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This paper reviews the supply chain risk management (SCRM) literature to identify as well as to discuss and elaborate on the impact and origin of major supply chain risk factors in an Indian context. Through a combination of existing literature and a survey instrument, we identify major SCRM issues including underlying supply chain risks and thereafter identify gaps, issues and opportunities for further research. SCRM has become a popular research topic, in part owing to increased globalisation of business. Moreover competitive factors such as shorter product life cycles, technological innovations and changing government policies have brought this topic more sharply into focus. We carried out a survey among Indian supply chain professionals, based on supply chain risk constructs developed from a literature review. Statistical analysis utilised exploratory and confirmatory factor analyses to determine the major risk factors in the Indian supply chain sector. We found a range of supply chain risks prevalent in Indian supply chains, classified here ascultural, operational, infrastructure, economic, forecasting and supplier-related risks. However, for a variety of reasons and as discussed in the paper, the implications can vary considerably. Based on the findings we provide a future SCRM research agenda from an Indian perspective. As international supply chains increasingly have Indian partners and domestic firms within India seek to be globally competitive, the risks need to be better understood. This is the first detailed study on SCRM practices in an Indian context. [ABSTRACT FROM AUTHOR]

STEM leadership education as a formal discipline is not present in the majority of higher institutions. Similar is the case with ethics in engineering schools. Although ethics is recognized as a crucial aspect in developing the professional identity of engineers, it is still not required as a mandatory course in all engineering curricula. This study introduces a project that simulates a real-world engineering application and uses this task to examine how the assignment objectives influence employment of students' leadership skills and social responsibility awaress. The participants were from three different groups - (1) learning communities, (2) traditional sections, and (3) international sections. It was hypothesized that there would be different outcomes of the students teams projects considering the three different missions of the groups. Results corroborated the hypothesis. The learning community teams proposed projects that best addressed the assignment objectives and enhanced professional skills in the utilization of the course project compared to the traditional and international sections. Outcomes are discussed in terms of underlying links in assignment objectives and the enhancement of professional skills in engineering instruction. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the oral health-related quality of life (OHRQoL) of young children in a randomized clinical trial (RCT) of silver diammine fluoride (SDF) and five percent sodium fluoride varnish (NaFV) to manage early childhood caries (ECC). Methods: Children younger than 72 months of age with active dentinal caries lesions (ICDAS 5 or 6) in primary teeth received two applications of 38 percent SDF and five percent NaFV as part of an RCT testing three different frequency regimes (one, four, and six months apart). The Early Childhood Oral Health Impact Scale (ECOHIS) questionnaire was completed at three study visits. Statistical analyses included descrip- tive and parametric methods. A P -value of ≤0.05 was significant. Results: Eighty-two children (58.5 percent male) were recruited with a mean age of 44.3±14.2 months. Significant improvement in total ECOHIS scores for all children was observed following treatment (baseline mean scores=4.52±4.77 versus third visit mean scores=3.19±3.78, P =0.01) and family impact scores for all children (base- line mean scores=3.00±2.98 versus third visit mean scores=1.68±2.01, P ≤0.001). However, no significant change in the mean child impact score was observed among all the children ( P =0.97). The parental distress and family function domains showed the most improvement with SDF treatment. No significant ECOHIS score differences were found among the three frequency groups across visits. Conclusions: Children showed better OHRQoL after applying 38 percent SDF and five percent NaFV. No significant differences were found between treatment groups. SDF is a viable non-restorative option for managing ECC as it has a positive effect on OHRQoL.

Patients with head and neck cancer (HNC) have ongoing pain but Stellate ganglion block which is a sympatholytic block may be a viable therapy for treating it. The data were retrospectively collected from five histopathologically confirmed HNC patients who had completed chemotherapy and radiation doses. Stellate ganglion block was given to these patients and was subsequently monitored for 3 months to assess pain alleviation and overall satisfaction. Over a 3-month period, there was a decrease in the pain levels with a better quality of life so the stellate ganglion block can be a promising modality for reducing the pain of HNC., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Family Medicine and Primary Care.)

Background and Aims: Thoracolumbar spine surgery is one of the most painful surgical procedures. This study's primary objective was to evaluate the effect of erector spinae plane (ESP) block on post-operative cumulative morphine consumption at 24 h in patients undergoing thoracolumbar spine surgery., Methods: Seventy adults posted for thoracolumbar spine surgery were randomised into the control group [Number of patients (n)=35], who received general anaesthesia without any nerve block, and the intervention group (n = 35), who received bilateral ultrasound (US)-guided ESP block at the level of spine surgery with 0.25% bupivacaine 20 mL after standard general anaesthesia. Along with intravenous patient-controlled analgesia morphine, post-operative analgesia was standardised for both groups. Total morphine consumption, visual analogue scale (VAS) score to evaluate pain, overall patient satisfaction, and any side effects were compared at 24 h. The statistical analysis was done using Statistical Package for Social Sciences (SPSS Inc., Chicago, IL)., Results: Post-operative total morphine consumption at 24 h was significantly decreased in the intervention group compared to the control group [5.69 (1.549) versus 9.51 (1.634) mg; P < 0.001]. Post-operative VAS scores were also significantly decreased in the intervention group at rest ( P < 0.001) and on movement ( P < 0.001). Patient satisfaction scores were more favourable in the intervention group [3.8 (0.4) versus 3.2 (0.6); P < 0.001]. Post-operative nausea and vomiting were found more in the control group but were not significant (n = 14 versus 8; P = 0.127)., Conclusion: US-guided ESP block significantly reduces post-operative morphine consumption and improves analgesia and patient satisfaction without adverse effects in patients undergoing thoracolumbar spine surgery., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Indian Journal of Anaesthesia.)

