Mejora del proceso de planificación de la demanda en la empresa de Aceros Metalcor S.A

Hoy en día, China, una de las principales economías del mundo, exporta alrededor de 533.000 toneladas de tubos de acero laminados en caliente al año, siendo el Perú el número 22 de su lista de compradores, importando 6.700 toneladas de tubos en el 2017 (Trademap 2018). Aceros Metalcor S.A., compañía dedicada a la fabricación de elementos de acero en el mercado peruano con aproximadamente 35 años de experiencia, ha presentado en los últimos meses del 2017 y 2018 problemas de liquidez que deben ser resueltos para que la organización pueda enfrentar sus costos operativos como los pagos a los proveedores de materia prima, por ejemplo, bobinas laminadas de acero, representando aproximadamente el 65% de la estructura de costos para la fabricación de tubos de acero. Nos hemos centrado en su proceso de planificación y proyección de producción de tubos de acero con el objetivo de reducir capital de trabajo de mercadería sin sacrificar el nivel de servicio al cliente y dando mayor exactitud en el modelo de planificación de la demanda bajo el modelo de planeación S&OP intermedio-base

Guía de práctica clínica para el manejo de cáncer de cuello uterino estadios tempranos

Background: This article summarizes the clinical practice guideline (CPG) for the management of early-stage cervical cancer (IA1, IA2, IB1, IB2 o IIA1) in the Social Security of Peru (EsSalud). Objective: To provide clinical recommendations based on evidence for the management of early-stage cervical cancer in EsSalud. Material and methods: A CPG for the management of early-stage cervical cancer in EsSalud was developed. To this end, a guideline development group (local GDG) was established, including medical specialists and methodologists. The local GDG formulated 8 clinical questions to be answered by this CPG. Systematic searches of systematic reviews and -when it was considered pertinent- primary studies were conducted in Pubmed, Embase y CENTRAL during 2017 - 2018. The evidence to answer each of the posed clinical questions was selected. The quality of the evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In periodic work meetings, the local GDG used the GRADE methodology to review the evidence and formulate the recommendations, points of good clinical practice, and the flowchart of management. Finally, the CPG was approved with Resolution No. N° 27-IETSI-ESSALUD-2020. Results: This CPG addressed 8 clinical questions on the management of early-stage cervical cancer (IA1, IA2, IB1, IB2 o IIA1). Based on these questions, 10 recommendations (2 strong recommendations and 8 weak recommendations), 7 points of good clinical practice, and 4 flowcharts were formulated. Conclusion: This article summarizes the methodology and evidence-based conclusions from the CPG for the management of early-stage cervical cancer in EsSalud.Introducción: Este artículo resume la guía de práctica clínica (GPC) para el manejo de cáncer de cuello uterino estadios tempranos (IA1, IA2, IB1, IB2 o IIA1) en el Seguro Social del Perú (EsSalud). Objetivo: Proveer recomendaciones clínicas basadas en evidencia para el manejo de cáncer de cuello uterino estadios tempranos en EsSalud. Material y métodos: Se conformó un grupo elaborador de la guía (GEG) que incluyó médicos especialistas y metodólogos. El GEG formuló 8 preguntas clínicas a ser respondidas por la presente GPC. Se realizó búsquedas sistemáticas de revisiones sistemáticas y –cuando fue considerado pertinente– estudios primarios en Pubmed, Embase y CENTRAL durante el 2017 - 2018. Se seleccionó la evidencia para responder cada una de las preguntas clínicas planteadas. La certeza de la evidencia fue evaluada usando la metodología Grading of Recommendations Assessment, Development, and Evaluation (GRADE). En reuniones de trabajo periódicas, el GEG usó la metodología GRADE para revisar la evidencia y formular las recomendaciones, los puntos de buenas prácticas clínicas y los flujogramas de manejo. Finalmente, la GPC fue aprobada con Resolución N° 27-IETSI-ESSALUD-2020. Resultados: La presente GPC abordó 8 preguntas clínicas abordando el manejo del cáncer de cuello uterino en estadios tempranos. En base a dichas preguntas se formularon 10 recomendaciones (2 recomendaciones fuertes y 8 recomendaciones condicionales), 7 puntos de buena práctica clínica, y 4 flujogramas. Conclusión: El presente artículo resume la metodología y las conclusiones basadas en evidencias de la GPC para el manejo del cáncer de cuello uterino en estadios tempranos en EsSalud

