Analysis of Several Productive Development Policies in Uruguay

This paper reviews and assesses some of the Productive Development Policies currently being implemented in Uruguay. Three horizontal and three vertical policies are considered in light of the market and public failures they attempt to address and minimize. Horizontal policies comprise Innovation, Industrial Promotion and Directives for Industrial and Technological Development. Vertical policies include the analysis of Forestry Law, Meat Traceability and the Sustainable Production Project in the agricultural sector.Public economics, Regulation and industrial policy, Industrial policy

Process improvement approaches for increasing the response of emergency departments against the Covid-19 pandemic: a systematic review

The COVID-19 pandemic has strongly affected the dynamics of Emergency Departments (EDs) worldwide and has accentuated the need for tackling different operational inefficiencies that decrease the quality of care provided to infected patients. The EDs continue to struggle against this outbreak by implementing strategies maximizing their performance within an uncertain healthcare environment. The efforts, however, have remained insufficient in view of the growing number of admissions and increased severity of the coronavirus disease. Therefore, the primary aim of this paper is to review the literature on process improvement interventions focused on increasing the ED response to the current COVID-19 outbreak to delineate future research lines based on the gaps detected in the practical scenario. Therefore, we applied the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to perform a review containing the research papers published between December 2019 and April 2021 using ISI Web of Science, Scopus, PubMed, IEEE, Google Scholar, and Science Direct databases. The articles were further classified taking into account the research domain, primary aim, journal, and publication year. A total of 65 papers disseminated in 51 journals were concluded to satisfy the inclusion criteria. Our review found that most applications have been directed towards predicting the health outcomes in COVID-19 patients through machine learning and data analytics techniques. In the overarching pandemic, healthcare decision makers are strongly recommended to integrate artificial intelligence techniques with approaches from the operations research (OR) and quality management domains to upgrade the ED performance under social-economic restrictions

Propuesta de un proceso de Planeamiento, Ejecución y Control de la Producción mediante herramientas de gestión por procesos con la finalidad de mejorar la productividad de las mypes del sector de uvas de mesa en la provincia de Ica

El crecimiento económico disminuye el nivel de pobreza de un país. En Perú, la mayor concentración de empresas son mypes que generan empleabilidad en la población. Las mypes agrícolas enfrentan un gran problema que es la baja productividad. El sector de uvas en el Perú ha tenido un gran desarrollo en los indicadores como la producción y el área cosechada, pero el rendimiento es menor que otros países. Por ello, es fundamental realizar el diagnóstico respectivo para identificar las causas del problema de la zona. El diagnóstico se logró mediante entrevistas a profundidad a 53 productores de uvas en la provincia de Ica. En los primeros resultados se encontró que las actividades de producción se realizan en base a las experiencias que adquirieron de sus ancestros, lo que genera una baja productividad. Además, se tuvo que identificar los factores que afectan a 3 procesos relacionados con la gestión de calidad, planeamiento y control de la producción, y la gestión logística. La presente investigación propone diseñar un proceso de planeamiento, ejecución y control de la producción mediante las herramientas de gestión por procesos con la finalidad de incrementar la productividad de uvas en la provincia de Ica.Economic growth lowers the poverty level of a country. In Peru, the highest concentration of companies are MSEs, which generate employability in the population. Agricultural MSEs have a big problem is low productivity. The grape sector in Peru has had a great development in indicators such a production and harvested area, but the yield is lower than other countries. Therefore, it is essential to carry out the corresponding study to identify the causes of the problem. The diagnosis was achieved through in-depth interviews with 53 grape growers in the province of Ica. In the first results, it was found that production activities are carried out based on the experiences they acquired from their ancestors, which generates low productivity. In addition, it was necessary to identify factors that affect three processes related to quality management, production planning and control, and logistics management. This research proposes to design a process for planning, executing and controlling production using process management tools in order to improve productivity.Tesi

Stochastic unit commitment in microgrids: Influence of the load forecasting error and the availability of energy storage

A Stochastic Model for the Unit Commitment (SUC) problem of a hybrid microgrid for a short period of 24 h is presented. The microgrid considered in the problem is composed of a wind turbine (WT), a photovoltaic plant (PV), a diesel generator (DE), a microturbine (MT) and a Battery Energy Storage System (BESS). The problem is addressed in three stages. First, based on the historical data of the demanded power in the microgrid, an ARMA model is used to obtain the demand prediction. Second, the 24-h-ahead SUC problem is solved, based on generators’ constraints, renewable generation and demand forecast and the statistical distribution of the error in the demand estimation. In this problem, a spinning reserve of the dispatchable units is considered, able to cover the uncertainties in the demand estimation. In the third stage, once the SUC problem has been solved, a case study is established in real time, in which the demand estimation error in every moment is known. Therefore, the objective of this stage is to select the spinning reserve of the units in an optimal way to minimize the cost in the microgrid operation

