Diagnóstico Financiero y Estratégico de la Empresa Royal DSM para los periodos 2014 -2016

Proyecto de Graduación (Maestría en Administración de Empresas) Instituto Tecnológico de Costa Rica. Escuela de Administración de Empresas, 2017.Royal DSM is Holland based global company with operations in all 5 continents. It mission is to create brighter lives for people today and generations to come through active science in the fields of health, nutrition and supplies. During the period 2010-2015, the company focused on a strategy of growth called “Driving Focused Growth” on which market mega—trends were identified, as well as how to reach them (Health and Well-Being, Global Changes and Climate, and Energy). Part of this strategy consisted of the acquisitions of other companies. Since 2016, and a final term up to 2018, Royal DSM starts a new strategy called “Driving Profitable Growth” which is pretended to profit on the management applied during the period 2010-2015 with. This current project seeks to determine of financial effects aligned the objectives expected from both strategies. This will be achieved through the elaboration of a financial diagnosis on which main tools available were used through an automated spreadsheet that can be applied in the future to make financial diagnosis for any other company

Can malignant and inflammatory pleural effusions in dogs be distinguished using computed tomography

Computed tomography (CT) is the primary imaging modality used to investigate human patients with suspected malignant or inflammatory pleural effusion, but there is a lack of information about the clinical use of this test in dogs. To identify CT signs that could be used to distinguish pleural malignant neoplasia from pleuritis, a retrospective case‐control study was done based on dogs that had pleural effusion, pre‐ and postcontrast thoracic CT images, and cytological or histopathological diagnosis of malignant or inflammatory pleural effusion. There were 20 dogs with malignant pleural effusion (13 mesothelioma, 6 carcinoma; 1 lymphoma), and 32 dogs with pleuritis (18 pyothorax; 14 chylothorax). Compared to dogs with pleuritis, dogs with malignant pleural effusions were significantly older (median 8.5 years vs. 4.9 years, P = 0.001), more frequently had CT signs of pleural thickening (65% vs.34%, P = 0.05), tended to have thickening of the parietal pleura only (45% vs. 3%, P = 0.002) and had more marked pleural thickening (median 3 mm vs. 0 mm, P = 0.03). Computed tomography signs of thoracic wall invasion were observed only in dogs with malignant pleural effusions (P = 0.05). There were no significant differences in pleural fluid volume, distribution or attenuation, degree of pleural contrast accumulation, amount of pannus, or prevalence of mediastinal adenopathy. Although there was considerable overlap in findings in dogs with malignant pleural effusion and pleuritis, marked thickening affecting the parietal pleural alone and signs of thoracic wall invasion on CT support diagnosis of pleural malignant neoplasia, and may help prioritize further diagnostic testing

Using A Transmission Dynamic Model Of Rotavirus Infection To Determine The Cost-Effectiveness Of Rotavirus Vaccination In Bangladesh

INTRODUCTION: Rotavirus is the leading cause of severe gastroenteritis worldwide. Due to the morbidity and mortality of the disease, introduction of rotavirus vaccination in routine childhood immunization programs is recommended for all nations by the World Health Organization. OBJECTIVE: The primary objective of this study was to assess the cost-effectiveness of rotavirus vaccine introduction in Bangladesh from 2015 to 2024. METHODS: We used a compartmental SIRS-like model developed by Pitzer et al (2009) to simulate health outcomes due to rotavirus infection in Bangladesh under two scenarios: 92% vaccination coverage and no vaccination (Pitzer et al., 2009). The model was first fitted to data on age-specific rotavirus hospitalizations at the International Center for Diarrheal Disease Research, Bangladesh (iccddr,b) hospital in Dhaka to estimate transmission parameters such as R0, and then scaled to the entire country by refitting to estimates of rotavirus disease burden for Bangladesh. We calculated medical costs associated with each health outcome and determined the cost of introducing the rotavirus vaccine. We used these estimates to develop an Excel model that examined the incremental cost effectiveness, from the health care system perspective, of introducing rotavirus vaccine into Bangladesh’s National Immunization Program. The outcome measure selected was discounted (3%) US$per Disability Adjusted Life Year (DALY) averted, in children under five. RESULTS: According to our model, vaccine introduction would prevent ~49,000 deaths over ten years. Under vaccination, 10.2 million discounted DALYs would be averted, and$25.7 million in discounted costs of treating rotavirus infection would be saved; the total discounted cost of vaccine introduction would be $550 million. The incremental cost per DALY saved was$51.19, and varied from $6.80 to$78.0 per DALY averted when conducting one-way sensitivity analyses of model variables. The variables that had the biggest impact on the cost per DALY were vaccine efficacy, vaccine price and annual number of rotavirus episodes. CONCLUSION: Judged by the WHO’s widely-accepted standards, introduction of rotavirus vaccination to Bangladesh is very cost-effective and would likely be instrumental in decreasing morbidity and mortality caused by rotavirus in children under five

The blind side of international investment law and policy: The need for investor-state conflict management mechanisms fostering investment retention and expansion

Most countries strive to attract FDI, yet around one fourth of all FDI projects established in developing countries are discontinued due to unresolved investor-state conflicts that never reach the limelight of investor-state litigation. This Perspective introduces investor-state conflict-management mechanisms (CMMs) to facilitate investment permanence and expansion in host countries

Comparison of computed tomographic angiography and intraoperative mesenteric portovenography for extrahepatic portosystemic shunts

Objectives Comparison of intra-operative mesenteric portovenography and computed tomographic angiography for the documentation of the portal vasculature in patients with single extrahepatic portosystemic shunts. Methods Retrospective study of patients with extrahepatic portosystemic shunts that underwent preoperative computed tomographic angiography and intra-operative mesenteric portography. Studies were compared for identification of the intra- and extrahepatic portal vasculature. Results Computed tomographic angiography demonstrated all four portal vein tributaries and sub-tributaries. Intra-operative mesenteric portography inconsistently demonstrated the cranial mesenteric vein, the gastroduodenal vein (12 of 49 dogs and 0 of 10 cats), splenic vein (46 of 49 dogs and 8 of 10 cats) and caudal mesenteric vein (3 of 49 dogs and 2 of 10 cats). Computed tomographic angiography showed the intrahepatic portal vein with shunts emanating from the left gastric vein, splenocaval shunts or shunts involving the left colic vein. It showed intrahepatic portal branching in 5 of 12 patients with shunts involving the right gastric vein. Intra-operative mesenteric portography showed the intrahepatic portal vein in 29 of 59 patients but was outperformed by computed tomographic angiography in all cases except those patients with a shunt involving the right gastric vein. Clinical Significance In cases that have undergone diagnostic preoperative computed tomographic angiography there is no indication for diagnostic intra-operative mesenteric portovenography before ligation. In contrast, portovenography performed “after” temporary full ligation of the shunt provides clinical useful information and might be considered an integral investigation during shunt attenuation surgery

国际投资法律与政策的盲区：促进投资保留与扩大的投资者-国家冲突管理机制

Most countries strive to attract FDI, yet around one fourth of all FDI projects established in developing countries are discontinued due to unresolved investor-state conflicts that never reach the limelight of investor-state litigation. This Perspective introduces investor-state conflict-management mechanisms (CMMs) to facilitate investment permanence and expansion in host countries