Modelación del riesgo de insolvencia en las empresas del sector salud en Colombia: un análisis para el período 2010-2013

En este trabajo de investigación, proponemos aplicar un modelo de distribución logística y efectuar una serie de pruebas paramétricas y no paramétricas que permitan predecir el riesgo de insolvencia, con uno, dos y tres años de anterioridad, para las empresas del sector salud de Colombia en el período 2010-2013, utilizando información de la Superintendencia de Sociedades, la Superintendencia de Salud, el Ministerio de Salud, las Secretarías de Salud Departamental y la aplicación de encuestas electrónicas -- Para esto, se parte del análisis fundamental, centrado en los indicadores de rentabilidad, apalancamiento, liquidez y solvencia, y se sigue el trabajo propuesto por Gómez, de la Torre y Román (2008) para pymes industriales en España -- El aporte de esta investigación es el énfasis en las variables financieras y no financieras relacionadas con la calidad en la prestación de los servicios de salud y su efecto en la probabilidad de quiebra -- Como principal hallazgo se establecen los efectos de las variables analizadas y su relación con las variables de otros estudios relacionados, que abren un debate frente a la sostenibilidad de la salud financiera de las empresas del sector salud -- El trabajo no tiene precedente en el país para este secto

Diagnosis and management of complicated urogenital schistosomiasis: a systematic review of the literature

Bladder cancer; Hydronephrosis; Neglected tropical diseasesCàncer de bufeta; Hidronefrosi; Malalties tropicals desatesesCáncer de vejiga; Hidronefrosis; Enfermedades tropicales desatendidasBackground Currently, there are no standardized guidelines for the diagnosis or management of the complications of urogenital schistosomiasis (UGS). This systematic review of the literature aims to investigate the state of the art in reference to diagnostic approaches and the clinical management of this condition. Methods A systematic review of literature published between January 1990 and January 2021 was conducted in the MEDLINE database, scoping for articles regarding diagnostic means or therapeutic options for the complications of UGS, namely obstructive uropathy, bladder cancer, abortion, ectopic pregnancy, infertility, kidney failure, urolithiasis and the need for invasive procedures. Relevant data were then extracted from the articles deemed eligible according to the inclusion criteria. Main results In total, 3052 articles were identified by the research query, of which 167 articles fulfilling inclusion criteria after title/abstract screening and full-text evaluation were included, 35% on both diagnostic and therapeutic aspects, and 51% on diagnosis and 14% on therapy. Ultrasound was the most frequently tool employed for the diagnosis of UGS complications showing a good performance. Concerning the management of hydronephrosis, the majority of available evidences came from community-based studies where universal treatment with praziquantel was used leading to decrease of prevalence of obstructive uropathy. Concerning studies on surgical procedures, laser endoureterotomy followed by stenting was mostly employed in adult patients leading to a crude cure rate of 60% (43 of 71 patients). In the case of severe hydronephrosis, surgery consisting of ureteral re-implantation showed excellent results with a crude cure rate of 98% (157 cured patients of 160 treated). Concerning bladder cancer, data on 93 patients with a clear diagnosis of UGS-related bladder were available reporting a variable and sometime combined approach based on disease stage. Available data on diagnosis and management of abortion, ectopic pregnancy, infertility, kidney failure, urolithiasis and the need for invasive procedures due to UGS are also presented. Conclusions The review produced a complete picture of the diagnostic and therapeutic options currently available for complicated UGS. These results can be useful both for guiding clinicians towards correct management and for tracing the direction of future research.Open access funding provided by Università degli Studi di Firenze within the CRUI-CARE Agreement. The authors did not receive support from any organization for the submitted work

Development of a simulation model as a decision support system for sugarcane supply

