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This article adopts tools from political science and political anthropology to re-evaluate the prevailing discourses of accountability and marketisation that continue to shape education policies across the developing world. Following an exploration of studies promoting the quasi-marketisation of education and reforms that empower parents to exercise their voice and choice, this paper adopts principal–agent theory, social dominance theory and concept of the everyday to argue that such community-centric policies–which were initially devised to offset the capture of education by the state–may de facto lead to the education landscape becoming intrinsically politicised and reflective of national political discourses, albeit not in the way we conventionally believe. It argues that parents can no longer be regarded as passive, apolitical agents in education discourse. Rather, citizens’ interests are continually in conflict, and in a marketised system designed to respond to the interests of more dominant parents, schools may become sites in which inter-group contestations and competing political beliefs are reified. This article invites us to revise our current understanding of education and politics, and question: What–or whom–do we define as political, and why is this becoming increasingly important?.

Summary As we head into the third year of the COVID-19 pandemic, there is an increasing need to consider the long-term mental health outcomes of health care workers (HCWs) who have experienced overwhelming work pressure, economic and social deprivation, burnout, and post-traumatic stress disorder (PTSD). This scoping umbrella review summarizes the mental health outcomes of published evidence syntheses on HCWs worldwide. We analyzed 39 evidence syntheses representing the findings from 1297 primary studies. We found several persistent fears and concerns (job-related fears, fear of stigmatization, worries about the pandemic, and infection-related fears) that shaped HCW experiences in delivering health care. We also describe several risk factors (job-related, social factors, poor physical and mental health, and inadequate coping strategies) and protective factors (individual and external factors). This is the first scoping umbrella review comprehensively documenting the various risk and protective factors that HCWs have faced during the COVID-19 pandemic. HCWs continue to fear the risk that they may infect their family and friends since they regularly interact with COVID-19 patients. This places HCWs in a precarious situation requiring them to balance risk to their family and friends and potential social deprivation from isolation.

This study was conducted to elucidate the link of site-specific, tooth-related, and patient-associated factors with bleeding on pocket probing (BOPP) and the impact of scaling and root planing over these factors.This cross-sectional study comprised of 50 untreated periodontitis patients and 50 periodontitis patients who had received scaling and root planing in the last 6 to 12 months and were on supportive periodontal therapy. Multilevel modeling was applied to data, with BOPP being the dichotomous outcome variable. Variables that revealed a significant association with BOPP in multilevel modeling were analyzed further to find the influence of the treatment group (untreated periodontitis and treated periodontitis) on the association between predictor variables and BOPP.Odds ratio (OR) for BOPP in untreated periodontitis versus treated periodontitis was 1.493, and in molars versus anterior teeth this was 1.439. Untreated periodontitis had an OR of 3.500 compared to treated periodontitis, in anterior teeth with Plaque Index 0. This was 2.795 and 7.734 in treated periodontitis and 5.106 and 12.762 in untreated periodontitis at Plaque Index 1 and 2, respectively. Bleeding on marginal probing had an OR of 6.984 for BOPP. Bleeding on marginal probing negative sites had higher OR in untreated periodontitis irrespective of the probing pocket depth.Plaque control is more effective in controlling periodontal inflammation after scaling and root planing. The probability of BOPP in the absence of bleeding on marginal probing is higher in untreated patients. The scope of influence of marginal inflammation on periodontal inflammation in shallow pockets is more in untreated periodontitis as compared to treated periodontitis; however, the trend reverses in deep pockets.