Introduction: Limb amputation is an extremely stressful event for an individual, following which the amputee develops inferior body image, anxiety, and changes in self-concept and identity. For holistic rehabilitation, understanding the psychosocial status of the amputee and its' predictors is of utmost importance., Objective: The aim of the article is to assess the psychological adjustments in patients with lower limb amputation and determine its clinical and sociodemographic correlates., Material and Methods: A observational cross-sectional study was conducted from 2020 to 2022 among lower limb amputees of a tertiary care hospital in Lucknow which serves as the only rehabilitation and artificial limb center for the whole state of Uttar Pradesh. Baseline sociodemographic and clinical data were collected. The Hospital Anxiety and Depression Scale was used to determine underlying depression and anxiety, while the Trinity Amputation and Prosthesis Experience Scale was used for understanding the psychological adjustment., Results: The mean age of the amputee was 39.47 ± 16.99 years. The mean general, social adjustment, and adjustment to limitation score was 16.3 ± 3.34, 15.19 ± 3.59, and 12.76 ± 3.15, respectively. Male amputees, aged >40 years, and pensioners had significantly higher scores for general adjustment ( P < 0.05). Those aged >40 years were pensioners and had no underlying depression and anxiety and had better social adjustment ( P < 0.05). Those with transfemoral amputation had a significantly lesser adjustment to limitation (P = 0.003)., Conclusion: Young age amputees had poor general and social adjustments and more activity restriction but high prosthesis satisfaction as compared to the elderly. Those with transfemoral amputation had a poor adjustment to limitation while those wearing above-knee prosthesis had more activity restriction., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Industrial Psychiatry Journal.)

Here we report the morpho-functional features of a novel type of deep-layer neuron. The neuron was selected from a large pool of intracellularly labelled cells based on the large cell body, numerous spine-free dendrites with an overall interneuron morphology. However, the axon gave off long-range axons up to 2.8 mm from the parent soma in layers 5/6 before entering the white matter. The boutons were uniformly distributed along the axon without forming distinct clusters. Dendritic length, surface area and volume values were at least 3 times larger than any known cortical neuron types with the exception of giant pyramidal cells of layer 5. Electron microscopy of the boutons revealed that they targeted dendritic spines (78%) and less frequently dendritic shafts (22%). Nearly half of the postsynaptic dendrites were immunopositive to GABA. Superimposing the axonal field on the orientation map obtained with optical imaging showed a preponderance of boutons to cross-orientations (38%) and an equal representation of iso- and oblique orientations (31%). The results suggest an integrating role for the layer 6 stellate neuron which projects to a functionally broad range of neurons in the deep cortical layers and to other cortical and/or subcortical regions., (© 2022. The Author(s).)

The mirror technique adapted for electron microscopy allows correlating neuronal structures across the cutting plane of adjoining light microscopic sections which, however, have a limited thickness, typically less than 100 µm (Talapka et al. in Front Neuroanat, 2021, https://doi.org/10.3389/fnana.2021.652422 ). Here, we extend the mirror technique for tissue blocks in the millimeter range and demonstrate compatibility with serial block-face electron microscopy (SBEM). An essential step of the methodological improvement regards the recognition that unbound resin must be removed from the tissue surface to gain visibility of surface structures. To this, the tissue block was placed on absorbent paper during the curing process. In this way, neuronal cell bodies could be unequivocally identified using epi-illumination and confocal microscopy. Thus, the layout of cell bodies which were cut by the sectioning plane can be correlated with the layout of their complementary part in the adjoining section processed for immunohistochemistry. The modified mirror technique obviates the spatial limit in investigating synaptology of neurochemically identified structures such as neuronal processes, dendrites and axons., (© 2022. The Author(s).)