This research presents a discrete-event simulation model of cane supply as a decision support system for managers in a sugarcane mill. The research considers harvesting, transporting, and unloading cane at the mill yard, including the time windows, inherent uncertainty in the system, and queues of all operations. The model was implemented in C++, and the Qt Creator development environment was used to generate a graphical interface. We found that fifty percent of the time, the trailers are waiting; we also assessed the impact of mill downtime on the unloaded cane in the mill yard. Additional environments were also evaluated: rainy period, harvesting in remote places, and an alternative configuration at the unloading area that improves the process efficiency.Esta investigación presenta un modelo de simulación de eventos discretos del sistema de abastecimiento de caña como sistema de soporte a las decisiones para los administradores en los ingenios azucareros. Comprende las operaciones de cosecha, transporte y descarga de la caña en el patio del ingenio, además tiene en cuenta ventanas de tiempo, la incertidumbre inherente del sistema y considera las colas de todas las operaciones. El modelo fue implementado en C++ utilizando el entorno de desarrollo Qt Creator para generar una interfaz gráfica. Se encontró que el 50% del tiempo las tractomulas se encuentran en espera, además se evaluó el impacto de los paros de molienda en la cantidad de caña descargada. Otros ambientes fueron también evaluados: época lluviosa, cosecha en campos lejanos y una configuración alternativa en la zona de descarga de caña que mejora la eficiencia del proceso

Propuesta de un sistema de gestión de producción y seguridad y salud ocupacional basado en la Ley N° 30222 para reducir los costos de la empresa Productos Industriales del Cuero S.A.C. – Trujillo

RESUMEN El presente trabajo tuvo como objetivo general el desarrollo de una propuesta de mejora de un sistema de gestión de producción y Seguridad y Salud en el Trabajo para reducir costos de la empresa PRODUCTOS INDUSTRIALES DEL CUERO S.A.C. – Trujillo. La investigación se inicia con un diagnóstico de la situación actual del área de Producción, a través de indicadores, determinándose los costos innecesarios que se incurren por una inadecuada técnica de Planificación de Producción, así como por la falta de un Sistema de Seguridad y Salud en el Trabajo. Habiendo identificado las oportunidades de mejora, se emplearon distintas herramientas, metodologías pertenecientes a la Ingeniería Industrial, tales como Perfil de Puesto, Análisis de desempeño, Plan de capacitación (Producción), Estudio de Tiempos, VSM, MRP, 5S’s; y a las normativas nacionales vigentes en Seguridad y Salud en el Trabajo, la modificatoria de la Ley N° 29783 de Seguridad y Salud en el Trabajo, Ley N° 30222. Luego de la aplicación de estas herramientas, metodologías y normativas, se evalúa la propuesta, recalculando los indicadores diseñados inicialmente, para tener una medición objetiva sobre el beneficio percibido. Finalmente, el análisis financiero que incluye los costos asociados a la investigación y a la implementación de la propuesta (S/. 116 209.00), concluye que el proyecto y la implementación son rentables al generar un VAN de S/. 748 549 y una TIR anual de 196%.ABSTRACT The current study had as objective the development of an improvement proposal for a production management system and safety and health strategy at work to reduce costs at PRODUCTOS INDUSTRIALES DEL CUERO S.A.C. - Trujillo. The investigation begins with a diagnosis of the current situation of the production site, through indicators, determining the unnecessary costs incurred by inadequate technical production planning, as well as the lack of a Safety and Health System at work. Having had identified improvement opportunities, different tools were used, methodologies pertaining to Industrial Engineering, such as Job Description, Performance Assessment, Training Plan (Production), Study of Terms, VSM, MRP, 5S Methodology; and current national regulations on Safety and Health at Work, the amending of Ley N° 29783 de Seguridad y Salud en el Trabajo, Ley N° 30222. After the application of these tools, methodologies and regulations, the proposal is evaluated by recalculating the initial designed indicators to have an objective measurement of the perceived benefit. Finally, the financial analysis which includes the costs associated with research and implementation of the proposal (S/.116 209.00), concludes that the project and its execution are profitable to generate a NPV of S/.748 549 and an annual IRR of 196%

Schistosoma haematobium infection and morbidity risk factors for pre-school age children in western Angola: A knowledge, attitudes and practices survey

