Discrete events simulation method for analyze cycle time: a case study in the plastics industry sector

This work shows the potential of the Discrete-Event Simulation -DES- in a software modeling process applied to business decision making, using a descriptive methodology in a productive process of a manufacturing plastic bags company. The analysis identified the process characteristics and built a simulated model in Arena® software. Simulation shown variability in the process greater than 50% in the cycle time, which negatively affects the economic interests of the company, impacting opportunities to supply the market risking its position with other companies in the sector. The method implemented in the present work allows to know the critical points of the process, evaluate them and project a path to obtain the optimal or most viable solution, and propose modifications rising up the probability of success of any improvement plan. This makes any economic investment or locative change a desition-making quantitative supported

Rucaparib maintenance treatment for recurrent ovarian carcinoma after response to platinum therapy (ARIEL3): a randomised, double-blind, placebo-controlled, phase 3 trial

Background: Rucaparib, a poly(ADP-ribose) polymerase inhibitor, has anticancer activity in recurrent ovarian carcinoma harbouring a BRCA mutation or high percentage of genome-wide loss of heterozygosity. In this trial we assessed rucaparib versus placebo after response to second-line or later platinum-based chemotherapy in patients with high-grade, recurrent, platinum-sensitive ovarian carcinoma. Methods: In this randomised, double-blind, placebo-controlled, phase 3 trial, we recruited patients from 87 hospitals and cancer centres across 11 countries. Eligible patients were aged 18 years or older, had a platinum-sensitive, high-grade serous or endometrioid ovarian, primary peritoneal, or fallopian tube carcinoma, had received at least two previous platinum-based chemotherapy regimens, had achieved complete or partial response to their last platinum-based regimen, had a cancer antigen 125 concentration of less than the upper limit of normal, had a performance status of 0–1, and had adequate organ function. Patients were ineligible if they had symptomatic or untreated central nervous system metastases, had received anticancer therapy 14 days or fewer before starting the study, or had received previous treatment with a poly(ADP-ribose) polymerase inhibitor. We randomly allocated patients 2:1 to receive oral rucaparib 600 mg twice daily or placebo in 28 day cycles using a computer-generated sequence (block size of six, stratified by homologous recombination repair gene mutation status, progression-free interval after the penultimate platinum-based regimen, and best response to the most recent platinum-based regimen). Patients, investigators, site staff, assessors, and the funder were masked to assignments. The primary outcome was investigator-assessed progression-free survival evaluated with use of an ordered step-down procedure for three nested cohorts: patients with BRCA mutations (carcinoma associated with deleterious germline or somatic BRCA mutations), patients with homologous recombination deficiencies (BRCA mutant or BRCA wild-type and high loss of heterozygosity), and the intention-to-treat population, assessed at screening and every 12 weeks thereafter. This trial is registered with ClinicalTrials.gov, number NCT01968213; enrolment is complete. Findings: Between April 7, 2014, and July 19, 2016, we randomly allocated 564 patients: 375 (66%) to rucaparib and 189 (34%) to placebo. Median progression-free survival in patients with a BRCA-mutant carcinoma was 16·6 months (95% CI 13·4–22·9; 130 [35%] patients) in the rucaparib group versus 5·4 months (3·4–6·7; 66 [35%] patients) in the placebo group (hazard ratio 0·23 [95% CI 0·16–0·34]; p<0·0001). In patients with a homologous recombination deficient carcinoma (236 [63%] vs 118 [62%]), it was 13·6 months (10·9–16·2) versus 5·4 months (5·1–5·6; 0·32 [0·24–0·42]; p<0·0001). In the intention-to-treat population, it was 10·8 months (8·3–11·4) versus 5·4 months (5·3–5·5; 0·36 [0·30–0·45]; p<0·0001). Treatment-emergent adverse events of grade 3 or higher in the safety population (372 [99%] patients in the rucaparib group vs 189 [100%] in the placebo group) were reported in 209 (56%) patients in the rucaparib group versus 28 (15%) in the placebo group, the most common of which were anaemia or decreased haemoglobin concentration (70 [19%] vs one [1%]) and increased alanine or aspartate aminotransferase concentration (39 [10%] vs none). Interpretation: Across all primary analysis groups, rucaparib significantly improved progression-free survival in patients with platinum-sensitive ovarian cancer who had achieved a response to platinum-based chemotherapy. ARIEL3 provides further evidence that use of a poly(ADP-ribose) polymerase inhibitor in the maintenance treatment setting versus placebo could be considered a new standard of care for women with platinum-sensitive ovarian cancer following a complete or partial response to second-line or later platinum-based chemotherapy. Funding: Clovis Oncology

