Mejora de procesos en una empresa especializada en servicios de facilities management de Lima

A través de los capítulos que componen el presente estudio, se demuestra la viabilidad técnica y económica de la implementación de mejoras al sistema de gestión de servicio del área de Infraestructura y gestión de espacios de una empresa de Facilities Management. En el primer capítulo se describen los aspectos teóricos del servicio de Facilities Management y las definiciones propias del área de Infraestructura y gestión de espacios. Además se incluyen los conceptos de mejora de procesos sumado- a las herramientas útiles (DFD, DAP, DSD, entre otras), para describir la situación actual y desarrollar la propuesta de mejora. Hacia la parte final, se presenta el procedimiento a seguir en los siguientes capítulos. En el segundo capítulo se revisa el aspecto organizacional de la empresa y cómo están relacionados los procesos con estos. Se define el servicio y sus tres etapas: Asesorfa, Diseño y Obra. Además se muestra el alcance de la tesis. En el tercer capítulo se realiza el diagnóstico del proceso, primero se desarrolla el análisis del sistema actual haciendo uso de las herramientas DFD con el fin de identificar los flujos de datos, almacenamientos y procesos deficientes, de igual forma se realiza el análisis DAP de los procesos críticos. Posteriormente, se presentan los resultados obtenidos, culminando con el resumen de las oportunidades de mejora. En el cuarto capítulo se plantean las características del nuevo sistema, seguidas de las implicancias de las mejoras en los nuevos almacenamientos, procesos y flujos de datos. De igual forma, se presentan los diagramas DFD del nuevo sistema propuesto así como los cambios en la organización del área, incluyendo los nuevos responsables del sistema y los efectos económicos de las mejoras a implementar .. Por último, en el quinto capítulo se evalúa impacto económico financiero de la propuesta. En base a los costos calculados en el capítulo anterior sumado a la inversión inicial necesaria y la estimación de beneficios, se elabora el flujo de caja proyectado así como los indicadores de rentabilidad y el análisis de sensibilidad correspondiente. Teniendo como costo de oportunidad de capital del accionista 9.2%, por medio de la simulación financiera se valida la viabilidad del proyecto y se recomienda su implementaciónTesi

Tiltrotor with double mobile wing

A convertiplane structure (100), having a longitudinal axis x and a plane n orthogonal to it, comprises a main wing (120) arranged to rotate about at least one transversal rotation axis y, an auxiliary wing (130), which is located back with respect to main wing (120), and arranged to rotate about at least one transversal rotation axis y', at least two main propellers (220) located on the main wing (120), and at least two auxiliary propellers (230) located on the auxiliary wing (130). The auxiliary wing (130) is located at a vertical height higher than main wing (120). Two vertical wings (140) are also provided located in such a way that the projections on the plane n of the main wing (120), of the auxiliary wing (130) and of the vertical wings (140) shape a closed polygon, thus reducing the induced drag and increasing the overall aerodynamic efficiency

Flight dynamics model for preliminary design of PrandtlPlane wing configuration with sizing of the control surfaces

The purpose of this paper is to present design procedures and tools for the aerodynamic optimization of a large freighter aircraft with a PrandtlPlane configuration. Suitable optimization tools have been developed and are shortly described in the paper; sensitivity analyses for high speed flight conditions have been performed, and, also, low speed performances are evaluated to provide a complete preliminary design of the PrandtlPlane freighter

Aerodynamic optimization of a large PrandtlPlane configuration

The purpose of this paper is to present design procedures and tools for the aerodynamic optimization of a large freighter aircraft with a PrandtlPlane configuration. Suitable optimization tools have been developed and are shortly described in the paper; sensitivity analyses for high speed flight conditions have been performed, and, also, low speed performances are evaluated to provide a complete preliminary design of the PrandtlPlane freighter