Introduction: Behavior modification is defined as the attempt to alter human behavior and emotion in a beneficial way and accordance with the laws of learning. Play therapy is one such behavior modification technique. The study aimed to evaluate the efficacy of play therapy among children undergoing dental treatment by the graphological method., Materials and Methods: Children were made to draw before treatment, after treatment of one class 1 lesion without application of any behavior modification technique and after treatment of the second lesion of class 1 caries with play therapy. Graphologist and scores assessed drawings were given by graphological method., Results: Significant reductions in stress levels were observed in the drawings which were made after play therapy., Conclusion: Play therapy is an effective behavior modification technique in pediatric dentistry, which may be used in routine dental practice. How to cite this article: Kiran SDP, Vithalani A, Sharma DJ. Patel MC, Bhatt R, Srivastava M. Evaluation of the Efficacy of Play Therapy among Children Undergoing Dental Procedure through Drawings Assessed by Graphological Method: A Clinical Study. Int J Clin Pediatr Dent.,2018;11(5):412-416., Competing Interests: Source of support: Nil Conflict of interest: None

Context: The identification of sex is the first and the foremost step in forensic science. Teeth consist of enamel which is the hardest tissue available in the body, protector of DNA presents in pulp tissue at the time of exposure of tooth to adverse conditions. Teeth can be stated as a sealed box of mystery as it contains various human and bacterial DNA for molecular utilization., Aim and Objective: The aim is to determine sex from mesiodens on the basis of gene identification by the polymerase chain reaction (PCR)., Settings and Design: Total number of sample was 8 human-extracted mesiodens. DNA was isolated and was subjected to PCR analysis with use of predesigned primers for amelogenin (AMEL) X and AMEL Y genes., Results: Isolation of genomic and mitochondrial DNA from mesiodens was successful in six samples (75%). In samples, quantity of DNA present was also calculated., Conclusion: Mesiodens are a good source of DNA and are a very useful tool in identification of sex using PCR analysis which was simple and effective. Hence, the procedure presented in the present study can be applied for extraction of DNA and identification of sex for forensic purpose., Competing Interests: There are no conflicts of interest.

Background: A significant number of patients undergo endovascular repair of abdominal aortic aneurysms (EVAR) outside the instructions for use (IFU). This study will examine various aortic neck features and their predictors of clinical outcomes., Study Design: We performed a retrospective analysis of prospectively collected data on EVAR patients. Neck features outside IFU were analyzed. Kaplan-Meier and multivariate analyses were used to predict their effect as single features, or in combination, on outcomes., Results: Fifty-two percent of 526 patients had 1 or more features outside the IFU. The overall technical success rate was 99%, and perioperative complication rates were 7% and 12% for IFU vs outside IFU use, respectively (p = 0.04). Type I early endoleak and early intervention rates were 7% and 10% for IFU vs 18% and 24% for outside IFU (p = 0.0002 and p < 0.0001). At a mean follow-up of 30 months, freedom from late type I endoleak and late reintervention at 1, 2, and 3 years for IFU were 99.5%, 99.5%, and 98.4%, and 99.4%, 98%, and 96.8%; vs 98.9%, 98.1%, and 98.1%, and 97.5%, 96.2%, and 95.2% for outside IFU (p = 0.049 and 0.799), respectively. Survival rates at 1, 2, and 3 years for IFU were 97%, 93.5%, and 89.8%; vs 93.7%, 88.8%, and 86.3% for outside IFU (p = 0.035). Multivariate analysis showed that a neck angle > 60 degrees had odds ratios for death, sac expansion, and early intervention of 6, 2.6, and 3.3, respectively; neck length < 10 mm had odds ratios of 2.8 for deaths, 3.4 for early intervention, 4.6 for late reintervention, and 4.3 for late type I endoleak., Conclusions: Patients with neck features outside IFU can be treated with EVAR; however, they have higher rates of early and late type I endoleak, early intervention, and late death., (Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.)

Background: This study analyzed the effect of statins on clinical outcomes after carotid endarterectomy (CEA) and the rate of restenosis., Study Design: We performed a retrospective analysis of prospectively collected data on 500 consecutive CEAs followed at 1, 6, and 12 months and every year., Results: There were 299 patients on statins vs 201 without. Combined perioperative MI/death rates were 2.7% vs 4% (p = 0.416) and MI/stroke/death rates were 4% vs 5% (p = 0.607) for statins vs no statins. At mean follow-up (27 months), MI, stroke, and death rates were: 9.7%, 2.3%, and 2.3% vs 9%, 2.5% and 4.5% (p = 0.18) for statins vs no statins, respectively. Diabetic patients not on statins had 4 times more deaths (8.5% vs 2.3%) and twice as many strokes/deaths (10.2% vs 5.3%). Patients with hypercholesterolemia who were not on statins had twice as many deaths (4.3% vs 2.2%). Rates of freedom from stroke/MI/death at 1, 2, 3, and 4 years were: 94%, 90%, 85% and 77% vs 94%, 89%, 85%, and 82% (p = 0.87) for statins vs no statins, respectively. Rates of freedom from death only for patients on statins vs no statins at 1, 2, 3, and 4 years were: 98%, 98%, 97.4% and 97.4% vs 98%, 96%, 94.8% and 94.8%, respectively (p = 0.191). For diabetic patients, rates of freedom from death at 1, 2, 3, and 4 years were 99%, 99%, 97%, and 97% for statins vs 97%, 90%, 90%, and 90% without statins, respectively (p = 0.048). Post-CEA restenosis rates ≥ 50% were not significantly different between statins vs no statins (p = 0.64)., Conclusions: Statins significantly lowered death rates in patients with diabetes and tended to lower both death and stroke rates in diabetic patients and patients with hypercholesterolemia. Statins had no effect on post-CEA restenosis., (Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.)