Objective This study sought to answer the following question: What are the complications and assisted reproductive technology outcomes among women with hydrosalpinges managed by hysteroscopic microinsert tubal occlusion compared with women with hydrosalpinges managed by laparoscopic proximal tubal occlusion or salpingectomy? Methods This was a retrospective cohort study conducted from January 2009 to December 2014 at two academic, tertiary care, in vitro fertilization centres in Toronto, Ontario. All patients (n = 52) who underwent hysteroscopic tubal occlusion for hydrosalpinges were identified. Patients who proceeded with embryo transfer cycles after hysteroscopic microinsert (n = 33) were further age matched to a cohort of patients who underwent embryo transfer after laparoscopic proximal tubal occlusion or salpingectomy (n = 33). Main outcome measures were clinical pregnancy rate per patient and per embryo transfer cycle. Results Among 33 patients, there were 39 fresh and 37 frozen embryo transfer cycles in the hysteroscopic group (group A); among 33 patients in the laparoscopic group (group B), there were 42 fresh and 29 frozen embryo transfer cycles. The cumulative clinical pregnancy rate in group A and group B was similar (66.7% vs. 69.7%, respectively; P = 0.8). The clinical pregnancy rate per embryo transfer cycle was also similar in both groups (28.9% in group A vs. 32.4% in group B; P = 0.6). There were two incidents of ectopic pregnancy in the laparoscopic group and no ectopic pregnancy in the hysteroscopic group. There were three major complications: tubo-ovarian abscess, distal migration of the coil after microinsert placement, and an acute abdomen following the hysteroscopic procedure. Conclusion Pregnancy outcomes after hysteroscopic placement of a microinsert for hydrosalpinx management before embryo transfer were comparable to those following laparoscopic proximal tubal occlusion or salpingectomy. However, caution is advised regarding microinsert placement for hydrosalpinges before proceeding with assisted reproductive technology.

To compare the changes in periodontal parameters after orthodontic treatment in patients having isolated gingival recession treated with and without pre-orthodontic gingival recession coverage.Thirty-six patients requiring orthodontic treatment with a facially positioned mandibular anterior tooth with labial recession were randomly allocated to either test group: root coverage by subepithelial connective tissue graft (SCTG) followed by orthodontic treatment, or control group (orthodontic treatment only). Primary clinical parameters included recession depth, keratinized tissue width, root coverage, root esthetic score, and gingival phenotype. The patients were followed up for at least 1 year.Level of gingival margin attained in test group teeth after SCTG were maintained at end of orthodontic treatment (P = .727). Root coverage achieved was 69.33 ± 30.74% versus 22.36 ± 27.70% in test and control group, respectively (P = .000), and gain in keratinized tissue width was 1.59 ± 0.73 mm in test versus 0.41 ± 0.49 mm in control group (P = .000). The number of teeth with improved gingival phenotype and decreased hypersensitivity was also observed to be statistically significant in the test group (P = .049, P = .002).Root coverage procedure may be performed before the planned orthodontic treatment as graft stability is preserved throughout the course of orthodontic treatment.

Rationale & Objective Though studies have demonstrated a relationship between hypertensive disorders of pregnancy (HDP) and chronic kidney disease, there are limited data on the risk of acute kidney injury (AKI) following HDP. We examined the risk of AKI following the occurrence of HDP. Study Design Retrospective population-based cohort study. Setting & Participants Pregnant women of Ontario, Canada, aged 14-50 years who delivered at ≥ 20-weeks gestation between April 1, 2002 and March 31, 2015. Exposure Preeclampsia, gestational hypertension, or neither. Outcomes The primary outcome was AKI with receipt of dialysis (AKI-D) ≥ 90 days after delivery. The main secondary outcome was AKI based on a hospitalization with a diagnostic code for AKI ≥ 90 days after delivery. Analytical Approach Time-dependent Cox proportional and cause-specific hazards models were used to evaluate the relationship between HDP and outcomes of interest. Models were adjusted for baseline and time-varying covariates. Results Our cohort comprised 1,142,656 women and 1,826,235 deliveries, of which 1.7% were associated with gestational hypertension and 4.4% with preeclampsia. After a mean follow-up of 6.7 years, there were 322 episodes of AKI-D (0.41 per 10,000 person-years), and 1598 episodes of AKI based on diagnostic codes (2.04 per 10,000 person-years). After adjustment, neither preeclampsia nor gestational hypertension was associated with AKI-D. Preeclampsia was associated with AKI (HR 1.22, 95% CI 1.03-1.45) but gestational hypertension was not. Limitations Retrospective design and possible unmeasured confounding. Cases of HDPs and AKI may have been undetected. Conclusions Preeclampsia was a risk factor for AKI occurring ≥ 90 days after delivery. Our findings suggest the potential importance of obtaining a pregnancy history as part of a comprehensive risk profile for acute kidney disease and suggest that women with a history of HDP may benefit from monitoring of kidney function.

