Implementación de la herramienta CRM para mejorar el plan de ventas del área comercial en la empresa MULTISERVICIOS Z&R E.I.R.L, Chimbote - 2022

En esta investigación se tuvo como objetivo principal implementar la herramienta CRM para mejorar el plan de ventas del área comercial en la empresa MULTISERVICIOS Z&R E.I.R. L, la metodología empleada fue de tipo aplicada, enfoque cuantitativo y diseño pre experimental. Como resultado se tiene que la herramienta CRM tuvo un impacto positivo para el plan de ventas puesto que se tienen una la información de ventas a un 100%, por otro lado, capto clientes potenciales como lo es SIMA, TASA y HAYDUK, cabe resaltar que respondió a 5 objetivos trazados por el plan de ventas e identifico que los servicios que dan mayores ingresos son los de alineamiento, maniobra, inspección y verificación con el 73 y 66% en periodo Q1 y Q2 respectivamente. Como conclusión se obtuvo que la implementación del CRM permite mejorar los procesos involucrados en base a los clientes, así mismo genera reportes a tiempo real y estandariza el procesamiento de información, finalmente se identificó que las ventas de los periodos de enero a junio fueron S/ 289.485,53 con una efectividad del 29% respectivamente y un incremento de ventas de S/ 65.135,43 con respecto a los meses de julio a diciembre

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure &lt; 100 mmHg (n = 1127), estimated glomerular filtration rate &lt; 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

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

Taller de Proyecto II - SI646 - 202102

Descripción: El curso de especialidad de Taller de Proyecto II, de las carreras de Ciencias de la Computación (CC), Ingeniería de Software (ISW) e Ingeniería de Sistemas de Información (ISI), es de carácter teórico-práctico y está dirigido a los estudiantes del décimo ciclo. El curso busca desarrollar las competencias generales de comunicación oral y escrita, manejo de la información, ciudadanía y pensamiento innovador. Para CC, las competencias específicas que se desarrollan en el curso son: trabajo en equipos multidisciplinarios, responsabilidad ética y profesional, comunicación efectiva, análisis del impacto de la solución de ingeniería, necesidad de aprendizaje de por vida, aplicación de fundamentos matemáticos, diseño y construcción de sistemas complejos. Propósito: Este curso es importante dentro de la formación de los estudiantes pues permite la aplicación directa de todos los conocimientos adquiridos en ciclos anteriores; es el segundo taller a través de los cuales los estudiantes conjuntamente con los profesores involucrados en los cursos realizan el desarrollo de un Proyecto Profesional final. El taller se desarrolla bajo la aplicación de trabajos por roles. Los estudiantes desempeñan una serie de roles para el análisis, diseño, implementación y producción de un sistema de información que permite ejemplificar muy cercano a la realidad, el trabajo profesional que desarrollarán los futuros egresados. Contribuye con el desarrollo de las competencias generales de comunicación oral, pensamiento crítico, razonamiento cuantitativo, pensamiento innovador a nivel de logro 3 y ciudadanía a nivel de logro 2. Así como las competencias específicas (3) Comunicacicón Efectiva; (4) Responsabilidad ética y profesional; (5) Trabajo en equipos multidisciplinarios; (6) Aprendizaje contínuo y autónomo para la carrera de Ciencias de la Computación. Así como las competencias específicas (3) Comunicacicón Efectiva; (4) Responsabilidad ética y profesional; (5) Trabajo en equipos multidisciplinarios; (6) Análisis y emisión de conclusiones; (7) Aprendizaje contínuo y autónomo para las carreras de Ingeniería de Sistemas de Información e Ingeniería de Software

Taller de Proyecto II - SI646 - 202101

Descripción: El curso de especialidad de Taller de Proyecto II, de las carreras de Ciencias de la Computación (CC), Ingeniería de Software (ISW) e Ingeniería de Sistemas de Información (ISI), es de carácter teórico-práctico y está dirigido a los estudiantes del décimo ciclo. El curso busca desarrollar las competencias generales de comunicación oral y escrita, manejo de la información, ciudadanía y pensamiento innovador. Para CC, las competencias específicas que se desarrollan en el curso son: trabajo en equipos multidisciplinarios, responsabilidad ética y profesional, comunicación efectiva, análisis del impacto de la solución de ingeniería, necesidad de aprendizaje de por vida, aplicación de fundamentos matemáticos, diseño y construcción de sistemas complejos. Propósito: Este curso es importante dentro de la formación de los estudiantes pues permite la aplicación directa de todos los conocimientos adquiridos en ciclos anteriores; es el segundo taller a través de los cuales los estudiantes conjuntamente con los profesores involucrados en los cursos realizan el desarrollo de un Proyecto Profesional final. El taller se desarrolla bajo la aplicación de trabajos por roles. Los estudiantes desempeñan una serie de roles para el análisis, diseño, implementación y producción de un sistema de información que permite ejemplificar muy cercano a la realidad, el trabajo profesional que desarrollarán los futuros egresados. Contribuye con el desarrollo de las competencias generales de comunicación oral, pensamiento crítico, razonamiento cuantitativo, pensamiento innovador a nivel de logro 3 y ciudadanía a nivel de logro 2. Así como las competencias específicas (3) Comunicacicón Efectiva; (4) Responsabilidad ética y profesional; (5) Trabajo en equipos multidisciplinarios; (6) Aprendizaje contínuo y autónomo para la carrera de Ciencias de la Computación. Así como las competencias específicas (3) Comunicacicón Efectiva; (4) Responsabilidad ética y profesional; (5) Trabajo en equipos multidisciplinarios; (6) Análisis y emisión de conclusiones; (7) Aprendizaje contínuo y autónomo para las carreras de Ingeniería de Sistemas de Información e Ingeniería de Software