Potential group B Streptococcus interspecies transmission between cattle and people in Colombian dairy farms

Group B Streptococcus (GBS), is a leading cause of neonatal death and an emerging pathogen in adults. Additionally, GBS is a bovine pathogen causing intramammary infections. The likelihood of GBS interspecies transmission is largely unknown. We explored the potential transmission of GBS between cattle and people on dairy farms in Colombia and compared the antimicrobial resistance (AMR) profiles of isolates from both host species. Across 33 farms, throat swabs and rectal swabs were collected from 191 people, and rectal swabs and composite milk samples from 2092 cattle, yielding 60 human isolates and 301 bovine isolates. The majority (64%) of isolates belonged to shared sequence types (ST). Sequence type (ST) 1 was the most common strain in both host species, suggesting that interspecies transmission may be possible. Two members of the bovine-specific clonal complex 61/67 were detected in human samples (ST718 and ST1175), providing evidence for the lack of genuine species barriers. Apparent prevalence of penicillin resistance was surprisingly high in human and bovine isolates. Further investigation of this phenomenon is needed and could lead to modification of standard testing and treatment recommendations in human and veterinary medicine

The Effect of Patients’ Met Expectations on Consultation Outcomes. A Study with Family Medicine Residents

OBJECTIVES: To know the patients’ expectations and the fulfillment of these at family medicine consultations by resident doctors and to assess their effect on some consultation outcomes. DESIGN: A prospective cohort study. PARTICIPANTS: Patients attending family medicine consultations held by 38 resident doctors: 1,301 eligible patients, 702 filled in all questionnaires. MEASUREMENTS: Before each visit, the patients’ expectations about that particular consultation were registered. Right after the visit was over, their perception of several aspects of the communicative interaction with the doctor was measured. Later, patients were interviewed on the phone to know how their expectations had been fulfilled, how satisfied they were about the consultation, how they had followed the doctor’s suggestions, if they were going to seek further care for the same cause later, and the evolution of their clinical problem. Logistic regression was the main analysis used. RESULTS: The most common expectations were the doctor showing interest and listening (30.5%), getting some information about the diagnosis (16.3%), and sharing problems and doubts (11.1%). The rate of main expectations that were met was 76.5%. Satisfaction with the encounter was associated with the clinical evolution [odds ratio (OR) 2.23; confidence interval (CI): 1.32–3.75], and the fulfilling of the patients’ main or two main expectations was significantly related to all the measured outcomes (satisfaction OR 3.51, CI: 1.73–7.8; adherence OR 1.80, CI: 1.11–2.92; clinical evolution OR 1.54, CI: 1.01–2.35; and seeking further care later OR 0.54, CI:0.36–0.81) CONCLUSIONS: Patients prioritize expectations of a more general sort when they attend primary care consultations and residents fulfill these acceptably. The fulfillment of expectations seems to affect the studied outcomes more than other factors

A Systematic Review of the Frequency of Neurocyticercosis with a Focus on People with Epilepsy

Neurocysticercosis (NCC) is a parasitic infection of the brain caused by the tapeworm Taenia solium, which infects humans and pigs. There have been increasing case reports and epidemiological studies on this disease, but its global frequency has never been determined, partly due to the fact that blood tests are not very good for the diagnosis of NCC. We present here a systematic review of the literature on the frequency of NCC diagnosed with neuroimaging worldwide. Overall, 565 articles were retrieved and 290 (51%) selected for further review. Of those, only 26 had information valid enough to estimate the frequency of NCC in various populations. Only one study estimated the prevalence of NCC in the general population. The most striking finding was that the proportion of NCC among persons with epilepsy was very consistent and estimated at 29.6% (95%CI: 23.5%–36.1%) from 12 studies conducted in Latin America, Sub-Saharan Africa and Southeast Asia. A reinforcement of the suggested universal guidelines for the diagnostic process, declaring NCC an international reportable disease and standardizing procedures for data collection could improve our understanding of the frequency of NCC worldwide and hence its global burden