Intervención grupal para el tratamiento psicológico de autolesiones no suicidas en adolescentes: un estudio piloto

[spa] La autolesión no suicida (nonsuicidal self-injury, NSSI) es la destrucción deliberada y auto-infligida de tejido corporal que suele producir sangrado, hematoma o dolor, con daño físico leve o moderado. La prevalencia de esta conducta en muestras clínicas adolescentes oscila entre 21.7% en nuestro país y 40 % a nivel internacional. La hipótesis de la regulación emocional propone que las conductas NSSI producen un alivio inmediato de los estados emocionales desagradables, a pesar de las consecuencias negativas a largo plazo. Así el presente estudio tiene como objetivo conocer si se producen cambios antes y después de una intervención grupal de 12 sesiones que introduce un componente de mindfulness. Los ejes principales del programa fueron: autocuidado, tolerancia al malestar y afrontamiento, defensas y distorsiones cognitivas, límites y relaciones interpersonales e identidad. Se esperaba un aumento de la atención plena, una mejoría de la regulación emocional, la reducción de los sentimientos de depresión, ansiedad y estrés, y una disminución de la frecuencia de las autolesiones. Las participantes eran 12 adolescentes mujeres de 13-17 años con conductas NSSI atendidas en un dispositivo sanitario de la Comunidad de las Islas Baleares. Los resultados indican una disminución significativa de las autolesiones después del tratamiento, con un tamaño del efecto grande. La conducta NSSI más frecuente son los cortes en diferentes partes del cuerpo. Las estrategias de regulación emocional desadaptativas y los síntomas de depresión, ansiedad y estrés disminuyen, aunque no significativamente, con un tamaño de efecto medio-alto. Sin embargo, no se obtuvieron los resultados esperados en el aumento de la atención plena. A pesar de las limitaciones, la reducción significativa de las autolesiones es un resultado prometedor que necesita ser investigado en el futuro a través de un estudio controlado y aleatorizado, con una muestra más numerosa y con un protocolo de intervención manualizado[eng] Nonsuicidal self-injury (NSSI) is the deliberate and self-inflicted destruction of body tissue that often results in bleeding, bruising or pain, with mild or moderate physical damage. The prevalence of this behavior in adolescent clinical samples ranges from 21.7% in our country to 40% at the international level. The emotional regulation hypothesis proposes that NSSI behaviors produce immediate relief from unpleasant emotional states, despite the longterm negative consequences. Thus the present study aims to know if there are changes before and after a group intervention of 12 sessions that introduces a component of mindfulness. The main axes of the program were: self-care, tolerance to malaise and coping, defenses and cognitive distortions, limits and interpersonal relationships and identity. Increased mindfulness, improved emotional regulation, reduced feelings of depression, anxiety and stress, and decreased frequency of self-harm were expected. The participants were 12 female adolescents aged 13- 17 years with NSSI behaviors treated in a mental health service of the Community of the Balearic Islands. The results indicate a significant decrease in post-treatment self-injury, with a large effect size. The most common NSSI behavior is cuts in different parts of the body. Maladaptive emotional regulation strategies and symptoms of depression, anxiety and stress decrease, although not significantly, with a medium-high effect size. However, the expected results in the increase in mindfulness were not obtained. Despite the limitations, a significant reduction in self-harm is a promising result that needs to be investigated in the future through a randomized controlled study, with a larger sample and a manualized intervention protocol

