Canales de distribución: características principales de los distribuidores mayoristas de materiales de construcción de extracción minera en Barranquilla - Colombia

The general objective of this research paper is to understand the main characteristics of wholesale distributors that make up the distribution channels of building materials mining in the city of Barranquilla, Colombia, enclosing it in four dimensions: the logistics operation, the level of customer service, the characteristics of the concentration of power and conflicts that arise among its members. Construction materials are a production chain of importance in the social and economic development of the country and there are not recent research on the behavior of the distribution channels in Barranquilla, Colombia industry. The research methodology used was the case method by applying interviews conducted with officials of the most representative wholesale distributors of Barranquilla such as Ferretería Samir, Ferretería Metropolis and Granitos de la Costa. We conclude that the carriers are specialized units of the distribution channel, allowing the movement of product from the quarries. Also the decision to pack and transport agglomerated by wholesale distributors has changed the structure of distribution channels. Power is concentrated on conveyors and wholesale distributors and finally no found evidence of conflict between wholesale distributors.   El objetivo general del presente artículo de investigación consiste en comprender las principales características de los distribuidores mayoristas que componen los canales de distribución de los materiales de construcción de extracción minera en la ciudad de Barranquilla-Colombia, delimitándolo en las siguientes cuatro dimensiones: la operación logística, el nivel de servicio al cliente, las características de la concentración de poder y los conflictos que se presentan entre sus miembros. Los materiales de construcción son una cadena productiva de importancia en el desarrollo social y económico del país y no hay investigaciones recientes sobre el comportamiento de los canales de distribución del sector en Barranquilla- Colombia. La metodología de investigación que se utilizó fue el método del caso mediante la aplicación de entrevistas dirigidas a funcionarios de los distribuidores mayoristas más representativos de la ciudad de Barranquilla como son la Ferretería Samir, la Ferretería Metrópolis y Granitos de la Costa. Se concluye que los transportadores son las unidades especializadas del canal de distribución, ya que permiten el movimiento del producto desde las canteras. Así mismo la decisión de empacar y de transportar aglomerado por parte de los distribuidores mayoristas ha cambiado la estructura de los canales de distribución. El poder se concentra en los transportadores y en los distribuidores mayoristas y finalmente no se encontraron evidencias de conflictos entre los distribuidores mayoristas. &nbsp

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Valoración de buenas prácticas docentes a través de observación sistemática

The best teaching practices, an issue of particular relevance in determining the quality of higher education, requires different forms of measuring design. A big part of good practice in teacher performance corresponds to behaviors developed by the teacher in the classroom, which can be measured and analyzed using observational methodology. The study evaluates ten teachers from the University of La Laguna (Spain) and seven from Guadalajara (Mexico). Their behavior was coded using a rating scale and the behavioral interaction patterns with students were coded using the Observational Protocol of Teaching Functions (Protocolo de Observación de Funciones Docentes, PROFUNDO_UNI). The lag sequential analysis extracted significant patterns related to the feedback given to questions from the students, the reinforcement and the encouragement given to the students for their participation.Las buenas prácticas docentes, un tema de especial relevancia para determinar la calidad de la educación superior y requiere diseñar distintas formas de medirlo. Una gran parte de las buenas prácticas corresponden a comportamientos desarrollados por el profesor en el aula de clase, que se puede medir y analizar mediante metodología observacional. Se seleccionaron diez profesores de la universidad de La Laguna (España) y siete de la de Guadalajara (México), codificando sus comportamientos mediante una escala de calificación y los patrones comportamentales de interacción con el alumnado mediante el Protocolo de Observación de Funciones Docentes (PROFUNDO_UNI). El análisis secuencial de retardos extrajo patrones significativos relacionados con la retroalimentación a las preguntas del alumnado, el refuerzo dado y el fomento a la participación de los estudiantes

