Explore the vast range of titles available.

The Cold Supply Chain (CSC) is an integral part of the supply chain of perishable products. The aim of this research is to examine the inhibitors that have a major impact on the performance of CSC operations in the United Arab Emirates (UAE). This study provides a synthesis and suggests a hierarchical model among CSC inhibitors and their respective relevance. The hierarchical synthesis of twelve (12) primary CSC inhibitors is achieved through a comprehensive literature review and consultation with academics and CSC professionals. This study used semi-structured interviews, a fuzzy interpretive structural modeling (FISM) and a Fuzzy-MICMAC (FMICMAC) analysis to explore and establish the relationship between and among identified inhibitors. FISM is used to examine the interaction between inhibitors, while FMICMAC analysis is used to examine the nature of inhibitors on the basis of their dependence and driving power. The results of the FISM and FMICMAC analysis show the inter-relationships and relative dominance of identified inhibitors. The results show that some inhibitors are of high strategic importance due to their high driving power and low dependence. These inhibitors seek more management attention in order to improve their effectiveness. The result of a hierarchical model helps to understand the influence of a particular inhibitor on others. ‘Higher capital and operating costs’ occupy the highest level in the FISM model. The ‘fragmented cold supply chains’, ‘lack of skilled labor’, ‘inadequate information system infrastructure’ and ‘lack of commitment by top level management’ had strong driving power but weak dependence, which characterizes them as independent inhibitors. Management should be extra careful when dealing with these inhibitors as they influence the effects of other variables at the top of the FISM hierarchy in the overall management of the cold supply chain. The study also suggests a number of recommendations for addressing these inhibitors in cold supply chains operating in the UAE. With due attention and care for these inhibitors, the operation of the cold supply chains is likely to be even more successful.

Between 2008 and 2015, bus rapid transit system (BRTS) in India increased its implementation from two cities to eight cities with a significant increase in total ridership. This paper attempts to give a detailed review of BRTS implementation in cities of India. This is a systematic effort that could inform readers about the current system and network characteristics of Indian BRTS. Different system and corridor characteristics including off board and on board ticketing systems are adopted in India. Gross cost revenue collection model is adopted by almost all special purpose vehicle (SPV) companies developed to manage BRT systems. A variety of carriageway concept designs for BRTS are implemented in these cities considering a right of way of 22, 24, 30, 32, 40, 45, 60 meters respectively. Out of the eight cities, Ahmedabad has almost 30% of the total fleet size. In terms of regulatory context, SPV companies are formed in almost all eight cities after observing Ahmedabad BRT success. Documentation of these operating systems shall provide a sound database to planners and decision makers actively involved with BRT system implementation in developing countries.

Cardiac catheterization remains the gold standard for the diagnosis and management of pediatric pulmonary hypertension (PH). There is lack of consensus regarding optimal anesthetic and airway regimen. This retrospective study describes the anesthetic/airway experience of our single center cohort of pediatric PH patients undergoing catheterization, in which obtaining hemodynamic data during spontaneous breathing is preferential. A total of 448 catheterizations were performed in 232 patients. Of the 379 cases that began with a natural airway, 274 (72%) completed the procedure without an invasive airway, 90 (24%) received a planned invasive airway, and 15 (4%) required an unplanned invasive airway. Median age was 3.4 years (interquartile range [IQR] 0.7–9.7); the majority were either Nice Classification Group 1 (48%) or Group 3 (42%). Vasoactive medications and cardiopulmonary resuscitation were required in 14 (3.7%) and eight (2.1%) cases, respectively; there was one death. Characteristics associated with use of an invasive airway included age <1 year, Group 3, congenital heart disease, trisomy 21, prematurity, bronchopulmonary dysplasia, WHO functional class III/IV, no PH therapy at time of case, preoperative respiratory support, and having had an intervention (p < 0.05). A composite predictor of age <1 year, Group 3, prematurity, and any preoperative respiratory support was significantly associated with unplanned airway escalation (26.7% vs. 6.9%, odds ratio: 4.9, confidence interval: 1.4–17.0). This approach appears safe, with serious adverse event rates similar to previous reports despite the predominant use of natural airways. However, research is needed to further investigate the optimal anesthetic regimen and respiratory support for pediatric PH patients undergoing cardiac catheterization.

Background: Tobacco is one of the world's leading avoidable causes of premature death, disease, and disability. According to the World Health Organization (WHO) survey 2020, there are about 120 million tobacco users in India, and WHO estimates that about 4.9 million die due to tobacco annually, and that by 2020 it will be the principal cause of death and disability. This study is done with objectives to access the prevalence of tobacco consumption, evaluate the impact of health education and intervention. Methods: It was community-based health educational interventional study conducted in urban slum setting in Bhopal India, comprising 1598 subjects, and out of these 520 participants were assessed for final outcome with 3 months study duration. A predesigned, pretested questionnaire proforma was developed containing the study variables including socio-demographic, education, age, occupation, type of tobacco product consumed and so on and distributed to all study participants in pre-interventional phase and only in tobacco consumers of post-interventional phase and then was finally evaluated. Results: The prevalence of tobacco use was 32.50% among the tobacco user; 87% were males and rest were females. In post-interventional phase there was a significant difference (P < 0.0001) observed in tobacco consumption frequency, impact of staring with criticism, condemnation, denigration and total number of tobacco quitter. Conclusion: After the health educational interventional motivation, majority of users are ready to quit, so we have to help them in quitting which must include the effectual intervention to control the tobacco use by making an effective strong policy by increasing their knowledge by means of IEC and health education.