Transformation textures in hot rolled steels

The way in which texture development is affected by hot rolling, intercritical rolling, and warm rolling was studied in a plain carbon, a niobium microalloyed and an interstitial free steel. Three processing parameters were varied: the austenitizing temperature (1250$sp circ$C or 1150$sp circ$C), amount of reduction (90% or 75%) and finish rolling temperature (1020$sp circ$C, 870$sp circ$C, 770$sp circ$C, 730$sp circ$C and 630$sp circ$C for the first two materials, and 1020$sp circ$C, 920$sp circ$C, 870$sp circ$C, 820$sp circ$C, 720$sp circ$C and 620$sp circ$C for the IF steel). It was found that lower reheating temperatures and larger deformations lead to more intense textures. The effect of finish rolling temperature was different for each steel. In the plain carbon, only warm rolling produced a strong texture. In the interstitial free steel, the strongest textures were again produced by rolling in the ferrite range. In the niobium microalloyed steel, the retardation of austenite recrystallization intensifies the fcc deformation texture components; thus, a fairly strong texture is inherited by the ferrite, which is in turn enhanced by further deformation. The experimental textures were compared with the transformation textures predicted by using the Kurdjumov-Sachs relationship. It was found that when most of the reduction was applied in the austenite recrystallization range, the cube texture appeared to form, which transformed preferentially into the rotated cube ${ 001 } langle110 rangle$. When the austenite remained in the pancaked state, the expected transformation products of the fcc rolling texture, i.e. the copper ${ 112 } langle111 rangle$, brass ${ 110 } langle112 rangle$, S ${ 123 } langle634 rangle$ and Goss ${ 110 } langle001 rangle,$ again appeared, with clear preferences for particular variants. The calculations indicate that the final ferrite texture formed from either recrystallized or deformed austenite is significantly modif

Diseño y estudio de experiencia de usuario de un laboratorio web interactivo de estimulación cognitiva para personas mayores: LABPSI

El laboratorio web LABPSI (http://www.labpsi.mdp.edu.ar/ejercicioscognitivos) es una página con una doble finalidad (véase Figura 1). Por un lado, tiene un acceso para estudiantes de psicología para que puedan encontrar ejercicios que les permitan poner en práctica los conceptos teóricos que ven en ciertas asignaturas de la carrera. Esta parte es la que dio origen al laboratorio. Posteriormente, se creó el segundo acceso que es el de Ejercicios para la Comunidad, que contiene ejercicios de estimulación cognitiva para distintos procesos mentales (ej. atención, memoria, lenguaje, etc.). El mismo fue desarrollado de manera colaborativa con las terapistas ocupacionales de la ONG Centro Integral de la Memoria GAMA como un espacio donde poder digitalizar actividades de estimulación que puedan ser utilizadas tanto de manera individual como grupal. Las actividades están destinadas a personas mayores con o sin experiencia en el uso de la tecnología y con o sin deterioro cognitivo. Este laboratorio cuenta hoy con más de 70 ejercicios, con distintos niveles de complejidad, que pueden ser usados de manera libre y gratuita por la población. Es una página web responsiva de modo que se adapta y puede ser utilizada en teléfonos celulares y tabletas.Fil: Vivas, Leticia Yanina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Psicología Básica, Aplicada y Tecnología. Universidad Nacional de Mar del Plata. Facultad de Psicología. Instituto de Psicología Básica, Aplicada y Tecnología.; ArgentinaFil: Lopez Moreno, Maria Celeste. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Psicología Básica, Aplicada y Tecnología. Universidad Nacional de Mar del Plata. Facultad de Psicología. Instituto de Psicología Básica, Aplicada y Tecnología.; ArgentinaFil: Revollo Sarmiento, Elsa Araceli. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Psicología Básica, Aplicada y Tecnología. Universidad Nacional de Mar del Plata. Facultad de Psicología. Instituto de Psicología Básica, Aplicada y Tecnología.; ArgentinaFil: Ortells, Tobias. Universidad Nacional de Mar del Plata. Facultad de Psicología; ArgentinaFil: Vera, Rocío Belén. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Psicología Básica, Aplicada y Tecnología. Universidad Nacional de Mar del Plata. Facultad de Psicología. Instituto de Psicología Básica, Aplicada y Tecnología.; ArgentinaFil: Butrón, Patricia. Grupo de Autoayuda Al Mal de Alzheimer; ArgentinaFil: Ramella, Juliana. Grupo de Autoayuda Al Mal de Alzheimer; ArgentinaFil: Chimento, Ana. Universidad Nacional de Mar del Plata. Facultad de Arquitectura, Urbanismo y Diseño; ArgentinaFil: Salinas, Germán Emanuel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Psicología Básica, Aplicada y Tecnología. Universidad Nacional de Mar del Plata. Facultad de Psicología. Instituto de Psicología Básica, Aplicada y Tecnología.; ArgentinaFil: Vivas, Jorge Ricardo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Psicología Básica, Aplicada y Tecnología. Universidad Nacional de Mar del Plata. Facultad de Psicología. Instituto de Psicología Básica, Aplicada y Tecnología.; Argentin

