Análisis de los errores en el picking y verificación de unidades sueltas en el centro de distribución de comercial Nutresa Bogotá

Para el centro de distribución de Comercial Nutresa, el proceso de preparación de pedidos tiene dos conceptos fundamentales: eficiencia y efectividad. La eficiencia se refiere a la velocidad con la que realizan el alistamiento de los pedidos, mientras que la efectividad corresponde a la exactitud con que se alista la mercancía que se había solicitado. La promesa de servicio al cliente consiste en entregarle los productos solicitados, en el plazo pactado y en las cantidades acordadas. Cuando existen errores en el proceso de alistamiento de mercancía que no son solucionados antes del envío al cliente, se corre el riesgo de perder ventas y generar molestias. Actualmente, Comercial Nutresa presenta errores constantes en las ordenes despachadas, a pesar de realizar una verificación del 100% de los alistamientos, solo logra identificar el 40% de los casos con novedades en las cantidades alistadas. Con el objetivo de disminuir la cantidad de errores y optimizar recursos en el proceso alistamiento, se propone una lista de recomendaciones y buenas prácticas, acompañadas de un modelo de aprendizaje automático capaz de reconocer alistamientos con alta probabilidad de ser defectuosos. La propuesta logra reducir un 70% la cantidad de alistamientos a verificar, logrando identificar el 60% de los errores. En términos de negocio, esto representa ahorros operativos cercanos a 320 millones de pesos colombianos anuales.At Comercial Nutresa distribution center, the order picking process has two fundamental concepts: efficiency and effectiveness. The efficiency consists of the time taken to complete orders packaging, while the effectiveness is the accuracy in which the merchandise requested was delivered. The customer service level agreement consists of the delivery of requested products, at the right moment and in the required quantities. Before sending merchandise to the customers, orders should fulfill all commercial requirements, otherwise the risk of losing sales and generating discomfort increases. Currently, Comercial Nutresa constantly presents issues in the product sent to its customers. Despite performing a 100% verification of the enlistments, Comercial Nutresa has only been able to identify 40% of faulty picking orders. In order to reduce the number of errors and optimize resources in the enlistment process, a list of recommendations and good practices are proposed, along with a machine learning model capable of recognizing enlistments with a high probability of being defective. The proposal manages to reduce the number of enlistments to be verified by 70% while identifying 60% of the errors. In terms of business, this represents operating savings close to 320 million Colombian pesos annually.Magíster en Analítica para la Inteligencia de NegociosMaestrí

Reliability and validity of the Colombian version of the Revised Sociosexual Orientation Inventory

Sociosexuality refers to an individual’s disposition to have casual sex without establishing affective bonds and has been widely studied worldwide using the Revised Sociosexual Orientation Inventory (SOI-R; Penke & Asendorpf, 2008). Despite its many validations in different cultural contexts, no psychometric analyses of this instrument have been conducted in Spanish-speaking Latin American countries. To address this gap in the literature, we examined the psychometric properties of the SOI-R in Colombia. In a cross-sectional study with a large sample of participants (N = 812; 64% women), we conducted exploratory and confirmatory factor analyses to identify different factor structures and determine which had the best fit for our sample and examined the reliability of the scale. Results showed that a three-factor structure, with sociosexual behaviors, attitudes, and desire as first-order factors, and global sociosexuality as a second-order factor, had the best fit indexes. Each factor presented good reliability indexes. Replicating already established gender differences, we also found that men scored higher on each factor when compared to women. These findings show that the SOI-R is a reliable and valid instrument to assess sociosexuality in countries where sociosexuality research is underrepresented.info:eu-repo/semantics/publishedVersio

Clinical Correlation Between Computerized Tomography Findings and Pathologic Diagnosis in Patients Surgically Treated for Complex Renal Cysts in a Colombian Tertiary Center

IntroductionRecent data have reexamined the historical rates of malignancy observed in Bosniak IIF and III cystic lesions, and this has led to an endorsement of the use of active surveillance as the standard of care for Bosniak III renal cysts by affirming that overtreatment rates for this subgroup are close to 50%. In light of this, the present study describes the correlation between imaging studies and pathologic diagnosis in patients surgically treated for complex renal cysts in Colombia.Materials and methodsThis is a retrospective, descriptive, and observational study. We analyzed the medical histories of patients who had been surgically treated for complex renal cysts between 2010 and 2018 in the urology department of a tertiary center in Bogota, Colombia. The exclusion criteria were incomplete clinical histories and absent diagnostic images or their official interpretation.ResultsOut of the 235 urological procedures performed, nine were excluded. And 6.19% (n = 14) were cases of surgically treated complex renal cysts; 38.46% were compatible with Bosniak 46.15% were Bosniak III, and 15.38% were Bosniak IV. The percentage of renal cancer as revealed by the histopathological study was 60, 66.7 and 100 for renal cysts Bosniak IIF, III, and IV, respectively; 77.7% of these confirmed oncological cases had received a diagnosis of clear cell renal carcinoma.ConclusionsIn our study, the percentage of malignancy in patients with renal cysts Bosniak IIF and III was found to be greater compared to the findings in the recent medical literature. We believe that the management offered to the population with complex renal cysts in Colombia should be tailored to the individual risk characteristics of each patient