Stochastic unit commitment in microgrids based on model predictive control

This article deals with the problem of Stochastic Unit Commitment (SUC), considering the stochastic nature of demand and meteorological phenomena. This paper shows the optimal operation of a hybrid microgrid composed of the following generation units: wind turbine (WT), photovoltaic solar panel (PV), diesel engine generator (DE), micro-turbine (MT), as well as storage devices such as Battery Energy Storage (BES), considering its constraints and the requirements of the reserve generation. For this purpose, a Model-based Predictive Control (MPC), which uses dynamic models of prediction of renewable power and demand in real time, is developed, allowing feedback at each step of time, which corrects the uncertainty of the models. A comparison with a classic UC formulation has been made. The results reach a lower cost solution

Major Adverse Cardiovascular Events in Coronary Type 2 Diabetic Patients: Identification of Associated Factors Using Electronic Health Records and Natural Language Processing

Diabetes mellitus; Natural language processing; Risk factorsDiabetis mellitus; Processament del llenguatge natural; Factors de riscDiabetes mellitus; Procesamiento del lenguaje natural; Factores de riesgoPatients with Type 2 diabetes mellitus (T2DM) and coronary artery disease (CAD) are at high risk of developing major adverse cardiovascular events (MACE). This is a multicenter, retrospective, and observational study performed in Spain aimed to characterize these patients in a real-world setting. Unstructured data from the Electronic Health Records were extracted by EHRead®, a technology based on Natural Language Processing and machine learning. The association between new MACE and the variables of interest were investigated by univariable and multivariable analyses. From a source population of 2,184,662 patients, we identified 4072 adults diagnosed with T2DM and CAD (62.2% male, mean age 70 ± 11). The main comorbidities observed included arterial hypertension, hyperlipidemia, and obesity, with metformin and statins being the treatments most frequently prescribed. MACE development was associated with multivessel (Hazard Ratio (HR) = 2.49) and single coronary vessel disease (HR = 1.71), transient ischemic attack (HR = 2.01), heart failure (HR = 1.32), insulin treatment (HR = 1.40), and percutaneous coronary intervention (PCI) (HR = 2.27), whilst statins (HR = 0.73) were associated with a lower risk of MACE occurrence. In conclusion, we found six risk factors associated with the development of MACE which were related with cardiovascular diseases and T2DM severity, and treatment with statins was identified as a protective factor for new MACE in this study.This study was funded by AstraZeneca Spain (Externally Sponsored Scientific Research, ESR-18-13815) and sponsored by the Spanish Society of Cardiology

Impact of Advanced Age on the Incidence of Major Adverse Cardiovascular Events in Patients with Type 2 Diabetes Mellitus and Stable Coronary Artery Disease in a Real-World Setting in Spain

Coronary artery disease; Type 2 diabetes mellitusArteriopatía coronaria; Diabetes mellitus tipo 2Arteriopatia coronària; Diabetis mellitus tipus 2Patients with type 2 diabetes mellitus (T2DM) and coronary artery disease (CAD) without myocardial infarction (MI) or stroke are at high risk for major cardiovascular events (MACEs). We aimed to provide real-world data on age-related clinical characteristics, treatment management, and incidence of major cardiovascular outcomes in T2DM-CAD patients in Spain from 2014 to 2018. We used EHRead® technology, which is based on natural language processing and machine learning, to extract unstructured clinical information from electronic health records (EHRs) from 12 hospitals. Of the 4072 included patients, 30.9% were younger than 65 years (66.3% male), 34.2% were aged 65–75 years (66.4% male), and 34.8% were older than 75 years (54.3% male). These older patients were more likely to have hypertension (OR 2.85), angina (OR 1.64), heart valve disease (OR 2.13), or peripheral vascular disease (OR 2.38) than those aged <65 years (p < 0.001 for all comparisons). In general, they were also more likely to receive pharmacological and interventional treatments. Moreover, these patients had a significantly higher risk of MACEs (HR 1.29; p = 0.003) and ischemic stroke (HR 2.39; p < 0.001). In summary, patients with T2DM-CAD in routine clinical practice tend to be older, have more comorbidities, are more heavily treated, and have a higher risk of developing MACE than is commonly assumed from clinical trial data.This study was funded and sponsored by the Spanish Society of Cardiology