Preliminary transonic CFD analyses of a PrandtlPlane transport aircraft

In the framework of the PARSIFAL research project, funded by the European Community in the Horizon 2020 program, the PrandtlPlane (PrP) configuration has been proposed as an innovative alternative to the current commercial aircraft of conventional architecture; the PrP configuration development is presented in order to satisfy the future air traffic growing requirements with better performances than conventional one, in terms of fuel efficiency, safety, pollution and noise emissions. In this paper a preliminary aerodynamic investigation of the transonic behaviour of the PrP wing system is presented; this study has been carried out by means of CFD analyses, with the aim to collect relevant information and to detect the proper design and operative space, fundamental for the following aerodynamic design activity of the aircraft. Investigations have been made on macro parameters (like wing loading or cruise Mach number) and also on local critical issues. The results obtained allows to design some initial reference configurations with satisfactory cruise performance in this very initial stage of the design process

PreserFlo® MicroShunt: an overview of this minimally invasive device for open-angle glaucoma

For moderate-to-severe glaucoma, trabeculectomy remains the “gold standard” intraocular pressure (IOP)-lowering treatment; nonetheless, this method requires extensive post-operative maintenance. Microinvasive glaucoma surgery (MIGS) treatments are designed to lessen intra- and post-operative care burden while offering an acceptable IOP decrease for individuals with mild to moderate glaucoma. The PreserFlo® MicroShunt (previously InnFocus MicroShunt) is an 8.5 mm glaucoma drainage device manufactured from poly(styrene-block-isobutylene-block-styrene) (SIBS), an extremely biocompatible and bioinert material. The lumen is narrow enough to prevent hypotony, but big enough to avoid being obstructed by sloughed cells or pigment. The device is implanted ab externo, as a stand-alone procedure or in conjunction with cataract surgery, with intraoperative mitomycin C, and a bleb is produced under the conjunctiva and Tenon’s capsule. The MicroShunt was CE-marked in 2012 and designed for primary open-angle glaucoma, the IOP of which remains uncontrolled after maximally tolerated topical treatment. Several clinical trials evaluating the MicroShunt’s long-term safety and effectiveness have been conducted, highlighting the effectiveness of the device over time, along with a tolerable safety profile. The present review aims to gather evidence of PreserFlo’s effectiveness and safety results almost 10 years after its introduction, and furthermore, to compare it with other MIGS and with the gold-standard trabeculectomy for glaucoma management

La protección ambiental y su evolución en el marco constitucional ecuatoriano

El presente trabajo de investigación se encuentra orientado a la protección ambiental y su evolución en el marco constitucional ecuatoriano, en donde, destaca su objetivo general que es el analizar el contenido histórico de la normativa constitucional, que ha regulado el derecho ambiental, estudiando los acontecimientos jurídicos y de esta forma realizar una distinción entre las diferentes constituciones, obteniendo así una valoración en relación a la protección ambiental y su eficacia en el territorio ecuatoriano a lo largo de la historia. Para tal efecto, se planteó una base teórica doctrinaria, en donde encontramos los principales aportes constitucionales, relacionado a la protección ambiental, así como indicadores relevantes en lo relativo a la evolución en el marco constitucional ecuatoriano. Para lograr una profundización en el presente tema, se utilizó la investigación exploratoria, misma que nos abrió paso a la obtención de conocimientos previos sobre el problema planteado, dentro de la normativa constitucional, leyes y sentencias, que han contribuido con el alcance actual que posee la normativa que regula la protección del ambiente. Por medio del método analítico, histórico y exegético, se logró obtener la interpretación de la normativa jurídica presentes en las distintas constituciones que han estado vigentes en el Ecuador, logrando obtener e interpretar el sentido en la que fueron redactadas. Así mismo, estos métodos nos permitieron obtener una idea clara sobre el origen de las distintas normas que regulan la protección ambiental y por medio de una ficha de resumen organizar el histórico proceso de la misma. Definitivamente el estudio de la protección ambiental y su evolución en el marco constitucional, establece un aporte a las ciencias jurídicas, brindando como conclusión, que, gracias a este proceso evolutivo, en la actualidad, si es reconocido como sujeto de derecho, brindándole las garantías que establece la constitución

Investigating the impact of influenza on excess mortality in all ages in Italy during recent seasons (2013/14 - 2016/17 seasons)

