Criterios de Buenas Practicas de Manufactura (BPM) en Empresa Molinera de Arroz

En este trabajo se analiza el proceso productivo realizado por la empresa PRODUARROZ SAS, empresa ubicada en el Municipio de Puerto Lopez Meta, la cual desarrolla la actividad de MOLINERIA DE ARROZ, esta empresa tiene una capacidad de almacenamiento de 15.000 toneladas. El abastecimiento de materia prima se realiza con agricultores del Departamento del Meta de los municipios de Puerto Lopez, Villavicencio, Cubayaro, Paratebueno, Acacias, Granada, San Carlos de Guaroa, Castilla la Nueva y Puerto Gaitán (Altillanura) El proceso industrial está estructurado para la compra de arroz paddy verde, “El paddy verde es el estado natural del arroz cuando es cosechado en campo” para luego realizar un proceso industrial de prelimpieza, secamiento, limpieza y almacenamiento, Trilla y almacenamiento de producto terminado arroz blanco para consumo humano, adicionalmente se generan unos sub productos como la harina, granza, cristal, empaquetado, cargue y despachos para comercialización. Todo el sistema de calidad de la empresa está estructurado bajo procedimientos de calidad de molinería internos, parámetros de la industria. La normatividad sanitaria para la inocuidad de alimentos que la empresa desarrolla es la siguiente: • Resolución 2674 de 2013 del Invima, establece los requisitos sanitarios que deben cumplir las empresas que realicen actividades de fabricación y procesamiento de alimentos. • Procesos de higiene la resolución 604 de 1993. • Calidad del agua el Decreto 1575 de 2007. • BPM Buenas Prácticas de Manufactura, decreto 3075 de 1997, adaptados a la actividad Molinera. Palabras clave: Trilla, Calidad de granos, Inocuidad de alimentos, buenas prácticas de manufacturas, plan de saneamiento básico.This work analyzes the production process carried out by the company PRODUARROZ SAS, a company located in the Municipality of Puerto Lopez Meta, which carries out the activity of MOLINERIA DE ARROZ. This company has a storage capacity of 15,000 tons. The supply of raw materials is carried out with farmers from the Meta Department of the municipalities of Puerto Lopez, Villavicencio, Cubayaro, Paratebueno, Acacias, Granada, San Carlos de Guaroa, Castilla la Nueva and Puerto Gaitán (Altillanura) The industrial process is structured for the purchase of green paddy rice, "The green paddy is the natural state of the rice when it is harvested in the field" to later carry out an industrial process of pre-cleaning, drying, cleaning and storage, threshing and storage of finished product white rice for human consumption, additionally some by-products are generated such as flour, pellets, glass, packaging, loading and dispatches for commercialization. The entire quality system of the company is structured under internal milling quality procedures, industry parameters. The sanitary regulations for food safety that the company develops are as follows: • Invima Resolution 2674 of 2013, establishes the sanitary requirements that companies that carry out food manufacturing and processing activities must comply with. • Hygiene processes resolution 604 of 1993. • Water quality Decree 1575 of 2007. • BPM Good Manufacturing Practices, decree 3075 of 1997, adapted to the milling activity. Key words: Threshing, Grain quality, Food safety, good manufacturing practices, basic sanitation plan

Kinescan/IBV V11: Biomechanical assessment in real time

[EN] Experts in biomechanical assessment are very interested in increasing precision of the measurements, reducing the needed time for evaluating patients and giving more flexibility to their labs. Therefore, we developed a new version of our system for kinematic analysis of human movement: Kinescan/IBV V11. Kinescan/IBV V11 is based in digital video technology and is able to make a distributed pre-processing. So it can analyse automatically movements in real time and use an unlimited number of cameras. The labs of functional assessment can reduce their costs, reduce their needed time for the assessment and increase their precision and reliability.[ES] El interés de los expertos en valoración biomecánica por incrementar la precisión de las medidas, reducir los tiempos de valoración y dotar de mayor flexibilidad a sus laboratorios es cada vez más creciente. Por esos motivos, hemos desarrollado una nueva versión de nuestro sistema de análisis cinemático de los movimientos humanos: Kinescan/IBV V11. Kinescan V11 es un sistema basado en tecnología vídeo digital con preprocesado distribuido que permite, entre otras características, analizar los movimientos en tiempo real y de forma automática y utilizar cuantas cámaras sean necesarias. Gracias a esta tecnología, los laboratorios de valoración funcional del IBV podrán reducir sus costes de operación, reducir los tiempos de valoración e incrementar su precisión y fiabilidad.Montero Vilela, J.; Parra Gonzalez, F.; Parrilla Bernabé, E.; Medina Ripoll, E.; Lopez Pascual, J.; Moreno Cano, R.; Castelli., A.... (2013). Kinescan/IBV v11: Valoración biomecánica en tiempo real. Revista de biomecánica. 59:35-38. http://hdl.handle.net/10251/38676S35385

Bleeding symptoms in patients diagnosed as type 3 von Willebrand disease : Results from 3WINTERS-IPS, an international and collaborative cross-sectional study

