Consulting for the textile company Creditex S.A.A

Creditex is one of the largest Peruvian textile companies listed on the Lima stock exchange. The main activity of the company is the manufacture of textile products, including ginning, spinning, weaving, dyeing, finishing and all activities related to the industrial processing of natural fibers of plant, animal and synthetic origin. Creditex is specialized in the development of complete clothing packages for major international brands such as Tommy Bahamas, Life is good, Island Company, and others. Creditex is facing a decline in its sales and an increase in its manufacturing and labor costs. One reason for the rapid decline in sales is seen in ineffective product development. Therefore, the research question of this thesis is as follows: Which product development for the Latin American and US market enables Creditex to achieve sustainable success? The methodology used is a single case study. Relevant literature was collected by means of a literature review and expert interviews. Following the literature review, four different possible solutions are presented, which are then systematically analyzed and ranked according to several assessment criteria. The company Creditex is shown one short and one long term solution. The proposed solution suggested to the company is to implement a new product line focusing on medical clothing and sports and leisurewear, taking into account the current demand for both products and the growing expectations of both markets.Creditex es una de las empresas textiles peruanas más grandes que cotiza en la Bolsa de Valores de Lima. La principal actividad de la empresa es la fabricación de productos textiles, incluyendo el desmotado, hilado, tejido, tintorería, acabados y todas las actividades relacionadas con el procesamiento industrial de fibras naturales de origen vegetal, animal y sintético. Creditex está especializada en el desarrollo de paquetes completos de ropa para las principales marcas internacionales como Tommy Bahamas, Life is good, Island Company y otras. Creditex enfrenta una disminución en sus ventas y un aumento en sus costos de fabricación y mano de obra. Una de las razones de la rápida disminución de las ventas se ve en el desarrollo ineficaz de productos. Por tanto, la pregunta de investigación de esta tesis es la siguiente: ¿Qué desarrollo de producto para el mercado Latinoamericano y Estadounidense puede permitir a Creditex lograr un éxito sostenible? La metodología utilizada es un estudio de caso único. La literatura relevante se recopiló mediante una revisión de la literatura y entrevistas a expertos. Tras la revisión de la literatura, se presentan cuatro posibles soluciones diferentes, que luego se analizan sistemáticamente y se clasifican de acuerdo con varios criterios de evaluación. A la empresa Creditex se le muestra una solución a corto y una a largo plazo. La solución propuesta que se sugiere a la compañía es implementar una nueva línea de productos enfocada en ropa médica y ropa deportiva y casual, teniendo en cuenta la demanda actual de ambos productos y las crecientes expectativas de ambos mercados.Tesi

Vascular access for lipid apheresis: a challenge in young children with homozygous familial hypercholesterolemia

Background: Homozygous familial hypercholesterolemia (hoFH) is a rare genetic disorder leading to extremely increased LDL-cholesterol (LDL-C), resulting in high cardiovascular risk in early childhood. Lipid apheresis (LA) is an effective treatment and should be started as early as possible to prevent premature cardiovascular events. As peripheral punctures in children can be challenging due to small vessels and anxiety, this study aimed to evaluate feasibility and safety of central venous catheters (CVCs) as vascular access for LA in young children with hoFH. Methods: Retrospective analysis (2016-2019) on four children with hoFH aged 3-5 years, performing weekly or biweekly LA with a CVC. Results: LDL-C decreased by> 60%. In three children, the use of a permanent CVC for 698, 595, and 411 days, respectively, avoided difficult peripheral access, without the occurrence of occlusion or thrombosis. Unfortunately, one child had recurrent CVC-related infections and needed an arteriovenous fistula from the age of 5.Although the mean dwell time per catheter was 212 days, there were, as expected, severe side effects of early catheter infections with sepsis and accidental self-removal. Starting LA at an early age improved or stabilized carotid intima-media thickness (IMT) in three children. However, IMT did increase in one child caused by intolerance to peripheral punctures and LA interruption. Conclusions: Permanent CVCs are a viable temporary access choice for LA in young children with hoFH until peripheral venipuncture is practicable. The risk of CVC-related infections needs to be taken into account

Superior consistency of ambulatory blood pressure monitoring in children: implications for clinical trials

Background Casual office blood pressure (CBP) measurements are still standard in antihypertensive drug trials. In pediatric hypertensive trials, ethical considerations, very low disease prevalence and the marked impact of white-coat hypertension create the need for very sensitive and reproducible techniques of BP assessment. We hypothesized that ambulatory BP monitoring (ABPM) may identify treatment effects more sensitively than CBP and thereby reduce sample sizes required in pediatric antihypertensive trials

Low levels of urinary epidermal growth factor predict chronic kidney disease progression in children

Urinary epidermal growth factor (uEGF) has recently been identified as a promising biomarker of chronic kidney disease (CKD) progression in adults with glomerular disease. Low levels of uEGF predict CKD progression and appear to reflect the extent of tubulointerstitial damage. We investigated the relevance of uEGF in pediatric CKD. We performed a post hoc analysis of the Cardiovascular Comorbidity in Children with CKD (4C) study, which prospectively follows children aged 6-17 years with baseline estimated glomerular filtration rate (eGFR) of 10-60 ml/min/1.73 m(2). uEGF levels were measured in archived urine collected within 6 months of enrollment. Congenital abnormalities of the kidney and urinary tract were the most common cause of CKD, with glomerular diseases accounting for <10% of cases. Median eGFR at baseline was 28 ml/min/1.73 m(2), and 288 of 623 participants (46.3%) reached the composite endpoint of CKD progression (50% eGFR loss, eGFR < 10 ml/min/1.73 m(2), or initiation of renal replacement therapy). In a Cox proportional hazards model, higher uEGF/Cr was associated with a decreased risk of CKD progression (HR 0.76; 95% CI 0.69-0.84) independent of age, sex, baseline eGFR, primary kidney disease, proteinuria, and systolic blood pressure. The addition of uEGF/Cr to a model containing these variables resulted in a significant improvement in C-statistics, indicating better prediction of the 1-, 2- and 3-year risk of CKD progression. External validation in a prospective cohort of 222 children with CKD demonstrated comparable results. Thus, uEGF may be a useful biomarker to predict CKD progression in children with CKD