84 research outputs found
Sistema web para el control de la producción en la empresa metal mecánica Camacho S.A.C
El presente proyecto tiene como finalidad desarrollar e implementar un
sistema informático para el control de producción de servicios en la empresa
Metal Mecánica Camacho SAC. La situación actual de la empresa presenta
una problemática en el control de los servicios y ordenes de fabricación.
originando efectos en la entrega de mercadería y en la instalación de algunos
servicios; se identificaron las causas del problema en las fases de
planificación, por la sobrecarga de la capacidad operativa de la planta para la
ejecución de órdenes de fabricación y en la realización de algunos servicios,
debido a que dichos requerimientos entre el área de ventas y la de producción
e hacen de manera verbal y con una estimación poco exacta para en lo que
respecta a la duración de cada orden de fabricación y a la capacidad instala
de la planta, lo cual implica que la información sea errónea y genere
incomodidad con los clientes; por ende se evidencia un alto índice de
reprocesos y una bajo eficacia del servicio y ordenes de fabricación.
El objetivo del estudio es determinar la influencia de un sistema informático en
el control de producción de órdenes de fabricación de la empresa Metal
Mecánica Camacho S.A.C. Para el desarrollo del sistema informático se
empleó el entiti Framework y el gestor de base de datos SQL, así mismo, la
metodología de desarrollo fue SCRUM.
La presente investigación es de tipo aplicada- experimental y diseño preexperimental. Así mismo, se tomó como indicadores el reproceso y eficiencia
d e la producción con u n a m u e s t r a d e 3 0 ó r d e n e s de fabricación
para a m b o s indicadores. Para esta investigación se concluye que el Sistema
Web incrementó el Nivel de eficiencia en un 4,39%. Asi como también
disminuye el porcentaje de reproceso en un 6,31%.Finalmente, después de
haber obtenido resultados satisfactorios de los indicadores de estudio, se
concluye que el sistema informático mejoró el control de producción en la
empresa Metal Mecánica Camacho
Experimental Stark widths and shifts of V II spectral lines
We have measured the Stark widths and shifts of V II spectral lines in the wavelength range 2000-4200 Å belonging to 75 multiplets. The spectra are emitted by laser-induced plasmas generated from fused glass discs prepared by borate fusion. The electron density and temperature are in the ranges (0.72-6.5) × 1017 cm-3 and (11 000-14 900) K, respectively. To avoid self-absorption, we have used seven samples with vanadium concentrations selected by the CSigma graph methodology. This has allowed to include strong and weak lines in the study, including resonance and forbidden lines. The experimental widths and shifts are compared with theoretical values available in the literature.Fil: Manrique Rosel, Javier. Universidad CEU San Pablo; EspañaFil: Diaz Pace, Diego Martin. Universidad Nacional del Centro de la Provincia de Buenos Aires. Centro de Investigaciones en Física e Ingeniería del Centro de la Provincia de Buenos Aires. - Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tandil. Centro de Investigaciones en Física e Ingeniería del Centro de la Provincia de Buenos Aires. - Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas. Centro de Investigaciones en Física e Ingeniería del Centro de la Provincia de Buenos Aires; ArgentinaFil: Aragón, Concepción. Universidad Publica de Navarra. Departamento de Ciencias.; EspañaFil: Aguilera Andoaga, Jose antonio. Universidad Publica de Navarra. Departamento de Ciencias.; Españ
The role of entrepreneurship and green innovation intention on sustainable development: moderating impact of inclusive leadership
Today, sustainable development (SD) is a worldwide requirement due to the numerous environmental challenges that require the attention of academics. Consequently, the current study explores the effect of entrepreneurial and green innovation aims on SD in Peru. In addition, the study examines the moderating effect of inclusive leadership on entrepreneurship, green innovation intention, and sustainable development in Peru. The study utilized primary data collection instruments such as questionnaires to collect information from the selected respondents. The paper also used smart-PLS to examine the data's dependability and the correlation between factors. In Peru, entrepreneurship and green innovation intentions were found to have a good relationship with sustainable development. In addition, the data demonstrated that inclusive leadership moderates the relationship between entrepreneurship, green innovation intention, and SD in Peru. The essay supports policy-making authorities in formulating SD-related policies by refocusing entrepreneurs' attention on green innovation.Wilson Cruz Mamani (Universidad Peruana Unión Juliaca), Germain Marcos Lagos Manrique (Universidad Nacional Federico Villarreal), Soraya del Pilar Carranco Madrid (Universidad Central del Ecuador), Edward Espinoza Herrera (Universidad Nacional Federico Villarreal), David Barrial Acosta (Universidad Nacional Micaela Bastidas de Apurímac), Rolando Remy Rivas-Diaz (Universidad Nacional de San Agustín), José Luis Arias-Gonzáles (University of British Columbia), Yuselino Maquera Maquera (Universidad Nacional del Altiplano Puno), Francisco Samael Saravia Ramos (Universidad Nacional De San Agustín)Includes bibliographical references
Utilidad del score SOFA en la predicción de muerte materna en la UCI materna del INMP
Objective: To compare the SOFA score at admission and 24 hours and evaluate its usefulness in predicting maternal death. Materials and methods: A cross-sectional descriptive study of patients admitted to the Maternal ICU of the INMP was carried out from August 2014 to July 2019. Parametric and non-parametric tests were applied according to a previous evaluation of normality and a statistical significance p<0.05. Statistical analysis was performed using the statistical package STATA version 13. Results: The mean age corresponds to 28.32 years. The mean gestational age corresponded to 31.33 weeks; The mean hospital stay was 4.52 days. The area under the curve for SOFA at entry was 0.8818 and the area under the curve for SOFA at 24 hours was 0.9755. P=0.1225. No significant differences were found between them. It was determined that the best cut-off point corresponds to a Score of 6 with a sensitivity that corresponds to 89.29% and a specificity of 79.13%. Conclusions: The SOFA Score adapts well to obstetric patients admitted to Maternal Intensive Care settings, maintaining