Schistosomiasis; Medical risk factors; MorbidityEsquistosomiasi; Factors de risc mèdic; MorbilitatEsquistosomiasis; Factores de riesgo médico; MorbilidadBackground Urogenital schistosomiasis is one of the most prevalent parasitic diseases in sub-Saharan Africa. It is a poverty-related disease conditioned by behavioural practices. Methods Our objective is to evaluate the awareness, mindset and habits about urogenital schistosomiasis in the community of Cubal (Angola), as well as its association with infection and urinary tract morbidity in pre-school age children. A cross-sectional study of knowledge, attitudes and practices at home was conducted between February and May 2022 with 250 participants. Results Overall, 93.6% of those surveyed had some prior knowledge about schistosomiasis and, among all the symptoms associated with this disease, blood in the urine was the best known (54.4%). Nevertheless, 57.6% obtained a medium knowledge score. Regarding attitude, the majority of respondents had a high attitude score (79.2%) with 96.0% willing to participate in mass drug administration campaigns. Laundry in the river was the most common risk practice (61.2%) and 55.2% out of the total were classified with a low practice score. Conclusion Low knowledge about symptoms and transmission by caregivers was the outstanding risk factor for infection in pre-school age children (OR = 16.93, 95%CI: 3.93–72.82), and lack of knowledge that avoiding entering the river prevents schistosomiasis was the main risk factor for morbidity in PSAC (OR = 8.14, 95%CI: 1.14–58.25).This research was supported by the Red de Investigación de Centros de Enfermedades Tropicales – RICET of the PN de I+D+I, ISCIII-Subdirección General de Redes y Centros de Investigación Cooperativa RETICS), Ministry of Health and Consumption, Madrid; by CIBER de Enfermedades Infecciosas (Projects CB21/13/00056 and CB21/13/00029), ISCIII, Ministry of Science and Education, Madrid; by Project No. 2021/004 of the PROMETEO Program, Programa de Ayudas para Grupos de Investigación de Excelencia, Generalitat Valenciana, Valencia, Spain. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Enhanced generation of reactive species by cold plasma in gelatin solutions for selective cancer cell death

Atmospheric pressure plasma jets generate reactive oxygen and nitrogen species (RONS) in liquids and biological media, which find application in the new area of plasma medicine. These plasma-treated liquids were demonstrated recently to possess selective properties on killing cancer cells and attracted attention toward new plasma-based cancer therapies. These allow for local delivery by injection in the tumor but can be quickly washed away by body fluids. By confining these RONS in a suitable biocompatible delivery system, great perspectives can be opened in the design of novel biomaterials aimed for cancer therapies. Gelatin solutions are evaluated here to store RONS generated by atmospheric pressure plasma jets, and their release properties are evaluated. The concentration of RONS was studied in 2% gelatin as a function of different plasma parameters (treatment time, nozzle distance, and gas flow) with two different plasma jets. Much higher production of reactive species (H2O2 and NO2–) was revealed in the polymer solution than in water after plasma treatment. The amount of RONS generated in gelatin is greatly improved with respect to water, with concentrations of H2O2 and NO2– between 2 and 12 times higher for the longest plasma treatments. Plasma-treated gelatin exhibited the release of these RONS to a liquid media, which induced an effective killing of bone cancer cells. Indeed, in vitro studies on the sarcoma osteogenic (SaOS-2) cell line exposed to plasma-treated gelatin led to time-dependent increasing cytotoxicity with the longer plasma treatment time of gelatin. While the SaOS-2 cell viability decreased to 12%–23% after 72 h for cells exposed to 3 min of treated gelatin, the viability of healthy cells (hMSC) was preserved (~90%), establishing the selectivity of the plasma-treated gelatin on cancer cells. This sets the basis for designing improved hydrogels with high capacity to deliver RONS locally to tumors.Peer ReviewedPreprin

Long-Term Dynamics of Bluetongue Virus in Wild Ruminants : relationship with Outbreaks in Livestock in Spain, 2006-2011

