Tecumseh Products (United States)

Discrete event simulation is a useful tool for optimizing complex systems in an environment with process variability. One such system is layout planning for a new manufacturing facility. However, creating a model of entire shop floor accurate enough to yield useful results is time consuming and resource demanding. In the Toyota Production System (TPS), the philosophy is to eliminate as much variation so that planning is simplified using deterministic tools. This case study examines a facilities layout plan for a greenfield manufacturing plant that practices TPS. Here, a TPS focused Systematic Layout Planning tool is largely used for the deterministic portion of the planning while a digital (Tompkins, White et al. 2010) twin is used to specifically model a new automated material handling process with high uncertainty within the plan. The results demonstrate the benefits of this deterministic approach coupled with a highly-focused digital twin portion for achieving optimal facilities layout in a timely manner.

BackgroundVaccine-induced neutralizing antibodies (NAbs) are key for COVID-19 protective-immunity. As the efficacy of SARS-CoV-2 vaccines declines over time and variants of the virus continue to emerge, the need for booster doses of vaccine remains on the agenda. The aim of this study was to assess NAbs dynamics and its correlation with anti-RBD IgG levels during the nine-month follow-up period after primary-CoronaVac vaccination and booster vaccinations to evaluate vaccination strategies.MethodsThis prospective longitudinal observational study followed 226 healthcare workers who received primary (two doses CoronaVac) and booster (CoronaVac or BNT162b2) immunization. Serum samples were collected at four different time points, two after primary vaccination and two after booster. Anti-RBD IgG antibody levels were assessed with the SARS CoV-2 IgG-II-QUANT kit (Abbott, USA) and neutralizing antibody levels were determined with the ACE2-RBD-Neutralization-Assay (Dia-Pro, Italy) using a surrogate virus neutralization method. Factors affecting antibody response were analyzed. Statistical analysis was performed with IBM-SPSS-22.0.ResultsOne month after the second dose of CoronaVac, 79.2% of participants had NAb, but this had decreased to 49.7% by the fourth month and was influenced by smoking, BMI and chronic diseases. Boosters, regardless of type, significantly raised NAb levels. Heterologous vaccination yielded higher NAb and anti-RBD IgG responses. Both single or double-BNT162b2 boosters resulted in similar NAb responses. There was a strong correlation between anti-RBD IgG and NAb levels following CoronaVac vaccination, leading to the identification of predictive IgG threshold for the presence of NAb. The type of booster influenced the correlation strength and threshold-value.ConclusionsNAbs levels decreased rapidly after primary CoronaVac vaccination. Boosters significantly increased levels while the heterologous vaccine combination induced a greater response. Anti-RBD IgG levels were able to predict the NAb response, however the correlation varied by the vaccine type, NAb response strength and the time since vaccination.

Purpose: The purpose of the current study was to assess the tendency and frequency of orthorexia nervosa (ON) among primary health care workers. At the same time, it was our special purpose to evaluate its relation with eating attitude disorders and obsessive-compulsive symptoms. Materials and methods: This cross-sectional study was conducted with the participation of primary health care workers in Istanbul, Turkey, in September-October 2016. The total number of 202 primary health care workers were composed of physicians and nurses. We reached 72.2% (n=156) of the research population. Participants completed a questionnaire inquiring about sociodemographic characteristics, and also three scales, namely ORTO11, Eating Attitude Test-40 (EAT-40), and Maudsly Obsessive-Compulsive Inventory (MOCI). Results: The mean ORTO-11 score of the participants was 26.8±4.8. The ORTO-11 score was higher in the physicians (27.8±4.62) than in the nurses (25.8±5.01) (p=0.018). Therefore, physicians tend to have less tendency for ON. There was a low but statistically significant correlation between the scores of ORTO-11 and EAT-40 (rho=- 0.299 and p<0.001) and MOCI (rho=-0.261 and p=0.001). EAT-40 and MOCI (rho=0.192 and p=0.016) scores were found to be statistically significant at low correlation. Conclusions: The tendency of ON, eating attitude disorder and obsessive-compulsive symptoms were found to be higher in nurses as compared to physicians as far as occupational groups were concerned. There can be a relation between ON tendency and eating attitude disorders and obsessivecompulsive symptoms. Keywords: orthorexia nervosa; eating attitude disorders; obsessive-compulsive symptoms; primary health care workers