Supplier selection is regarded as the primary goal of supply chain management (SCM) because it affects its performance, productivity, pleasure, flexibility, and system speed in lockdown. A new method is proposed based on a multi-stage fuzzy sustainable supplier index (FSSI). Experts can use the triple bottom line (TBL) criteria to select the best supplier. In addition, the worst method is proposed based on trapezoidal membership and fuzzy membership functions, which can cover uncertainties and ambiguous environments. Because it collects the related criteria and sub-criteria and uses a direct fuzzy methodology, this research has impacted the SCM literature because it helps solve previous expert methods’ computational difficulties. In addition, an ordered mean integration representation method has been implemented to prioritize the selection of the best supplier (SS) based on the sustainability performance of the best supplier, which improves the selection accuracy compared to the previous ranking method. This study can be used as a benchmark to determine which supplier is the best in sustainability. To provide the superiority and broad applicability of the proposed model, a practical case study was completed. On the other hand, the COVID-19 pandemic harms productivity, company performance, and selecting the best suppliers based on sustainability performance. The lockdown situation caused by the COVID-19 pandemic hurts company performance and management.

Background : Each year, over 300 million people undergo surgical procedures worldwide. Despite efforts to improve outcomes, postoperative morbidity and mortality are common. Many patients experience complications as a result of either medical error or failure to adhere to established clinical practice guidelines. This protocol describes a clinical trial comparing a telemedicine-based decision support system, the Anesthesiology Control Tower (ACT), with enhanced standard intraoperative care. Methods : This study is a pragmatic, comparative effectiveness trial that will randomize approximately 12,000 adult surgical patients on an operating room (OR) level to a control or to an intervention group. All OR clinicians will have access to decision support software within the OR as a part of enhanced standard intraoperative care. The ACT will monitor patients in both groups and will provide additional support to the clinicians assigned to intervention ORs. Primary outcomes include blood glucose management and temperature management. Secondary outcomes will include surrogate, clinical, and economic outcomes, such as incidence of intraoperative hypotension, postoperative respiratory compromise, acute kidney injury, delirium, and volatile anesthetic utilization. Ethics and dissemination : The ACTFAST-3 study has been approved by the Human Resource Protection Office (HRPO) at Washington University in St. Louis and is registered at clinicaltrials.gov ( NCT02830126 ). Recruitment for this protocol began in April 2017 and will end in December 2018. Dissemination of the findings of this study will occur via presentations at academic conferences, journal publications, and educational materials.

In recent years, companies have been under increasing pressure from consumers, grassroots and community organizations, governments, and shareholders to develop and practice sustainable business practices. Academic and corporate interest in sustainable supply chain management has risen considerably in recent years. This can be seen in the number of papers published. This paper aims to systematically investigate the discipline of supply chain management (SCM) within the context of sustainability. The two concepts are increasingly aligned, and sustainable supply chain management (SSCM) represents an evolving field where they explicitly interact. The study proposes a conceptual framework to classify various factors along the triple bottom-line pillars of sustainability issues in the context of supply chains. The findings indicate that the existing literature is primarily focused on individual sustainability and supply chain dimensions rather than taking a more integrated approach. Also, the economic benefits of developing a sustainable supply chain for an organization are discussed in addition to specific features of sustainable supply chains and limitations of existing research; this should stimulate further research. Our analysis revealed trends and gaps, allowing us to create a solid agenda for additional SSCM research.

Existing literature has overlooked investigating the factors that foster attachment in counterfeit consumers. This research developed and validated a model that considers social, personal, functional, and economic factors influencing brand attachment and purchase intention. The moderating effect of hedonic benefits was researched under well-established theories—the theory of planned behavior (TPB) and attachment theory. A multi-wave method using purposive sampling was applied to collect 529 responses from consumers about counterfeiting. This data was then analyzed through structural equation modeling (SEM) in AMOS 24.0. The results of the model fit indices of measurement (χ 2 /df = 2.1927; RMSEA = 0.048) and structural model (χ 2 /df = 2.552; RMSEA = 0.054) are indicated as satisfactory. The study found that most factors—social, personal, functional, and economic—have a significant positive association with brand attachment to counterfeit products. However, we found that transactional value, conformity, and novelty have an insignificant relationship with brand attachment. The findings also confirmed that brand attachment has a positive relationship with purchase intentions for luxury counterfeit products. Further, hedonic benefits positively moderate the relationship between brand attachment and the willingness to buy luxury counterfeit goods. This research contributes to the body of knowledge on brand attachment, psychology, consumer behavior, TPB, and attachment theory. The study aids luxury and apparel businesses and acknowledges limitations by offering research directions.

Background : Each year, over 300 million people undergo surgical procedures worldwide. Despite efforts to improve outcomes, postoperative morbidity and mortality are common. Many patients experience complications as a result of either medical error or failure to adhere to established clinical practice guidelines. This protocol describes a clinical trial comparing a telemedicine-based decision support system, the Anesthesiology Control Tower (ACT), with enhanced standard intraoperative care. Methods : This study is a pragmatic, comparative effectiveness trial that will randomize approximately 12,000 adult surgical patients on an operating room (OR) level to a control or to an intervention group. All OR clinicians will have access to decision support software within the OR as a part of enhanced standard intraoperative care. The ACT will monitor patients in both groups and will provide additional support to the clinicians assigned to intervention ORs. Primary outcomes include blood glucose management and temperature management. Secondary outcomes will include surrogate, clinical, and economic outcomes, such as incidence of intraoperative hypotension, postoperative respiratory compromise, acute kidney injury, delirium, and volatile anesthetic utilization. Ethics and dissemination : The ACTFAST-3 study has been approved by the Human Resource Protection Office (HRPO) at Washington University in St. Louis and is registered at clinicaltrials.gov ( NCT02830126 ). Recruitment for this protocol began in April 2017 and will end in December 2018. Dissemination of the findings of this study will occur via presentations at academic conferences, journal publications, and educational materials.