Propuesta de productos alimenticios no tradicionales de fréjol

En Ecuador existen cultivos de diversas clases de fréjol negro, pero los principales son la calima y la caraota, esta última es conocida en el país como fréjol negro, siendo muy apetecida en países como México, Brasil, Colombia y Venezuela. Ecuador produce principalmente este producto para la exportación, siendo la exportación de este producto realizada al mercado europeo. La demanda en el mercado europeo se ha incrementado, principalmente por el valor que los consumidores de este mercado brindan a su valor nutritivo, ya que este producto contiene carbohidratos, proteínas, vitaminas A y B, calcio, magnesio, fósforo, potasio, entre otros. Actualmente, dado el mayor volumen y difusión de estudios científicos, por ejemplo el de la Organización Mundial de la Salud sobre el potencial peligro para la salud debido al consumo de embutidos y carne roja, el consumidor está demandando mayor variedad de productos que puedan ser nutritivos y a la vez deliciosos, por lo cual, siendo el fréjol negro rico en proteínas y nutrientes se convierte en una alternativa ideal, cuyo mercado se expande incluso a aquellos consumidores con necesidades especiales, y que demandan productos sin gluten ni lactosa, por lo que la apuesta a ofrecer productos derivados del fréjol negro, como harinas, galletas y derivados saludables (sin azúcar, integrales, bajas en sal o sin grasas trans) tienen una oportunidad de crecimiento a nivel interno, pero principalmente a la exportación. Palabras Clave: Cultivos, Productos Alimenticios No Tradicionales, Fréjol Negro

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

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

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Search for gravitational-lensing signatures in the full third observing run of the LIGO-Virgo network

Gravitational lensing by massive objects along the line of sight to the source causes distortions of gravitational wave-signals; such distortions may reveal information about fundamental physics, cosmology and astrophysics. In this work, we have extended the search for lensing signatures to all binary black hole events from the third observing run of the LIGO--Virgo network. We search for repeated signals from strong lensing by 1) performing targeted searches for subthreshold signals, 2) calculating the degree of overlap amongst the intrinsic parameters and sky location of pairs of signals, 3) comparing the similarities of the spectrograms amongst pairs of signals, and 4) performing dual-signal Bayesian analysis that takes into account selection effects and astrophysical knowledge. We also search for distortions to the gravitational waveform caused by 1) frequency-independent phase shifts in strongly lensed images, and 2) frequency-dependent modulation of the amplitude and phase due to point masses. None of these searches yields significant evidence for lensing. Finally, we use the non-detection of gravitational-wave lensing to constrain the lensing rate based on the latest merger-rate estimates and the fraction of dark matter composed of compact objects

Estrategia de expansión para la Parrilla del Ñato a través de las franquicias en la ciudad de Manta. Período 2019

The expansion strategy for "Parrilla del Ñato" through franchises in the city of Manta, is an entrepreneurial case of distribution of exclusive foods to a sector promoted by tourism. The research tries to discover the level of acceptance of the enterprise in the city of Manta, with the purpose of increasing the market share and investing in new long-term projects. There are different business tactics that firms can implement for it, but it is necessary to evaluate with effectiveness and efficiency each of them, otherwise it would have a negative impact on the company's cash flow. That´s why, it is essential to study the current situation of the organization before making decisions, being these ones managerial or administrative.  The strategic administration suggests developing an analysis of the internal or external factors that affect the companies, before implementing effective strategies, for this reason the present case study evaluates the current status of the enterprise through academic instruments, which allows the researcher to make viable the success of the investment in a new strategic sector. This company has the operative and logistical tendency to be more profitable, since it maintains a good grilled meat product purchased with its trusted suppliers, in addition to keep a good quality service. The problem that arises is the stagnation in the city of Guayaquil and in the Samborondón sector, being the reason why it is important to expand through franchises in Manta city.La estrategia de expansión para la “Parrilla del Ñato” a través de franquicias en la ciudad de Manta, es un caso emprendedor de distribución de alimentos exclusivos a un sector promovido por el turismo. La investigación intenta descubrir el nivel de aceptación del emprendimiento en la ciudad de Manta, con el propósito de incrementar la participación de mercado e invertir en nuevos proyectos a largo plazo. Existen diferentes estrategias empresariales que los negocios pueden implementar para su expansión, es necesario evaluar con eficacia y eficiencia cada una de ellas, para evitar la incidencia negativa sobre el flujo de caja del negocio. Resulta necesario, estudiar la situación actual de la organización antes de tomar decisiones gerenciales o administrativas.  La administración estratégica sugiere desarrollar un análisis de los factores internos o externos que afectan a las entidades, antes de implementar estrategias efectivas, por tal motivo en el presente caso de estudio se evalúa el estado actual del emprendimiento a través de instrumentos académicos, que permite al investigador viabilizar el éxito de la inversión en un nuevo sector estratégico.  La “Parrilla del Ñato” tiene la tendencia operativa y logística para ser más rentable, ya que mantiene un buen producto de carne a la parrilla adquirido con sus proveedores de confianza, además de conservar un servicio de atención de calidad. El problema que se presenta es el estancamiento en la ciudad de Guayaquil y en el sector de Samborondón, por lo que se busca el crecimiento a través de franquicias como propuestas estratégicas hacia la ciudad de Manta

Planificación Estratégica Administrativa para Pymes en Tiempos Post Covid. Caso de Estudio de Empresa Textil para la toma de decisiones 2019-2020

SMEs in post covid times need strategic administrative planning to improve decision-making and increase profitability. The objective of the study is to carry out a comprehensive analysis of the administrative strategic planning for the SME textile Amy´s Factory Jeans, period 2016-2018, that allows it to increase profitability in post-covid times and improve decision-making 2019-2020. The methodology is descriptive, bibliographic and explanatory, including a non-experimental cross-sectional study, a purposive sampling, and a mixed approach. It was also used a semi-structured management interview, a focus group for members of the organization and the Balanced Scorecard as data collection tools. The main results found are: the Company didn’t get the objectives plans by 100% due to the non- execution of the proposed goals, because the decisions are made empirically without the correct use of the strategic plan.Las Pymes en tiempos post covid necesitan de la planificación estratégica administrativa para mejorar la toma de decisiones e incremento de la rentabilidad. El objetivo del estudio es realizar el análisis integral de la planeación estratégica administrativa para la Pyme textil Amy´s Factory Jeans, período 2016-2018, de tal manera que le permita fomentar la rentabilidad en tiempos post covid y mejorar la toma de decisiones 2019-2020. La metodología es descriptiva, bibliográfica y explicativa, además se ha aplicado un diseño no experimental de tipo transversal con muestreo no probabilístico dirigido y enfoque mixto, utilizando como herramientas de recolección de datos la entrevista semiestructurada a la gerencia, el grupo focal a miembros de la organización y el Cuadro de Mando Integral. Los principales resultados encontrados son: la empresa no cumplió los objetivos planteados en un 100%  por la inejecución de las metas propuestas, debido a que las decisiones son tomadas de manera empírica sin la correcta utilización del plan estratégico