European validation of a real-time PCR-based method for detection of Listeria monocytogenes in soft cheese

The classical microbiological method for detection of Listeria monocytogenes requires around 7days for final confirmation, and due to perishable nature of RTE food products, there is a clear need for an alternative methodology for detection of this pathogen. This study presents an international (at European level) ISO 16140-based validation trial of a non-proprietary real-time PCR-based methodology that can generate final results in the following day of the analysis. This methodology is based on an ISO compatible enrichment coupled to a bacterial DNA extraction and a consolidated real-time PCR assay. Twelve laboratories from six European countries participated in this trial, and soft cheese was selected as food model since it can represent a difficult matrix for the bacterial DNA extraction and real-time PCR amplification. The limit of detection observed was down to 10CFU per 25 of sample, showing excellent concordance and accordance values between samples and laboratories (>75%). In addition, excellent values were obtained for relative accuracy, specificity and sensitivity (82.75%, 96.70% and 97.62%, respectively) when the results obtained for the real-time PCR-based methods were compared to those of the ISO 11290-1 standard method. An interesting observation was that the L. monocytogenes detection by the real-time PCR method was less affected in the presence of Listeria innocua in the contaminated samples, proving therefore to be more reliable than the reference method. The results of this international trial demonstrate that the evaluated real-time PCR-based method represents an excellent alterative to the ISO standard since it shows a higher performance as well as reduce the extent of the analytical process, and can be easily implemented routinely by the competent authorities and food industry laboratories

Mediterranean diet and psychological well-being intervention to reverse metabolic syndrome in Chile (CHILEMED trial)

