LSS e I4.0 nas PMEs manufactureiras: uma revisão bibliográfica

Achieving productivity improvement in the operations of SMEs through the use of methodologies is the challenge that business leaders have, it is for this reason that an investigation is undertaken to identify the studies that have been addressed on the Lean Six Sigma (LSS) and Industry 4.0 (I4.0) in small and medium-sized manufacturing companies (SMEs) published between 2005 and 2020 in English as a preliminary input for the development of future research work in the area. The objective of the article is to determine, based on a review of the scientific literature, which are the trends, countries, authors and methodological factors with greater and lesser participation, through the simultaneous analysis of the LSS, the I4.0 and the SMEs to identify future research opportunities. For the development of the study, a Systematic Review of the Literature (RSL) is carried out, which guides the formulation of the research questions, the definition of the search criteria, the definition of inclusion and exclusion criteria, the evaluation of the quality of the articles and the identification of research opportunities. To complement the work, a taxonomic analysis of the literature is carried out, with the aim of characterizing and weighing elements of the systematic review, which allow the identification of key methodological factors to establish future research. After carrying out the search through the RSL, 105 articles are selected, where it is possible to identify the percentage of their participation in the thematic groups studied: 58% of the articles found are related to the LSS-Pymes; followed by 29% related to I4.0- SMEs; with 12% are the LSS-I4.0; and finally, SMEs-LSS-I4.0 with 1%. Derived from the analysis, it is identified that the topics studied have a growing interest in the scientific community according to the behavior evidenced in the publications between 2005 and 2020. Additionally, the authors and representative countries in the LSS-SMEs and I4.0-SMEs topics are identified, the relevant authors are Jiju Antony and Erwin Rauch and countries such as United Kingdom, India, Italy, United States and Germany. It is also identified that methodologies that integrate the SMEs, LSS and I4.0 study topics are relevant, but have been little explored, becoming a research opportunity that must be addressed to expand the frontier of knowledge on this topic.Lograr el mejoramiento de la productividad en las operaciones de las Pymes mediante el uso de metodologías que los soporten es el desafío que tienen los líderes empresariales, por esta razón  se emprende una investigación para identificar los estudios que han sido abordados sobre el Lean Six Sigma (LSS) y la Industria 4.0 (I4.0) en las pequeñas y medianas empresas manufactureras (Pymes) publicados entre los años 2005 y 2020 en idioma inglés, como un insumo preliminar para el desarrollo de futuros trabajos investigativos en el área. Este artículo busca determinar, con base en una revisión de la literatura científica, cuáles son las tendencias, países, autores y factores metodológicos de mayor y menor participación, a través del análisis del LSS, la I4.0 y las Pymes de modo que se identifiquen futuras oportunidades de investigación. Para el desarrollo del estudio se hace una revisión sistemática de la literatura (RSL), la cual orienta la formulación de las preguntas de investigación, la definición de los criterios de búsqueda, la definición de criterios de inclusión y exclusión, la evaluación de la calidad de los artículos y la identificación de oportunidades de investigación. Para complementar el trabajo se realiza un análisis taxonómico de la literatura, con el objetivo de caracterizar y ponderar elementos de la revisión sistemática que permitan identificar factores metodológicos clave para establecer investigaciones futuras. Después de hacer la búsqueda a través de la RSL se seleccionan 105 artículos, donde se logró identificar el porcentaje de participación de los mismos en las agrupaciones temáticas estudiadas: 58% de los artículos hallados están relacionados con el LSS-Pymes, seguidos de 29% de artículos relacionados con la I4.0-Pymes; con 12% están el LSS-I4.0 y, finalmente, Pymes-LSS-I4.0 con 1%. Derivado del análisis se identifica que las temáticas estudiadas tienen interés creciente en la comunidad científica de acuerdo con el comportamiento evidenciado en las publicaciones entre 2005 y 2020. Además, se identifican los autores y países representativos en las temáticas LSS-Pymes y I4.0-Pymes, destacándose autores como Jiju Antony y Erwin Rauch y países como Reino Unido, India, Italia, Estados Unidos y Alemania. También se identifica que las metodologías que integran las temáticas de estudio simultáneo de las Pymes, LSS e I4.0 son pertinentes pero han sido poco exploradas, convirtiéndose así estas en una oportunidad de investigación que debe ser abordada para ampliar la frontera de conocimiento en esta temática.Les chefs d'entreprise sont mis au défi de parvenir à une amélioration de la productivité dans les opérations des PME grâce à l'utilisation de méthodologies qui les soutiennent; pour cette raison, une recherche est entreprise pour identifier les études qui ont été abordées sur Lean Six Sigma (LSS) et l'Industrie 4.0 (I4.0) dans les petites et moyennes entreprises manufacturières (PME), publiées entre 2005 et 2020 en anglais, comme un apport préliminaire pour le développement de futurs travaux de recherche dans le domaine. Cet article cherche à déterminer, sur la base d'une revue de la littérature scientifique, quelles sont les tendances, les pays, les auteurs et les facteurs méthodologiques d'une plus ou moins grande participation, à travers l'analyse des LSS, I4.0 et des PME afin d'identifier les futures opportunités de recherche. Pour le développement de l'étude, une revue systématique de la littérature (SLR) est effectuée, qui guide la formulation des questions de recherche, la définition des critères de recherche, la définition des critères d'inclusion et d'exclusion, l'évaluation de la qualité des articles et l'identification des opportunités de recherche. Pour compléter ce travail, une analyse taxonomique de la littérature est réalisée afin de caractériser et de pondérer les éléments de la revue systématique pour identifier les facteurs méthodologiques clés pour établir les recherches futures. Après une recherche dans le SLR, 105 articles ont été sélectionnés, où il a été possible d'identifier le pourcentage de participation de ceux-ci dans les regroupements thématiques étudiés: 58% des articles trouvés sont liés aux LSS-PME, suivis de 29% d'articles liés aux I4.0-PME; avec 12% sont des LSS-I4.0 et, enfin, des PME-LSS-I4.0 avec 1%. L'analyse montre que les sujets étudiés présentent un intérêt croissant pour la communauté scientifique, conformément au comportement des publications entre 2005 et 2020. En outre, les auteurs et les pays représentatifs des thèmes LSS-PME et I4.0-PME sont identifiés, avec des auteurs comme Jiju Antony et Erwin Rauch et des pays comme le Royaume-Uni, l'Inde, l'Italie, les États-Unis et l'Allemagne. On constate également que les méthodologies qui intègrent les thèmes de l'étude simultanée des PME, des systèmes d'information géographique et de l'I4.0 sont pertinentes, mais qu'elles ont été peu explorées.Os líderes empresariais são desafiados a alcançar a melhoria da produtividade nas operações das PMEs através da utilização de metodologias que as apoiem; por esta razão, é realizada uma investigação para identificar os estudos que foram abordados sobre Lean Six Sigma (LSS) e Indústria 4.0 (I4.0) em pequenas e médias empresas de manufactura (PMEs) publicados entre 2005 e 2020 em inglês, como um contributo preliminar para o desenvolvimento de futuros trabalhos de investigação na área. Este artigo procura determinar, com base numa revisão da literatura científica, quais são as tendências, países, autores e factores metodológicos de maior e menor participação, através da análise da LSS, I4.0 e PMEs, a fim de identificar futuras oportunidades de investigação. Para o desenvolvimento do estudo, é realizada uma revisão sistemática da literatura (SLR), que orienta a formulação de questões de investigação, a definição de critérios de pesquisa, a definição de critérios de inclusão e exclusão, a avaliação da qualidade dos artigos e a identificação de oportunidades de investigação. Para complementar o trabalho, é realizada uma análise taxonómica da literatura a fim de caracterizar e ponderar elementos da revisão sistemática para identificar factores metodológicos chave para o estabelecimento de investigação futura. Após pesquisa através do SLR foram seleccionados 105 artigos, onde foi possível identificar a percentagem de participação destes nos agrupamentos temáticos estudados: 58% dos artigos encontrados estão relacionados com LSS-PME, seguidos de 29% dos artigos relacionados com I4.0-SME; com 12% são LSS-I4.0 e, finalmente, PME-LSS-I4.0 com 1%. A análise mostra que os temas estudados são de interesse crescente para a comunidade científica de acordo com o comportamento das publicações entre 2005 e 2020. Além disso, são identificados os autores e países representativos dos temas LSS-SMEs e I4.0-SMEs, destacando-se autores como Jiju Antony e Erwin Rauch e países como o Reino Unido, a Índia, a Itália, os Estados Unidos e a Alemanha. Também se identifica que as metodologias que integram os temas de estudo simultâneo das PME, LSS e I4.0, são relevantes mas têm sido pouco exploradas, pelo que esta se torna uma oportunidade de investigação que deve ser abordada para expandir a fronteira do conhecimento nesta área