Wild and domestic ruminants are susceptible to Bluetongue virus (BTV) infection. Three BTV serotypes (BTV-4, BTV-1 and BTV-8) have been detected in Spain in the last decade. Even though control strategies have been applied to livestock, BTV circulation has been frequently detected in wild ruminant populations in Spain. The aim of the present study is to assess the role for wild ruminants in maintaining BTV after the vaccination programs in livestock in mainland Spain. A total of 931 out 1,914 (48.6%) serum samples, collected from eight different wild ruminant species between 2006 and 2011, were BTV positive by ELISA. In order to detect specific antibodies against BTV-1, BTV-4 and BTV-8, positive sera were also tested by serumneutralisation test (SNT). From the ELISA positive samples that could be tested by SNT (687 out of 931), 292 (42.5%) showed neutralising antibodies against one or two BTV serotypes. For each BTV seroptype, the number of outbreaks in livestock (11,857 outbreaks in total) was modelled with pure autoregressive models and the resulting smoothed values, representing the predicted number of BTV outbreaks in livestock at municipality level, were positively correlated with BTV persistence in wild species. The strength of this relationship significantly decreased as red deer (Cervus elaphus) population abundance increased. In addition, BTV RNA was detected by real time RT-PCR in 32 out of 311 (10.3%) spleen samples from seropositive animals. Although BT outbreaks in livestock have decreased substantially after vaccination campaigns, our results indicated that wild ruminants have been exposed to BTV in territories where outbreaks in domestic animals occurred. The detection of BTV RNA and spatial association between BT outbreaks in livestock and BTV rates in red deer are consistent with the hypothesis of virus circulation and BTV maintenance within Iberian wild ruminant populations

Saliva secretory IgA kinetics in obese subjects submitted to a graded exercise test

INTRODUCTION: Secretory IgA (sIgA) is predominant immunoglobulin in secretions of the mucosal immune system. It inhibit attachment and replication of pathogenic microorganism, preventing colonization by these pathogens. Therefore, sIgA is consider the first line of defense against pathogens. Previous studies have indicated a direct link between low salivary sIgA levels with of upper respiratory tract infections (UTRI) episodes in endurance sports and elite athletes. PURPOSE: Determine the effect of a maximal graded exercise test on the saliva sIgA levels in obese adult subjects. METHODS: Eleven obese male subjects (Age 31± 1.53 years) were recruited. The Body Mass Index (BMI) and, Waist Circumference (WC) were measured. Graded exercise test was performed on an electrically-braked cycle ergometer (Lode). The Heart rate (HR) was registered using a digital pulse meter (Polar FT1 model) before, immediately finished the exercise and after 30 min post- exercise test. The saliva samples were collected alongside with HR during the test. RESULTS: The WC (110.37 ± 3.89 cm) and BMI (34.73 ± 1.62 kg/m2) values confirmed the obesity state in the participants. The HR at basal was 77.09 ± 3.10 bpm, at post exercise, the HR mean was 175.45 ± 4.94 bpm (p \u3c0.0001 vs basal). Finally, at 30 post exe, the HR was 91.81 ± 3.01 bpm (P \u3c0.0001 vs post-exe). In basal state, the sIgA concentration was 94.21 ± 13.57 µm/mL. At post exe, the sIgA mean was 175.9 ± 22.45 µm/mL (p\u3c0.05 vs basal). Finally, 30’ post-exercise the sIgA level was 91.39 ± 10.40 µm/mL. However, the sIgA was not modified by the exercise. CONCLUSION: The present work demonstrates that the salivary sIgA increases temporally as a response to the graded exercise test in obese adults. Although, the changes in the sIgA concentration was not accompanied with a major sIgA secretion in the saliva

Old zoonotic agents and novel variants of tick-borne microorganisms from Benguela (Angola), July 2017