Psychosocial status and lifestyle are key risk factors of non-communicable diseases (NCDs), which, in turn, are main drivers of healthcare costs and morbimortality worldwide, including Chile. Mediterranean diet (MedDiet) is one of the healthiest dietary patterns under study. However, its impact on high-risk conditions, such as metabolic syndrome (MetS), and NCDs outside the Mediterranean Basin remains mostly unexplored. Even though Central Chile has an environment, food production, and culinary traditions comparable to those present in Mediterranean countries, few studies -some with significant methodological limitations- have evaluated the effect of MedDiet on health and/or disease in Chilean subjects. Importantly, a Mediterranean lifestyle is a modus vivendi that integrates physical health with mental and social well-being. Psychological well-being (PWB) is associated with healthy behaviors, positive health outcomes, and longevity, thereby emerging as a novel healthcare goal. We report here an ongoing randomized controlled clinical trial in Chilean patients with MetS seeking to test whether (1) a PWB theory-based intervention facilitates induction to and increases long-term adherence to a locally adapted MedDiet, and (2) a MedDiet intervention -implemented alone or combined with well-being promotion- is more effective at reversing MetS compared to individuals following a low-fat diet without psychological support. The CHILEan MEDiterranean (CHILEMED) diet intervention study is a 1-year trial including patients with MetS living in Chile. Participants will be assigned randomly by a computer-generated random number sequence to one of the three intervention arms: a) low-fat diet as control group, b) MedDiet alone, and c) MedDiet plus well-being support. Patients will be followed-up by individual and/or group online nutritional sessions or phone cal as well as 6- and 12-month in-person re-assessment of medical history, medication use, food intake, PWB, anthropometrics/physical exam, and blood collection for laboratory analysis. The primary outcome of the trial will be the effect of the MedDiet -with or without PWB intervention- on overall reversal of MetS compared to low-fat diet alone. Based on a statistical superiority trial, expected impact, and patient loss, the estimated study sample is 339 subjects (113 individuals per arm in 3 equal-sized groups). Currently, we have enrolled 179 patients, predominantly women, evenly distributed by age (group means ranging from 45.7 to 48,9 years-old), 3/4 are obese with almost all of them showing abdominal obesity, 70% are hypertensive, whereas <10% exhibit diabetes. If findings turn out as expected (e.g., MedDiet -with or without PWB intervention- is better than the low-fat diet for reversion of MetS at 1-year follow-up), CHILEMED will provide further beneficial evidence of the MedDiet on NCD risk conditions beyond the Mediterranean region

European validation of Real-Time PCR method for detection of Salmonella spp. in pork meat

The classical microbiological method for detection of Salmonella spp. requires more than five days for final confirmation, and consequently there is a need for an alternative methodology for detection of this pathogen particularly in those food categories with a short shelf-life. This study presents an international (at European level) ISO 16140-based validation study of a non-proprietary Real-Time PCR-based method that can generate final results the day following sample analysis. It is based on an ISO compatible enrichment coupled to an easy and inexpensive DNA extraction and a consolidated Real-Time PCR assay. Thirteen laboratories from seven European Countries participated to this trial, and pork meat was selected as food model. The limit of detection observed was down to 10CFU per 25g of sample, showing excellent concordance and accordance values between samples and laboratories (100%). In addition, excellent values were obtained for relative accuracy, specificity and sensitivity (100%) when the results obtained for the Real-Time PCR-based methods were compared to those of the ISO 6579:2002 standard method. The results of this international trial demonstrate that the evaluated Real-Time PCR-based method represents an excellent alternative to the ISO standard. In fact, it shows an equal and solid performance as well as it reduces dramatically the extent of the analytical process, and can be easily implemented routinely by the Competent Authorities and Food Industry laboratories

Mexican Asthma Guidelines: GUIMA 2017

Background: The need for a national guideline, with a broad basis among specialists and primary care physicians was felt in Mexico, to try unifying asthma management. As several high-quality asthma guidelines exist worldwide, it was decided to select the best three for transculturation. Methods: Following the internationally recommended methodology for guideline transculturation, ADAPTE, a literature search for asthma guidelines, published 1-1-2007 through 31-12-2015 was conducted. AGREE-II evaluations yielded 3/40 most suitable for transculturation. Their compound evidence was fused with local reality, patient preference, cost and safety considerations to draft the guideline document. Subsequently, this was adjusted by physicians from 12 national medical societies in several rounds of a Delphi process and 3 face-to-face meetings to reach the final version. Results: Evidence was fused from British Thoracic Society Asthma Guideline 2014, Global Initiative on Asthma 2015, and Guía Española del Manejo del Asma 2015 (2016 updates included). After 3 Delphi-rounds we developed an evidence-based document taking into account patient characteristics, including age, treatment costs and safety and best locally available medication. Conclusion: In cooperation pulmonologists, allergists, ENT physicians, paediatricians and GPs were able to develop an evidence-based document for the prevention, diagnosis and treatment of asthma and its exacerbations in Mexico