un actor activo en la generación de innovaciones, que puede orientarlas a la consecución de los ODS. En este trabajo, se propone un marco de análisis que ayude a comprender el rol de la sociedad civil en las dinámicas de innova-ción y su aporte para el logro de la Agenda 2030. Para ello, se relacionan y analizan conceptos de sociedad civil, innovación y los ODS, los cuales se aplican a dos casos de estudio, explorando la participación de la sociedad civil en el desarrollo de innovaciones y su potencial transformador. Los resultados apuntan a que la sociedad civil constituye un actor fundamental para el cumplimiento de los ODS pero que, en algunos contextos, la intervención estatal puede ser decisiva para el potencial transformador de las innovaciones que tienen base social

Development and Validation of a Computational Model Ensemble for the Early Detection of BCRP/ABCG2 Substrates during the Drug Design Stage

Breast Cancer Resistance Protein (BCRP) is an ATP-dependent efflux transporter linked to the multidrug resistance phenomenon in many diseases such as epilepsy and cancer and a potential source of drug interactions. For these reasons, the early identification of substrates and nonsubstrates of this transporter during the drug discovery stage is of great interest. We have developed a computational nonlinear model ensemble based on conformational independent molecular descriptors using a combined strategy of genetic algorithms, J48 decision tree classifiers, and data fusion. The best model ensemble consists in averaging the ranking of the 12 decision trees that showed the best performance on the training set, which also demonstrated a good performance for the test set. It was experimentally validated using the ex vivo everted rat intestinal sac model. Five anticonvulsant drugs classified as nonsubstrates for BRCP by the model ensemble were experimentally evaluated, and none of them proved to be a BCRP substrate under the experimental conditions used, thus confirming the predictive ability of the model ensemble. The model ensemble reported here is a potentially valuable tool to be used as an in silico ADME filter in computer-aided drug discovery campaigns intended to overcome BCRP-mediated multidrug resistance issues and to prevent drug-drug interactions.Fil: Gantner, Melisa Edith. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; Argentina. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Departamento de Ciencias Biológicas; ArgentinaFil: Peroni, Roxana Noemi. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Farmacológicas. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Instituto de Investigaciones Farmacológicas; ArgentinaFil: Morales, Juan Francisco. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; Argentina. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Departamento de Ciencias Biológicas; ArgentinaFil: Villalba, Maria Luisa. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; Argentina. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Departamento de Ciencias Biológicas; ArgentinaFil: Ruiz, María Esperanza. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; Argentina. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Departamento de Ciencias Biológicas; ArgentinaFil: Talevi, Alan. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; Argentina. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Departamento de Ciencias Biológicas; Argentin