Anaplasmataceae; Ticks; Zoonotic agentsAnaplasmatàcies; Paparres; Agents zoonòticsAnaplasmatáceas; Garrapatas; Agentes zoonóticosBackground Ticks and tick-borne diseases constitute a real threat for the livestock industry, which is increasing in Angola. In addition, ticks are vectors of zoonoses of public health concern, and scarce information is available from this country. In an effort to contribute to the prevention of zoonotic infectious diseases affecting humans and animals, the molecular screening of certain tick-related microorganisms collected on cattle in Angola was performed under a ‘One Health’ scope. Methods Ticks collected from cattle in Cubal (Benguela Province, Angola) in July 2017 were analysed in pools using specific PCR assays for bacteria (Rickettsia, Anaplasmataceae, Borrelia, Coxiella and Spiroplasma) and protozoa (Theileria and Babesia) detection. Results A total of 124 tick specimens were grouped in 25 pools (two Amblyomma variegatum, three Hyalomma truncatum, 16 Rhipicephalus decoloratus, two Rhipicephalus duttoni, one Rhipicephalus evertsi mimeticus and one Rhipicephalus sp.). The amplified microorganisms were (pools): Rickettsia africae (two A. variegatum and one R. decoloratus), Rickettsia aeschlimannii (three H. truncatum), Ehrlichia spp. (six R. decoloratus), Coxiella spp. (all but H. truncatum), Francisella sp. (one H. truncatum), Spiroplasma sp. closely related to Spiroplasma ixodetis (three R. decoloratus), Babesia bigemina (two R. decoloratus) and Babesia spp. (two A. variegatum). The obtained nucleotide sequences from Ehrlichia spp., two Coxiella genotypes (from R. duttoni and Rhipicephalus sp.), Francisella sp. and Babesia spp. (from A. variegatum) reached low identities with known genetically characterized species. Conclusions This study demonstrates the circulation in Angola of the pathogen R. aeschlimannii and potential novel tick-related microorganisms belonging to Ehrlichia, Coxiella, Francisella, Spiroplasma and Babesia spp. and corroborates the presence of R. africae and B. bigemina. Our results should be considered in developing protocols for the management of fever of unknown origin and for veterinary practices. Further studies are required to evaluate the risk of tick-borne diseases in Angola.This work has been partially funded by European Regional Development Funds (FEDER)

Estrategias CRM en Dent Import S.A. y su rentabilidad en el negocio

Dent Import S.A. es una empresa del rubro odontológico, que se dedica a la importación y comercialización de las principales marcas del sector, contando con la exclusividad de ellas. Desde sus inicios ha estado dirigida por la familia Alcántara, quienes gozan de gran conocimiento del sector, gracias al trabajorealizado durante 45 años. El constante cambio del mercado, los productos, servicios y competidores, viene exigiendo a las empresas grandes cambios a favor de los clientes y consumidores, de no considerar nuevos enfoques se corre el riesgo de ser sorprendidos por los competidores y traicionados por las nuevas preferencias y estilos de compra. Buscamos analizar la situación actual del sector y la empresa, desarrollando estrategiasbasadas en CRM, para integrar y gestionar la relación entre la empresa y el cliente, construyendo relaciones duraderas en el tiempo y consolidar a Dent Import en el mercado, finalmente obtener mejores resultados de participación y rentabilidad de manera sostenible. La fidelización de los clientes es la base del éxito de toda empresa, siendo este el principal activo yen este sentido planteamos dejar de limitarnos a lanzar productos al mercado y captar clientes susceptibles de comprarlos, para pasar a la creación de relaciones estables y de continuidad con los mejores clientes de la compañía, pues bajo un entorno enormemente competitivo y tecnológico como el actual, con mercados saturados de oferta,podemos de ser sorprendidos por cualquier inofensivo competidor y sus agresivas estrategias. Nuestra propuesta CRM, tiene como base estrategias de segmentación, con una evaluación financiera que proyecta el beneficio y la rentabilidad para la empresa, con una TIR de 43.47% versus un WACC de 9.13%, resultado que estará sujeto a una buena implementación y una distribución de gastos eficiente, alineado al nuevo enfoque.Tesi