Objectives: In recent years, Italy has been registering peaks in death rates, particularly among the elderly during the winter season. Influenza epidemics have been indicated as one of the potential determinants of such an excess. The objective of our study was to estimate the influenza-attributable contribution to excess mortality during the influenza seasons from 2013/14 to 2016/17 in Italy. Methods: We used the EuroMomo and the FluMomo methods to estimate the annual trend of influenza-attributable excess death rate by age group. Population data were provided by the National Institute of Statistics, data on influenza like illness and confirmed influenza cases were provided by the National Institutes of Health. As an indicator of weekly influenza activity (IA) we adopted the Goldstein index, which is the product of the percentage of patients seen with influenza-like illness (ILI) and percentage of influenza-positive specimens, in a given week. Results: We estimated excess deaths of 7,027, 20,259, 15,801 and 24,981 attributable to influenza epidemics in the 2013/14, 2014/15, 2015/16 and 2016/17, respectively, using the Goldstein index. The average annual mortality excess rate per 100,000 ranged from 11.6 to 41.2 with most of the influenza-associated deaths per year registered among the elderly. However children less than 5 years old also reported a relevant influenza attributable excess death rate in the 2014/15 and 2016/17 seasons (1.05/100,000 and 1.54/100,000 respectively). Conclusions: Over 68,000 deaths were attributable to influenza epidemics in the study period. The observed excess of deaths is not completely unexpected, given the high number of fragile very old subjects living in Italy. In conclusion, the unpredictability of the influenza virus continues to present a major challenge to health professionals and policy makers. Nonetheless, vaccination remains the most effective means for reducing the burden of influenza, and efforts to increase vaccine coverage and the introduction of new vaccine strategies (such as vaccinating healthy children) should be considered to reduce the influenza attributable excess mortality experienced in Italy and in Europe in the last seasons. Keywords: Flu, Mortality, Italy, Vaccinatio

Anterior Segment-Optical Coherence Tomography Bleb Morphology Comparison in Minimally Invasive Glaucoma Surgery: XEN Gel Stent vs. PreserFlo MicroShunt

Background: The purpose of this study is to compare the morphology of six-month follow-up blebs created by a subconjunctival glaucoma surgical device (XEN45) to those created by a PreserFlo MicroShunt with a sub-Tenon insertion, utilizing AS-OCT. Methods: A retrospective study of 29 eyes who underwent XEN45 implantation and 29 eyes who underwent PreserFlo MicroShunt implantation. The patients were analyzed at 24 h, 1 week, 1 month, 3 months and 6 months. At each visit, the maturation and morphological alterations of the blebs were observed, as well as connections with the IOP. Results: In both groups, IOP showed significant reduction at all follow ups (p < 0.0001). In XEN group, the most common bleb morphology in the immediate postoperative was the subconjuntival separation type (42%) followed by the uniform type (34%), with a trend inversion at 6 month follow up (51% of uniform type). On the contrary, the most common morphology after PreserFlo was the multiple internal layer (55%), which showed a tendency to reduce over time and was substituted by the microcystic multiform, whose percentage increased over time (17% at day 1 vs. 44% at month 6). Uniform appearance was associated by the posterior episcleral fluid (PEF) lake presence. Both horizontal and vertical diameters significantly increased over time. Conclusion: XEN and PreserFlo implantation resulted in the production of diffuse blebs with different characteristics, which may influence IOP lowering capacity and bleb revisions necessity over time

Intraventricular Meningiomas: Clinical-Pathological and Genetic Features of a Monocentric Series

Intraventricular meningiomas (IVMs) are rare (0.5-5%) and usually low-grade (90% grade I) brain neoplasms. Their recurrence rate is lower than that of extra-axial meningiomas, but their surgical resection can be burdened with life-threatening complications, which represent the major cause of the reported 4% mortality. The aim of this study is to characterize the molecular portrait of IVMs to identify potential therapeutic targets. For this, we explored mutations and copy number variations (CNV) of 409 cancer-related genes and tumor mutational burden (TMB) of six cases, using next-generation sequencing. Five IVMs were grade I and one was grade II; none recurred, in spite of partial surgical resection in one case. NF2 mutation was the only recurring alteration and was present in three of the six IVMs, in association with SMARCB1 mutation in one case. None of the cases was hypermutated (TMB > 10 mutations/Mb). NF2-mutant progressing or recurring IVMs could potentially be treated with targeted therapies applied to other NF2-mutant tumors, as an alternative to surgery or radiosurgery, while in view of their low TMB they are unlikely candidates to immune check-point inhibition