NEOTROPICAL CARNIVORES: a data set on carnivore distribution in the Neotropics

Mammalian carnivores are considered a key group in maintaining ecological health and can indicate potential ecological integrity in landscapes where they occur. Carnivores also hold high conservation value and their habitat requirements can guide management and conservation plans. The order Carnivora has 84 species from 8 families in the Neotropical region: Canidae; Felidae; Mephitidae; Mustelidae; Otariidae; Phocidae; Procyonidae; and Ursidae. Herein, we include published and unpublished data on native terrestrial Neotropical carnivores (Canidae; Felidae; Mephitidae; Mustelidae; Procyonidae; and Ursidae). NEOTROPICAL CARNIVORES is a publicly available data set that includes 99,605 data entries from 35,511 unique georeferenced coordinates. Detection/non-detection and quantitative data were obtained from 1818 to 2018 by researchers, governmental agencies, non-governmental organizations, and private consultants. Data were collected using several methods including camera trapping, museum collections, roadkill, line transect, and opportunistic records. Literature (peer-reviewed and grey literature) from Portuguese, Spanish and English were incorporated in this compilation. Most of the data set consists of detection data entries (n = 79,343; 79.7%) but also includes non-detection data (n = 20,262; 20.3%). Of those, 43.3% also include count data (n = 43,151). The information available in NEOTROPICAL CARNIVORES will contribute to macroecological, ecological, and conservation questions in multiple spatio-temporal perspectives. As carnivores play key roles in trophic interactions, a better understanding of their distribution and habitat requirements are essential to establish conservation management plans and safeguard the future ecological health of Neotropical ecosystems. Our data paper, combined with other large-scale data sets, has great potential to clarify species distribution and related ecological processes within the Neotropics. There are no copyright restrictions and no restriction for using data from this data paper, as long as the data paper is cited as the source of the information used. We also request that users inform us of how they intend to use the data

Epidemiology of intra-abdominal infection and sepsis in critically ill patients: "AbSeS", a multinational observational cohort study and ESICM Trials Group Project

PURPOSE: To describe the epidemiology of intra-abdominal infection in an international cohort of ICU patients according to a new system that classifies cases according to setting of infection acquisition (community-acquired, early onset hospital-acquired, and late-onset hospital-acquired), anatomical disruption (absent or present with localized or diffuse peritonitis), and severity of disease expression (infection, sepsis, and septic shock). METHODS: We performed a multicenter (n = 309), observational, epidemiological study including adult ICU patients diagnosed with intra-abdominal infection. Risk factors for mortality were assessed by logistic regression analysis. RESULTS: The cohort included 2621 patients. Setting of infection acquisition was community-acquired in 31.6%, early onset hospital-acquired in 25%, and late-onset hospital-acquired in 43.4% of patients. Overall prevalence of antimicrobial resistance was 26.3% and difficult-to-treat resistant Gram-negative bacteria 4.3%, with great variation according to geographic region. No difference in prevalence of antimicrobial resistance was observed according to setting of infection acquisition. Overall mortality was 29.1%. Independent risk factors for mortality included late-onset hospital-acquired infection, diffuse peritonitis, sepsis, septic shock, older age, malnutrition, liver failure, congestive heart failure, antimicrobial resistance (either methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, extended-spectrum beta-lactamase-producing Gram-negative bacteria, or carbapenem-resistant Gram-negative bacteria) and source control failure evidenced by either the need for surgical revision or persistent inflammation. CONCLUSION: This multinational, heterogeneous cohort of ICU patients with intra-abdominal infection revealed that setting of infection acquisition, anatomical disruption, and severity of disease expression are disease-specific phenotypic characteristics associated with outcome, irrespective of the type of infection. Antimicrobial resistance is equally common in community-acquired as in hospital-acquired infection.status: publishe

Epidemiology of intra-abdominal infection and sepsis in critically ill patients: "AbSeS", a multinational observational cohort study and ESICM Trials Group Project

Purpose To describe the epidemiology of intra-abdominal infection in an international cohort of ICU patients according to a new system that classifies cases according to setting of infection acquisition (community-acquired, early onset hospital-acquired, and late-onset hospital-acquired), anatomical disruption (absent or present with localized or diffuse peritonitis), and severity of disease expression (infection, sepsis, and septic shock). Methods We performed a multicenter (n = 309), observational, epidemiological study including adult ICU patients diagnosed with intra-abdominal infection. Risk factors for mortality were assessed by logistic regression analysis. Results The cohort included 2621 patients. Setting of infection acquisition was community-acquired in 31.6%, early onset hospital-acquired in 25%, and late-onset hospital-acquired in 43.4% of patients. Overall prevalence of antimicrobial resistance was 26.3% and difficult-to-treat resistant Gram-negative bacteria 4.3%, with great variation according to geographic region. No difference in prevalence of antimicrobial resistance was observed according to setting of infection acquisition. Overall mortality was 29.1%. Independent risk factors for mortality included late-onset hospital-acquired infection, diffuse peritonitis, sepsis, septic shock, older age, malnutrition, liver failure, congestive heart failure, antimicrobial resistance (either methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, extended-spectrum beta-lactamase-producing Gram-negative bacteria, or carbapenem-resistant Gram-negative bacteria) and source control failure evidenced by either the need for surgical revision or persistent inflammation. Conclusion This multinational, heterogeneous cohort of ICU patients with intra-abdominal infection revealed that setting of infection acquisition, anatomical disruption, and severity of disease expression are disease-specific phenotypic characteristics associated with outcome, irrespective of the type of infection. Antimicrobial resistance is equally common in community-acquired as in hospital-acquired infection