Valoración de buenas prácticas docentes a través de observación sistemática

The best teaching practices, an issue of particular relevance in determining the quality of higher education, requires different forms of measuring design. A big part of good practice in teacher performance corresponds to behaviors developed by the teacher in the classroom, which can be measured and analyzed using observational methodology. The study evaluates ten teachers from the University of La Laguna (Spain) and seven from Guadalajara (Mexico). Their behavior was coded using a rating scale and the behavioral interaction patterns with students were coded using the Observational Protocol of Teaching Functions (Protocolo de Observación de Funciones Docentes, PROFUNDO_UNI). The lag sequential analysis extracted significant patterns related to the feedback given to questions from the students, the reinforcement and the encouragement given to the students for their participation.Las buenas prácticas docentes, un tema de especial relevancia para determinar la calidad de la educación superior y requiere diseñar distintas formas de medirlo. Una gran parte de las buenas prácticas corresponden a comportamientos desarrollados por el profesor en el aula de clase, que se puede medir y analizar mediante metodología observacional. Se seleccionaron diez profesores de la universidad de La Laguna (España) y siete de la de Guadalajara (México), codificando sus comportamientos mediante una escala de calificación y los patrones comportamentales de interacción con el alumnado mediante el Protocolo de Observación de Funciones Docentes (PROFUNDO_UNI). El análisis secuencial de retardos extrajo patrones significativos relacionados con la retroalimentación a las preguntas del alumnado, el refuerzo dado y el fomento a la participación de los estudiantes

Mean platelet volume in a series of 315 patients with rheumatoid arthritis: relationship with disease characteristics, including subclinical atherosclerosis and cardiovascular comorbidity

Mean platelet volume (MPV) refers to the average platelet size in femtoliters. Increased or decreased MPV has been associated with several disorders, including inflammatory and cardiovascular diseases. In the present study, our objective was to analyze the relationship of MPV with disease activity in a large and well-characterized series of patients with rheumatoid arthritis (RA). This is a cross-sectional study that included 315 patients with RA and 208 controls matched by sex and age. Complete blood count, including MPV, was assessed. Multivariable analysis was performed to examine the relationship of MPV with RA disease characteristics, carotid atherosclerosis, and traditional cardiovascular factors, including a comprehensive profile of lipid molecules and insulin resistance or beta cell function indices. The multivariable analysis, which includes other hematological modifications produced by the disease and platelet values, showed that MPV levels were significantly lower in RA patients than in controls. Erythrocyte sedimentation rate and interleukin-6, but not C-reactive protein, were negatively correlated with MPV after adjustment for covariates. Similarly, disease activity and MPV had a significant and independent negative correlation. No relationships were found between MPV and cardiovascular risk factors, lipid profile or insulin resistance indices or subclinical atherosclerosis. In conclusion, patients with RA have lower levels of MPV than controls. MPV is negatively related to acute phase reactants and disease activity in RA.Funding: This study has been funded by a grant to IF-A by Instituto de Salud Carlos III (ISCIII) through the project PI20/00084 and was co-funded by the European Union

Red cell distribution width association with subclinical cardiovascular disease in patients with rheumatoid arthritis

Red cell distribution width (RDW) is a measure of the variation in mean corpuscular volume that reflects the degree of anisocytosis on the peripheral blood smear. RDW value variation has been implicated in several disorders including chronic inflammatory processes and cardiovascular (CV) diseases. In the present work, our objective was to study the relationship that RDW has with the characteristics of the disease in patients with rheumatoid arthritis (RA), focusing on CV risk factors and subclinical atherosclerosis. A cross-sectional study was conducted that included 430 patients with RA and 208 controls matched by sex and age. Complete blood count, including RDW, was assessed. Multivariable analysis was performed to analyze the relationship of RDW with RA disease characteristics, subclinical carotid atherosclerosis, and traditional CV factors, including a comprehensive profile of lipid molecules and insulin resistance and beta cell function indices. After multivariable adjustment, the RDW was significantly higher in RA patients compared with controls (beta coefficient 1.0 [95% confidence interval 0.2 to 1.8] %, p = 0.020). Furthermore, although the erythrocyte sedimentation rate showed a positive and significant relationship with RDW, this association was not found with C-reactive protein and interleukin-6. A positive and independent relationship was observed between DAS28-ESR disease activity score and RDW. However, no association was found between the RDW and other disease activity scores that do not include erythrocyte sedimentation rate in their formula. The SCORE2 CV risk algorithm was positively and significantly associated with higher RDW values. Likewise, a negative relationship was found between RDW with total cholesterol and low-density lipoprotein cholesterol, and a positive relationship was found between RDW and insulin resistance indices. In conclusion, RDW values are higher in RA patients compared to matched controls. Although the relationship of RDW with disease activity was not consistent, RDW shows associations with subclinical CV disease risk factors, including dyslipidemia and insulin resistance, and with the SCORE2 CV disease-risk prediction algorithm.Funding: This work was supported by a grant to I. Ferraz-Amaro from the Spanish Ministry of Health, Instituto de Salud Carlos III (ISCIII), PI20/00084