Imported malaria in pregnancy in Madrid

<p>Abstract</p> <p>Background</p> <p>Malaria in pregnancy is associated with maternal and foetal morbidity and mortality in endemic areas, but information on imported cases to non-endemic areas is scarce.</p> <p>The aim of this study was to describe the clinical and epidemiological characteristics of malaria in pregnancy in two general hospitals in Madrid, Spain.</p> <p>Methods</p> <p>Retrospective descriptive study of laboratory-confirmed malaria in pregnant women at the Fuenlabrada University Hospital and the Príncipe de Asturias University Hospital, in Madrid, over a six- and 11-year period, respectively. Relevant epidemiological, clinical and laboratory data was obtained from medical records.</p> <p>Results</p> <p>There were 19 pregnant women among 346 malaria cases (5.4%). The average age was 27 years. The gestational age (trimester) was: 53% 3^rd, 31% 1st, 16% 2^nd. All but one were multigravidae. Three were HIV positive. All were sub-Saharan immigrants: two were recently arrived immigrants and seventeen (89%) had visited friends and relatives. None had taken prophylaxis nor seeked pre-travel advice. Presentation: 16 symptomatic patients (fever in fourteen, asthenia in two), three asymptomatic. Median delay in diagnosis: 7.5 days. Laboratory tests: anaemia (cut off Hb level 11 g/dl) 78.9% (mild 31.6%, moderate 31.6%, severe 15.8%) thrombocytopaenia 73.7%, hypoglycaemia 10.5%. All cases were due to <it>Plasmodium falciparum</it>, one case of hyperparasitaemia. Quinine + clindamycin prescribed in 84%. Outcomes: no severe maternal complications or deaths, two abortions, fifteen term pregnancies, no low-birth-weight newborns, two patients were lost to follow-up.</p> <p>Conclusions</p> <p>Though cases of malaria in pregnancy are uncommon, a most at risk group is clearly defined: young sub-Saharan mothers visiting friends and relatives without pre-travel counselling and recently-arrived immigrants. The most common adverse maternal and foetal effects were anaemia and stillbirth. Given that presentation can be asymptomatic, malaria should always be considered in patients with unexplained anaemia arriving from endemic areas. These findings could help Maternal Health programme planners and implementers to target preventive interventions in the immigrant population and should create awareness among clinicians.</p

Factors associated with excessive bleeding in cardiopulmonary bypass patients: a nested case-control study

<p>Abstract</p> <p>Introduction</p> <p>Excessive bleeding (EB) after cardiopulmonary bypass (CPB) may lead to increased mortality, morbidity, transfusion requirements and re-intervention. Less than 50% of patients undergoing re-intervention exhibit surgical sources of bleeding. We studied clinical and genetic factors associated with EB.</p> <p>Methods</p> <p>We performed a nested case-control study of 26 patients who did not receive antifibrinolytic prophylaxis. Variables were collected preoperatively, at intensive care unit (ICU) admission, at 4 and 24 hours post-CPB. EB was defined as 24-hour blood loss of >1 l post-CPB. Associations of EB with genetic, demographic, and clinical factors were analyzed, using SPSS-12.2 for statistical purposes.</p> <p>Results</p> <p>EB incidence was 50%, associated with body mass index (BMI)< 26.4 (25–28) Kg/m², (<it>P </it>= 0.03), lower preoperative levels of plasminogen activator inhibitor-1 (PAI-1) (<it>P </it>= 0.01), lower body temperature during CPB (<it>P </it>= 0.037) and at ICU admission (<it>P </it>= 0.029), and internal mammary artery graft (<it>P </it>= 0.03) in bypass surgery. We found a significant association between EB and 5G homozygotes for PAI-1, after adjusting for BMI (F = 6.07; <it>P </it>= 0.02) and temperature during CPB (F = 8.84; <it>P </it>= 0.007). EB patients showed higher consumption of complement, coagulation, fibrinolysis and hemoderivatives, with significantly lower leptin levels at all postoperative time points (<it>P </it>= 0.01, <it>P </it>< 0.01 and <it>P </it>< 0.01).</p> <p>Conclusion</p> <p>Excessive postoperative bleeding in CPB patients was associated with demographics, particularly less pronounced BMI, and surgical factors together with serine protease activation.</p