Estudio de prefactibilidad para la instalación de una planta procesadora de puré de manzana (Malus domestica) con quinua (Chenopodium quinoa) para infantes en doypack

This Project is about the research of the technical, economic, financial and social viability of a processing plant of an apple pure and quinoa in doypack for infants. The product to be studied will be 100 grams with a design suitable for marketing to infants between 2 to 12 years. The demand estimated for this project ranges from 843,386 units to 2021 to 1,039,742 units in 2025.After analyzing the most important location factors for this project, it was determined that the location for the plant would be in Lurin, Lima. When analyzing the limit sizes of the project, it was observed that the selection of the size would be determined by the market- size, that is, the demand, this is mostly due to the fact that the technology-size is relatively high, the point-size of balance is less than demand and productive resources are massively in our country. In the plant layout chapter, when analyzing using the Guerchet method, it was determined that the minimum plant size is 374 m2. Likewise, this chapter shows the general disposition of the productive and administrative areas, when using the relational analysis. In the chapter of investments and economic evaluation, it was determined that the total of initial investment is S /. 413,027.98; of which 30% will be provided by equity capital and 70% by loan from the financial institution that proposes the best terms. In this chapter, it was also determined that the best rate is that of GNB Peru with 24%. In addition, the economic and financial evaluation of the project has been calculated in a base of 5 years and with a COK of 19.75%. Likewise, a NPV of S /. 74,886.14 and an IRR of 34%.El presente proyecto trata sobre la investigación de la viabilidad técnica, económica, financiera y social de una planta procesadora de puré de manzana con quinua en envases doypack para infantes. El producto a estudiar será de 100 g con un diseño adecuado para su comercialización a infantes de entre 2 a 12 años. La demanda que se estimó para este proyecto va desde 843,386 unidades al 2021 hasta 1,039,742 unidades en el 2025. Luego, de analizar los factores más importantes de localización para este proyecto, se determinó que la locación para la planta sería en Lurín, Lima. Al analizar los tamaños límites del proyecto, se observó que la selección del tamaño sería determinada por el tamaño-mercado, es decir, la demanda, esto se debe en mayor parte a que el tamaño-tecnología es relativamente alto, el tamaño-punto de equilibrio es menor a la demanda y los recursos productivos se encuentran de forma masiva en nuestro país. En el capítulo de disposición de planta, al analizar mediante el método de Guerchet, se determinó que el tamaño mínimo de planta es de 374 m2 . Así mismo, en ese capítulo se muestra la disposición general de las áreas productivas y administrativas, al utilizar el análisis relacional. En el capítulo de inversiones y evaluación económica, se determinó que se requiere de un total de S/. 413,027.98 como inversión inicial; de la cual, un 30% será proporcionado por capital propio y un 70% por préstamo de la entidad financiera que proponga los mejores términos. En este capítulo, también se determinó que la mejor tasa es la del GNB Perú con un 24%. Además, la evaluación económica y financiera del proyecto se ha calculado en base a 5 años y con un COK de 19,75%. Así mismo, se tiene como resultado un VAN de S/. 74,886.14 y un TIR de 34%

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