Relationship of blood inflammatory composite markers with cardiovascular risk factors and subclinical atherosclerosis in patients with rheumatoid arthritis

The neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammatory index (SIRI, neutrophils × monocytes/lymphocytes) have been described as potential blood-derived inflammatory biomarkers in several diseases. Rheumatoid arthritis is an inflammatory disease that has been related to an increased risk of cardiovascular (CV) disease. In the present work, we analyze how these hematological composite scores of inflammation are related to classic CV risk factors and subclinical atherosclerosis in patients with RA. In this cross-sectional study that included 430 patients with RA, the NLR, MLR, PLR, and SIRI scores were calculated. Multivariable analysis was performed to examine the relationships of these composite blood scores with subclinical carotid atherosclerosis and with traditional cardiovascular factors, producing a complete profile of lipid molecules and insulin resistance or indices of beta-cell function, and a Systematic Coronary Risk Assessment (SCORE2) calculation. C-reactive protein and disease activity were significantly and positively associated with the four blood composite scores. SCORE2 was significantly associated with higher values of SIRI, NLR, and MLR, but not PLR. These relationships were maintained when SCORE 2 was considered categorical; patients in the very high CV risk category had higher values in all hematological composite scores, except PLR. In the multivariable analysis, SIRI and NLR were independently associated with higher levels of beta cell dysfunction. In conclusion, SCORE2 and the values of the hematological composite scores were positively correlated in patients with RA. In addition, there were some relationships of these scores with traditional CV risk factors, with their association with beta cell dysfunction being the most consistent.Funding: This work was supported by a grant to I. Ferraz-Amaro from the Spanish Ministry of Health, Instituto de Salud Carlos III (ISCIII), co-funded by European Regional Development Fund-FEDER- (PI20/00084), and by a grant to I. Ferraz-Amaro from the Spanish Foundation of Rheumatology 2021 Research Program

The ratio of monocytes to HDL-cholesterol is associated with cardiovascular risk and insulin resistance in patients with rheumatoid arthritis

The monocytes to high-density lipoprotein (HDL)-cholesterol ratio (MHR) indicates inflammation based on the anti-inflammatory properties of HDL-cholesterol as well as the pro-inflammatory effect of monocytes. Several studies have investigated MHR in various disorders, specifically in cardiovascular diseases. Consequently, MHR has been significantly associated with cardiovascular and all-cause mortality in the general population, regardless of established risk factors. However, its role in the augmented risk of cardiovascular disease found in rheumatoid arthritis (RA) has not been studied to date. This is a cross-sectional study that encompassed 430 patients with RA and 208 controls matched by sex and age. Complete blood cell count and complete lipid profile were evaluated. Multivariable analysis was made to analyze the relationship between MHR and RA disease and features subclinical carotid atherosclerosis, and traditional CV factors including insulin resistance and beta cell function indices. MHR values did not differ between controls and patients after multivariable adjustment (12 ± 6 vs. 11 ± 6, p = 0.18). No relationship between this ratio and the characteristics of the disease was found excluding ESR, which showed a significant and positive association with MHR after adjustment for covariates. MHR significantly correlated with Systematic Coronary Risk Evaluation-2 (SCORE2) cardiovascular risk algorithm, and insulin resistance and beta cell function parameters after adjustment. In conclusion, MHR does not differ between patients with RA and controls. The relationship of this biomarker with disease-related data is poor. However, MHR is highly and positively related to cardiovascular risk and insulin resistance in RA.Funding: This study has been funded by a grant to IF-A by Instituto de Salud Carlos III (ISCIII) through the project PI20/00084 and co-funded by the European Union