a cut-off of 6 for admission SOFA with good sensitivity and specificity. (89.29%, 79.13%). The SOFA score is useful in maternal ICU environments and it should be used in our country.Objetivo: Comparar el score SOFA al ingreso y a las 24horas, y evaluar su utilidad en la predicción de la muerte materna. Materiales y métodos: Se realizó un estudio descriptivo de tipo transversal de las pacientes admitidas a la UCI Materna del INMP desde agosto del 2014 a Julio del 2019. Se aplicaron pruebas paramétricas o no paramétricas según evaluación previa de normalidad y se usó una significación estadística p<0.05. El análisis estadístico se realizó utilizando el paquete estadístico STATA versión 13. Resultados: La media de la edad corresponde a 28.32 años. La media de la edad gestacional correspondió a 31.33 semanas; La media de la estancia hospitalaria fue de 4.52 días. El area bajo la curva para el SOFA al ingreso fue de 0.8818 y el area bajo la curva del SOFA a las 24horas fue de 0.9755. P=0.1225. No se encontraron diferencias significativas entre ellas. Se determinó que el mejor punto de corte corresponde a un Score de 6 con una sensibilidad que corresponde a 89.29% y una especificidad de 79.13%. Conclusiones: El Score SOFA se adapta bien a las pacientes obstétricas admitidas en los ambientes de Cuidados Intensivos Materno, manteniendo un corte de 6 para el SOFA de ingreso con una buena sensibilidad y especificidad. (89.29%, 79.13%). El Score SOFA es útil para ser usado en ambientes de UCI y además debe sugerirse su uso en toda UCI obstétrica de nuestro país
Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis
BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London
Procesos de aplicación conceptual y práctico de la normatividad tributaria en contextos investigativos procedimentales tributarios para el fortalecimiento de las competencias disciplinares y profesionales
La presente investigación planteó como objetivo realizar las memorias con las temáticas investigativas que se desarrollaron en el Seminario de Investigación Aplicada, con el fin de actualizar en los participantes y fortalecer sus conocimientos específicos en materia tributaria con base en los temas investigativos dispuestos y orientados por cada docente desde su inicio, elaboración, construcción y presentación ante los docentes evaluadores. Los trabajos cumplen su fin primordial con es fortalecer con los desarrollos temático de cada módulo visto en el SIA sus capacidades y competencias profesionales especialmente en el contexto tributario, en cumplimiento al requerimiento para otorgar al título de Especialistas en Gerencia Tributaria. Luego las memorias compiladas son el resultado de los trabajos presentados y evaluados oportunamente por cada docente comprometido con la calidad en cuanto a las temáticas investigativas, calidad de los contenidos, talleres teóricos prácticos, elementos metodológicos y de más lineamentos institucionales y del programa.
La importancia de las memorias radica en su contenido el cual desglosa definiciones, conceptos, desarrollos teóricos prácticos, constituyéndose en un ejemplar de consulta investigativa en áreas de conocimiento fiscal y tributario en el marco de la Ley 1819 de 2016 y sus decretos reglamentarios, en síntesis al interior encontraremos fundamentos teóricos prácticos, procedimentales y resolutivos de casos especiales de Gravamen a los Movimientos Financieros, Monotributo, Renta Personas Naturales, Renta Personas Jurídicas, Procedimiento Tributario, Impuestos Distritales, Normas internacionales de Información Financiera Pymes, entre otros temas
Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial
Background:
Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke.
Methods:
We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515.
Findings:
Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p<0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (<1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (<1%) deaths in the albiglutide group.
Interpretation:
In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes.
Funding:
GlaxoSmithKline
Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study
Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak.
Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study.
Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM.
Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide
Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study
Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world.
Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231.
Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001).
Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication
Global disparities in surgeons’ workloads, academic engagement and rest periods: the on-calL shIft fOr geNEral SurgeonS (LIONESS) study
: The workload of general surgeons is multifaceted, encompassing not only surgical procedures but also a myriad of other responsibilities. From April to May 2023, we conducted a CHERRIES-compliant internet-based survey analyzing clinical practice, academic engagement, and post-on-call rest. The questionnaire featured six sections with 35 questions. Statistical analysis used Chi-square tests, ANOVA, and logistic regression (SPSS® v. 28). The survey received a total of 1.046 responses (65.4%). Over 78.0% of responders came from Europe, 65.1% came from a general surgery unit; 92.8% of European and 87.5% of North American respondents were involved in research, compared to 71.7% in Africa. Europe led in publishing research studies (6.6 ± 8.6 yearly). Teaching involvement was high in North America (100%) and Africa (91.7%). Surgeons reported an average of 6.7 ± 4.9 on-call shifts per month, with European and North American surgeons experiencing 6.5 ± 4.9 and 7.8 ± 4.1 on-calls monthly, respectively. African surgeons had the highest on-call frequency (8.7 ± 6.1). Post-on-call, only 35.1% of respondents received a day off. Europeans were most likely (40%) to have a day off, while African surgeons were least likely (6.7%). On the adjusted multivariable analysis HDI (Human Development Index) (aOR 1.993) hospital capacity > 400 beds (aOR 2.423), working in a specialty surgery unit (aOR 2.087), and making the on-call in-house (aOR 5.446), significantly predicted the likelihood of having a day off after an on-call shift. Our study revealed critical insights into the disparities in workload, access to research, and professional opportunities for surgeons across different continents, underscored by the HDI
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