Analysis of core risk factors and potential policy options for sustainable supply chain: an MCDM analysis of Saudi Arabia's manufacturing industry.

Sustainable supply chain management (SSCM) has been a tough challenge for developing economies like Saudi Arabia. Implementation of SSCM practices in the manufacturing industry has been prone to multiple risk factors that need to be identified, evaluated, and prioritized especially considering the dynamics of the manufacturing industry in a developing economy. Moreover, it is also imperative to trace out feasible and sustainable strategies to overcome the risks to SSCM practices adoption.

Causes of recurrent lower limb varicose veins after surgical interventions in 141 limbs - five-year retrospective analysis of two centers.

Aim: The purpose of this study was to explore the causes of recurrent lower limb varicose veins after surgical interventions.

Methods: A retrospective five-year survey was conducted on patients who underwent second surgery due to recurrent lower limb varicose veins after surgical interventions. A total of 141 limbs (112 cases), including 72 cases of left lower limbs, 47 of right lower limbs and 22 of both limbs, were involved in the study.

Can maximum phonation time predict voice outcome after thyroplasty type I?

Background: Thyroplasty type I, as introduced by Isshiki and colleagues almost 30 years ago, has become the gold standard of improving glottal incompetence caused by unilateral vocal fold paralysis. Intraoperative assessment of the adequacy of glottal closure is subjective and based on the perceptual judgment of vocal quality and degree of improvement in glottal gap size.

Objective/hypotheses: The primary purpose of this study was to investigate whether the intraoperative measurement of maximum phonation time (MPT) is an adequate predictor of voice outcome after thyroplasty type I.

Spastic/spasmodic vs. tremulous vocal quality: motor speech profile analysis.

Strained, strangled, and tremulous vocal qualities that are typically seen in adductor spasmodic dysphonia (ADSD), voice tremor (Tremor), and the spastic dysarthria of amyotrophic lateral sclerosis (ALS) may sound similar and be difficult to differentiate. The purpose of this study was to determine if these vocal qualities of neurologic origin could be differentiated on the basis of acoustic and motor speech parameters. Three groups of subjects (ADSD, ALS, and Tremor) were analyzed by the Motor Speech Profile System (Kay Elemetrics, Lincoln Park, NJ) for fundamental frequency (Fo), standard deviation of Fo, diadochokinetic rate (ddk), standard deviation of ddk, mean intensity and standard deviation of ddk, frequency and amplitude variability in connected speech, and speaking rate in connected speech.

Early results of transcutaneous injection laryngoplasty with micronized acellular dermis versus type-I thyroplasty for glottic incompetence dysphonia due to unilateral vocal fold paralysis.

Medialization thyroplasty (type I) has become the gold standard to improve glottic closure due to unilateral vocal fold paralysis. A newer injection method utilizing homologous collagen from cadaveric human tissue has been described as an attractive alternative as no donor site is required, there is a very low risk of hypersensitivity, and the intact, acellular collagen fibers may suffer a reduced long-term reabsorption rate. Preliminary results on eight patients comparing presurgical and postsurgical parameters (perceptual, stroboscopic, acoustic, and aerodynamic) revealed comparable results when compared with a control group of individuals, age- and sex-matched, that had undergone standard medialization thyroplasty (type I).