Low-energy Calibration of XENON1T with an Internal 37^{37}Ar Source

A low-energy electronic recoil calibration of XENON1T, a dual-phase xenontime projection chamber, with an internal $^{37}$Ar source was performed. Thiscalibration source features a 35-day half-life and provides two mono-energeticlines at 2.82 keV and 0.27 keV. The photon yield and electron yield at 2.82 keVare measured to be (32.3$\pm$0.3) photons/keV and (40.6$\pm$0.5) electrons/keV,respectively, in agreement with other measurements and with NEST predictions.The electron yield at 0.27 keV is also measured and it is(68.0$^{+6.3}_{-3.7}$) electrons/keV. The $^{37}$Ar calibration confirms thatthe detector is well-understood in the energy region close to the detectionthreshold, with the 2.82 keV line reconstructed at (2.83$\pm$0.02) keV, whichfurther validates the model used to interpret the low-energy electronic recoilexcess previously reported by XENON1T. The ability to efficiently remove argonwith cryogenic distillation after the calibration proves that $^{37}$Ar can beconsidered as a regular calibration source for multi-tonne xenon detectors.<br

The Triggerless Data Acquisition System of the XENONnT Experiment

The XENONnT detector uses the latest and largest liquid xenon-based timeprojection chamber (TPC) operated by the XENON Collaboration, aimed atdetecting Weakly Interacting Massive Particles and conducting other rare eventsearches. The XENONnT data acquisition (DAQ) system constitutes an upgraded andexpanded version of the XENON1T DAQ system. For its operation, it reliespredominantly on commercially available hardware accompanied by open-source andcustom-developed software. The three constituent subsystems of the XENONnTdetector, the TPC (main detector), muon veto, and the newly introduced neutronveto, are integrated into a single DAQ, and can be operated both independentlyand as a unified system. In total, the DAQ digitizes the signals of 698photomultiplier tubes (PMTs), of which 253 from the top PMT array of the TPCare digitized twice, at $\times10$ and $\times0.5$ gain. The DAQ for the mostpart is a triggerless system, reading out and storing every signal that exceedsthe digitization thresholds. Custom-developed software is used to process theacquired data, making it available within $\mathcal{O}\left(10\text{ s}\right)$for live data quality monitoring and online analyses. The entire system withall the three subsystems was successfully commissioned and has been operatingcontinuously, comfortably withstanding readout rates that exceed $\sim500$ MB/sduring calibration. Livetime during normal operation exceeds $99\%$ and is$\sim90\%$ during most high-rate calibrations. The combined DAQ system hascollected more than 2 PB of both calibration and science data during thecommissioning of XENONnT and the first science run.<br

Low-energy calibration of XENON1T with an internal 37^{{\textbf {37}}}Ar source

A low-energy electronic recoil calibration of XENON1T, a dual-phase xenon time projection chamber, with an internal 37Ar source was performed. This calibration source features a 35-day half-life and provides two mono-energetic lines at 2.82 keV and 0.27 keV. The photon yield and electron yield at 2.82 keV are measured to be (32.3±0.3) photons/keV and (40.6±0.5) electrons/keV, respectively, in agreement with other measurements and with NEST predictions. The electron yield at 0.27 keV is also measured and it is (68.0+6.3−3.7) electrons/keV. The 37Ar calibration confirms that the detector is well-understood in the energy region close to the detection threshold, with the 2.82 keV line reconstructed at (2.83±0.02) keV, which further validates the model used to interpret the low-energy electronic recoil excess previously reported by XENON1T. The ability to efficiently remove argon with cryogenic distillation after the calibration proves that 37Ar can be considered as a regular calibration source for multi-tonne xenon detectors

Low-energy Calibration of XENON1T with an Internal 37^{37}Ar Source

A low-energy electronic recoil calibration of XENON1T, a dual-phase xenon time projection chamber, with an internal $^{37}$Ar source was performed. This calibration source features a 35-day half-life and provides two mono-energetic lines at 2.82 keV and 0.27 keV. The photon yield and electron yield at 2.82 keV are measured to be (32.3$\pm$0.3) photons/keV and (40.6$\pm$0.5) electrons/keV, respectively, in agreement with other measurements and with NEST predictions. The electron yield at 0.27 keV is also measured and it is (68.0$^{+6.3}_{-3.7}$) electrons/keV. The $^{37}$Ar calibration confirms that the detector is well-understood in the energy region close to the detection threshold, with the 2.82 keV line reconstructed at (2.83$\pm$0.02) keV, which further validates the model used to interpret the low-energy electronic recoil excess previously reported by XENON1T. The ability to efficiently remove argon with cryogenic distillation after the calibration proves that $^{37}$Ar can be considered as a regular calibration source for multi-tonne xenon detectors