Factores asociados a flebitis química en pacientes en tratamiento quimioterapéutico, revisión sistemática de la literatura

Objective: To describe the factors related to chemical phlebitis in patients diagnosed with cancer undergoing chemotherapeutic treatment. Methodology: A systematic review of the literature was carried out, according to recommendations of Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). Results: The factors that increase the risk of chemical phlebitis were: age older than 57 years, female sex, history of cancer, metastatic disease, arterial hypertension, neutropenia, smoking, lymph node emptying, hypoalbuminemia, use of cytotoxic drugs, epirubicin, fosaprepitant, anthracycline and vinorelbine, premixed presentation, dilution in 50 cc of Normal Saline Solution, administration time greater than 60 minutes, catheters of large gauges such as 18 G or 20 G and anatomical location of the catheter in the forearm or antecubital fossa. Conclusion: Factors related to chemical phlebitis found in the literature were features inherent to the patient and their treatment. Therefore, some of these are not modifiable.Objetivo: describir los factores relacionados a la flebitis química en pacientes con diagnóstico de cáncer en tratamiento quimioterapéutico, que evidencia la literatura. Metodología: se realizó una revisión sistemática de la literatura, según recomendaciones de Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). Resultados: los factores que aumentaron el riesgo de flebitis química hallados en la evidencia, fueron la edad mayor de 57 años, sexo femenino, antecedentes de cáncer, enfermedad metastásica, hipertensión arterial, neutropenia, tabaquismo, vaciamiento ganglionar, hipoalbuminemia, uso de medicamentos citotóxicos, epirrubicina, fosaprepitant, antraciclina y vinorelbina, presentación premezclada de los fármacos, dilución en 50cc de solución salina normal, tiempo de administración mayor a 60 minutos, catéteres de calibres grandes como 18G o 20G, y ubicación anatómica del catéter en antebrazo o fosa antecubital. Conclusión: los principales factores asociados a la flebitis química están relacionados con aspectos inherentes al paciente y a su tratamiento, algunos de estos son no modificables.  Objetivo: describir los factores relacionados a la flebitis química en pacientes con diagnóstico de cáncer en tratamiento quimioterapéutico, que evidencia la literatura. Metodología: se realizó una revisión sistemática de la literatura, según recomendaciones de Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). Resultados: los factores que aumentaron el riesgo de flebitis química hallados en la evidencia, fueron la edad mayor de 57 años, sexo femenino, antecedentes de cáncer, enfermedad metastásica, hipertensión arterial, neutropenia, tabaquismo, vaciamiento ganglionar, hipoalbuminemia, uso de medicamentos citotóxicos, epirrubicina, fosaprepitant, antraciclina y vinorelbina, presentación premezclada de los fármacos, dilución en 50cc de solución salina normal, tiempo de administración mayor a 60 minutos, catéteres de calibres grandes como 18G o 20G, y ubicación anatómica del catéter en antebrazo o fosa antecubital. Conclusión: los principales factores asociados a la flebitis química están relacionados con aspectos inherentes al paciente y a su tratamiento, algunos de estos son no modificables.

Análisis de los destinos turísticos del futuro

Actualmente, el mayor reto del mercado turístico es cubrir la demanda de viajeros que buscan nuevos destinos turísticos, y que a la vez desean experimentar una innovación tecnológica en ellos. El turismo espacial, se ha convertido en uno de los sectores más llamativos pertenecientes a la industria turística, y por ello las empresas relacionadas a este campo buscan satisfacer las futuras necesidades de los clientes a quienes van dirigidas sus actividades, e implementar un nuevo modelo de viaje que trabaje con los avances tecnológicos para así conocer el espacio exterior. En este artículo se analiza el impacto de las formas innovadoras de viaje actuales, y las que próximamente serán establecidas, basándose en los factores de brindar comodidad, seguridad y una experiencia completamente nueva a los clientes sin desaprovechar las nuevas tecnologías, para así lograr el reconocimiento del avance de la industria turística. Los resultados preliminares de esta investigación permiten evidenciar el número de proyectos que buscan ser implementados y lanzados al público, con relación a los destinos turísticos en el espacio exterior, y la posibilidad de lograr salir de este planeta de forma más asequible para los viajeros alrededor del mundo

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

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