Performance evaluation and sequence control of an automatedmanufacturing system

In an automated sequential manufacturing system Programmable Logic Controllers (PLC) are widely used. As the control specification varies, the control software needs to be rewritten to accommodate the new specification. Since PLC has high flexibility, one can update the current system while it is running thereby making easier implementation. In order to design flexible, reusable and maintainable control software, a good modeling tool is required. Petri nets are such a tool. Which facilitates analysis of behavioral properties, performance evaluation, and systematic construction of discrete event simulators and controllers. In this thesis a system with one robot and five sequential work stations is used as an example of an automated system. To illustrate the Petri net method, performance and other properties of this system are evaluated. The PLC program is also developed for sequence control of the system

Study - Evaluation of the efficacy, safety and tolerability of tacrolimus ointment in Indian patients of moderate to severe atopic dermatitis: A multicentric, open label, phase III study

Aim of study: Tacrolimus, a topical immunomodulator, has been introduced as a new treatment for moderate to severe atopic dermatitis. The present study was conducted to evaluate the efficacy, safety and tolerability of Tacrolimus ointment in patients of atopic dermatitis in an Indian setting. Methods: The present study was a prospective, open, multicentric, Phase III trial.The duration of study was 5 weeks, including a 3-week active treatment period, preceded by a 1-week washout phase and followed by a 1-week follow-up phase. Patients diagnosed to be suf fering from moderate to severe atopic dermatitis as per the Rajka and Langeland criteria were treated with Tacrolimus ointment 0.03% twice daily. Efficacy was assessed by modified Eczema Area Sensitivity Index (mEASI) score, patient’s and physician’s global assessment. Tolerability and safety was assessed by physical examination, laboratory parameters and evaluation of adverse events. Results: There was a statistically significant decrease in the modified Eczema Area Sensitivity Index (mEASI) score (P<0.05). Patient’s and Physician’s global evaluation of treatment was complete resolution to very good improvement in most of the patients. The laboratory values were within normal limits. The drug was well tolerated. Conclusions: This study confirms the efficacy and safety of Tacrolimus ointment 0.03% in Indian patients of moderate to severe atopic dermatitis

Indian research on disaster and mental health

The primary source for this annotation on disaster mental health research is the Indian Journal of Psychiatry. Key words like disasters, earthquake, cyclone, tsunami and flood were searched from its electronic database and relevant articles are discussed. The cross-referenced articles and relevant researches conducted on disasters in India which are published elsewhere were the secondary sources of information. There have been many epidemiological studies and only a few interventional studies on disasters in India. Prevalence figures of psychiatric disorders varied considerably across studies, secondary to nature and severity of disaster, degree of loss, support available and probably also due to the study methodology. Suggestions for intervention included pre-disaster planning, training of disaster workers, utilization of community-level volunteers as counselors, and strengthening existing individual, social and spiritual coping strategies. There is a need for more longitudinal follow-up studies and interventional studies

Gut CD4+ T cell phenotypes are a continuum molded by microbes, not by TH archetypes

CD4 effector lymphocytes (T ) are traditionally classified by the cytokines they produce. To determine the states that T cells actually adopt in frontline tissues in vivo, we applied single-cell transcriptome and chromatin analyses to colonic T cells in germ-free or conventional mice or in mice after challenge with a range of phenotypically biasing microbes. Unexpected subsets were marked by the expression of the interferon (IFN) signature or myeloid-specific transcripts, but transcriptome or chromatin structure could not resolve discrete clusters fitting classic helper T cell (T ) subsets. At baseline or at different times of infection, transcripts encoding cytokines or proteins commonly used as T markers were distributed in a polarized continuum, which was functionally validated. Clones derived from single progenitors gave rise to both IFN-γ- and interleukin (IL)-17-producing cells. Most of the transcriptional variance was tied to the infecting agent, independent of the cytokines produced, and chromatin variance primarily reflected activities of activator protein (AP)-1 and IFN-regulatory factor (IRF) transcription factor (TF) families, not the canonical subset master regulators T-bet, GATA3 or RORγ. + eff eff eff H

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P &lt; 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)