Cemeteries are important to society and represent a key piece of the fabric of municipalities. In the Province of Ontario, land use policy as articulated through official plans often fails to recognize cemetaries as a necessary element of municipalities. This paper examines the official plans of selected municipalities to ascertain the extent to which appropriate land use policies are provided to guide the development of cemetaries. Official plans are reviewed for the ten largest municipalities as determined by their population, all adjacent municipalities, and all associated regional municipalities of counties. In total, the official plans of forty-six municipalities are reviewed. The analysis focuses on eight key policy criteria identified in this paper that relate to cemetary development: need, planning horizon, location, size, intensification, compatibility, environment, and permanency. The review confirms the hypothesis that there is a general lack of appropriate land use policy necessary to guide cemetery development in Ontario.

Eloise Meldrum looks at the pros and cons of locum work

Recommended for antepartum screening in pregnancies of high-risk women, non-invasive prenatal testing (NIPT) is poised for wider use. A holistic approach to pregnancy requires that paternal genetic contribution be considered when evaluating genetic risk. High-risk male contribution to a pregnancy from advanced paternal age may be best screened for by NIPT. Given subtly older maternal ages, NIPT also provides a means for non-communicable disease early diagnosis.

BackgroundBreast cancer is an important public health issue among American Indian/Alaska Native (AI/AN) women in the US. This article describes the design and implementation of a culturally sensitive intervention to promote breast health among AI/AN women through a hybrid model that incorporates clinical and community-based approaches. This is one of the first studies using this model addressing breast cancer disparities among AI/AN populations in the US.MethodsThe Theory of Planned Behavior was used as the guiding framework of the intervention and Community Based Participatory Research was the primary vehicle for the intervention planning and implementation. Three preliminary studies took place that aimed to identify qualitatively and quantitatively what deterred or encouraged AI women to get past or future mammograms. The research results were shared with community members who, through a prioritization process, identified the theoretical focus of the intervention and its corresponding activities. The priority population consisted of AI women ages 40–74, with no recent mammogram, and no breast cancer history.ResultsThe intervention centered on the promotion of social modeling and physician recommendation. The main corresponding activities included enhancing patient-physician communication about screening mammography through a structured dialogue, receipt of a breast cancer brochure, participation in an inter-generational discussion group, and a congratulatory bracelet upon receipt of a mammogram. Environmental and policy related changes also were developed.ConclusionCreating a theory-based, culturally-sensitive intervention through tribal participatory research is a challenging approach towards eliminating breast cancer disparities among hard-to-reach populations.

Coming from an immigrant community, there has always been huge pressure on not losing one’s roots. Many apocryphal tales, anecdotes, and fables are told in this regard, and one in particular that sticks in my mind is that of the fox who lost his walk. The story, as it goes, was of a fox who used to be the envy of the other animals for his unique walk. One day, the fox saw a man who, rather than walking on four legs, walked on just two. Keen to maintain his reputation of being the best walker, the fox attempted to walk on two legs, though, try as he might, the fox could not replicate the walk of man. …

We live in a world where the flow of electronic information and communication has become a ubiquitous part of our everyday life. While our lives are enhanced in many ways, we also experience a myriad of challenges especially to our privacy and security. Survey data shows that the majority of people are 'very concerned' about privacy and security but that they don't always act in ways to protect their privacy. Our goal was to explore how participants understand and experience privacy and security as they engage in online activities. To that end we used a qualitative approach to understand the participants' mental models of online privacy and security. The data from our 40 interviews show that users have multiple mental models that guide their understanding of and experience with privacy and security. These mental models not only operate simultaneously but are rarely fully formed and often contradict each other.

Genital warts, or condylomata acuminata, are caused by the human papillomavirus (HPV). They are the most commonly diagnosed viral sexually transmitted infection in the UK. This article aims to describe the natural history of HPV and how to recognise and manage genital warts. A summary of the UK HPV vaccination programme is also included.