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

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

Arquitectura para la automatización del proceso de carga de información geográfica exigida en los informes de cumplimiento ambiental -ICA- : caso de estudio Colombia

En el presente artículo se presenta una arquitectura de software para integrar archivos base en formato Microsoft Excel con ArcMap, para la automatización del proceso de carga de información geográfica al modelo de almacenamiento geográfico (Geodatabase) requerido en la presentación de Informes de Cumplimiento Ambiental –ICA-. Para lo cual, se tomaron como referencia de prueba cinco feature class con geometría tipo punto contenidos en el modelo ICA. La arquitectura consistió en la aplicación de dos herramientas informáticas: Debug y ArcMap. Debug es un software desarrollado por el equipo colaborador de la presente investigación con el fin de automatizar la creación de los archivos base en formato Microsoft Excel para la carga de información geográfica en la Geodatabase. En ArcMap, se desarrolló un modelo de conversión, espacialización y carga de información geográfica usando la consola de programación ModelBuilder, cuyo objetivo fue la conversión de los archivos de entrada en formato Microsoft Excel a un formato compatible con el software, la espacialización de las entidades geográficas y la incorporación de los feature class dentro de la Geodatabase de un ICA. La metodología se testeo con puntos aleatorios ubicados en el municipio de Medellín usando los cinco feature class del modelo de almacenamiento geográfico. El proceso de carga resultó ser mucho más eficiente y amigable con el usuario final