Background Type 3 von Willebrand's disease (VWD) patients present markedly reduced levels of von Willebrand factor and factor VIII. Because of its rarity, the bleeding phenotype of type 3 VWD is poorly described, as compared to type 1 VWD. Aims To evaluate the frequency and the severity of bleeding symptoms across age and sex groups in type 3 patients and to compare these with those observed in type 1 VWD patients to investigate any possible clustering of bleeding symptoms within type 3 patients. Methods We compared the bleeding phenotype and computed the bleeding score (BS) using the MCMDM-1VWD bleeding questionnaire in patients enrolled in the 3WINTERS-IPS and MCMDM-1VWD studies. Results In 223 unrelated type 3 VWD patients, both the BS and the number of clinically relevant bleeding symptoms were increased in type 3 as compared to type 1 VWD patients (15 versus 6 and 5 versus 3). Intracranial bleeding, oral cavity, hemarthroses, and deep hematomas were at least five-fold over-represented in type 3 VWD. A more severe bleeding phenotype was evident in patients having von Willebrand factor antigen levels <20 IU/dL at diagnosis in the two merged cohorts. In type 3 patients, there was an apparent clustering of hemarthrosis with gastrointestinal bleeding and epistaxis, whereas bleeding after surgery or tooth extraction clusters with oral bleeding and menorrhagia. Conclusions In the largest cohort of type 3 VWD patients, we were able to describe a distinct clinical phenotype that is associated with the presence of a more severe hemostatic defect.Peer reviewe

All Roads Lead to Rome: Results of Non-Invasive Respiratory Therapies Applied in a Tertiary-Care Hospital Without an Intermediate Care Unit During the COVID-19 Pandemic

Introducción. Las terapias respiratorias no invasivas (TRNI) fueron ampliamente utilizadas en la primera ola de la pandemia de COVID-19, en escenarios distintos según los medios disponibles. El objetivo fue presentar la supervivencia a 90 días y los factores asociados a esta de los pacientes tratados con TRNI en un centro de tercer nivel sin Unidad de Cuidados Respiratorios Intermedios. Como objetivo secundario comparar los resultados obtenidos de las distintas terapias. Métodos. Estudio observacional de pacientes tratados con TRNI fuera de un ambiente de Cuidados Intensivos o Unidad de Cuidados Respiratorios Intermedios, diagnosticados de COVID-19 y con síndrome de distrés respiratorio agudo por criterios radiológicos y de ratio SpO2/FiO2. Se desarrolló un modelo multivariante de regresión logística para determinar las variables independientemente asociadas, y se compararon los resultados de la terapia de alto flujo con cánula nasal y la presión positiva continua en la vía aérea. Resultados. Se trataron 107 pacientes y sobrevivieron 85 (79,4%) a los 90 días. Antes de iniciar la TRNI el ratio medio de SpO2/FiO2 fue de 119,8±59,4. Un mayor score de SOFA se asoció significativamente a la mortalidad (OR 2,09; IC95% 1,34 – 3,27), mientras que la autopronación fue un factor protector (OR 0,23; IC95% 0,06 – 0,91). La terapia de alto flujo con cánula nasal fue utilizada en 63 sujetos (58,9%), y la presión positiva continua en la vía aérea en 41 (38,3%). No se encontraron diferencias entre ellas. Conclusión. Aproximadamente cuatro de cada cinco pacientes tratados con TRNI sobrevivieron a los 90 días, y no se encontraron diferencias significativas entre la terapia de alto flujo con cánula nasal y la presión positiva continua en la vía aérea.S

SARS-CoV-2 susceptibility and COVID-19 disease severity are associated with genetic variants affecting gene expression in a variety of tissues

Variability in SARS-CoV-2 susceptibility and COVID-19 disease severity between individuals is partly due to genetic factors. Here, we identify 4 genomic loci with suggestive associations for SARS-CoV-2 susceptibility and 19 for COVID-19 disease severity. Four of these 23 loci likely have an ethnicity-specific component. Genome-wide association study (GWAS) signals in 11 loci colocalize with expression quantitative trait loci (eQTLs) associated with the expression of 20 genes in 62 tissues/cell types (range: 1:43 tissues/gene), including lung, brain, heart, muscle, and skin as well as the digestive system and immune system. We perform genetic fine mapping to compute 99% credible SNP sets, which identify 10 GWAS loci that have eight or fewer SNPs in the credible set, including three loci with one single likely causal SNP. Our study suggests that the diverse symptoms and disease severity of COVID-19 observed between individuals is associated with variants across the genome, affecting gene expression levels in a wide variety of tissue types

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P &lt; 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Los modelos financieros del BIRF: Avances y retrocesos después de 50 años de creación

53 Páginas.El Banco Internacional de Reconstrucción y Fomento -BIRF- es un organismo creado luego de la II Guerra Mundial con el objetivo de reconstruir Europa después de la guerra. Sin embargo este objetivo se cumpliría rápidamente por lo que éste debió ser redefinido ante desafíos como la erradicación de la pobreza en los países de ingresos medios y bajos. Hoy, después de más de 50 años de creación, el BIRF ha emprendido una serie de luchas contra la pobreza en varios países a través de sus mecanismos de asistencia financiera. No obstante, a pesar de sus iniciativas, dicho organismo ha sido blanco de duras críticas por las medidas adoptadas y por la poca efectividad de sus políticas en la erradicación de la pobreza en los países en desarrollo