Background Several studies have implicated the role of periodontal phenotype (PP) in the outcome of various periodontal interventions. However investigations have not been performed to estimate such impact on the outcome of open flap debridement (OFD) for the management of chronic periodontitis. Methods A total of 73 individuals with chronic periodontitis underwent scaling and root planing (SRP). Eight weeks following SRP, modified Widman flap (MWF) surgery was performed in 40 patients (20 of either PP) presenting with probing depth (PD) ≥4 mm and gingival index (GI) ≥1 at ≥4 sites distributed over ≥2 anterior teeth with radiographic evidence of horizontal bone loss. PD, clinical attachment level (CAL), gingival recession, plaque index, GI, and bleeding on probing (BOP) were recorded at baseline, 3 and 6 months. PP was assessed using transparency of periodontal probe through the gingival margin at midfacial level. Results A total of 34 patients were re-evaluated after intervention. All periodontal parameters improved in both groups after periodontal surgery. PD & PP were found to have positive correlation with CAL gain in ≥7 mm probing sites. Attachment gain of >2 mm was observed in more percentage of sites in thick PP than in thin PP. Conclusion PP can be an important factor influencing CAL gain in OFD.

The increase in power demand has given rise to invest in renewable energy sources which are much better than conventional sources of power. But the renewable power sources such as wind, PV are variable in nature which affects the power quality of grid. Hence, the power system is required to make balance between power demand and generation. In order to improve the stability the PID controllers are used. But these are fixed gain controllers. So, to overcome this issue, AI techniques must be used. This paper presents the hybrid renewable energy system with wind, PV and Fuel cell connected to the grid. The PID controller is employed with the system whose parameters are tuned with Particle Swarm Optimization technique. This optimization improves the stability of the system. The modeling and simulations are done in MATLAB and results are observed for better performance under variable loading conditions.

The objective of this study was to assess the effects of elevated luteal-phase progesterone levels (PE) and high progesterone/estradiol ratio (‘P/E2’ ratio) on IVF outcomes, exclusively in GnRH-antagonist cycles with day-5 embryo transfer. PE was not found to have a significant effect on implantation or clinical pregnancy rate (CPR) (OR 0.56, 95% CI 0.25–1.25, p = .16). Elevated ‘P/E2’ ratio (≥0.55) on trigger day was associated with a poorer response to stimulation and lower clinical pregnancy rates (OR 0.58, 95% CI 0.34–1.00, p = .05). Patients with PE and low ‘P/E2’ ratio yielded significantly more oocytes than patients with PE and high ‘P/E2’ ratio. The mean implantation rate per patient decreased by 60% in the group with PE and high ‘P/E2’ ratio in comparison to the group with PE and low ‘P/E2’ ratio (17.9%±36.6 vs. 45.5%±47.2, p = .06), although no statistical significance was observed. The detrimental effect of PE may be mitigated by culturing embryos to day-5 before embryo transfer. Combined assessment of serum progesterone and ‘P/E2’ ratio may predict pregnancy outcome better than progesterone levels alone.

According to anthropological records, with a reduction in dietary intake of Vitamin D and reduced sun exposure, the prevalence of Vitamin D deficiency is increasing day by day. About 30%–50% of the general adult population has serum Vitamin D levels below the recommended values. Since its discovery of Vitamin D is always associated with regulation of calcium metabolism. Recently, it has been discovered that Vitamin D plays a role beyond this. Numerous evidences have indicated that the participants with Vitamin D deficiency are at a higher risk of bone loss, but they are also prone to many infectious and chronic inflammatory diseases. Through its effect on bone and mineral metabolism, innate immunity, and several Vitamin D receptor gene polymorphisms, it is now believed that Vitamin D benefits periodontal health and its deficiency is associated with the periodontal disease. This review will examine these actions of Vitamin D, in particular, the role of Vitamin D in periodontal diseases.

Introduction: Peripheral ossifying fibromas (POFs) and pyogenic granulomas (PGs) are non-neoplastic reactive lesions of gingiva that usually affect young females and are usually located in the anterior maxilla. It is possible to misdiagnose POF as PG, peripheral giant cell granuloma, or odontogenic tumors. Histopathologic examination is recommended and is essential for an accurate diagnosis of such lesions, and differential diagnosis is also important because POFs have a tendency to recur.Case Presentation: A clinical case of gingival swelling in the mandibular left second premolar and first molar region on the lingual side, which was diagnosed as a POF on histopathologic examination, is reported. Recurrence of the lesion was seen within 1 week of its excision. The recurrent overgrowth was again excised, thoroughly curetted, and histopathologically confirmed as a PG. No signs of recurrence were seen at the 6-month follow-up.Conclusion: This case shows the importance of complete excision of the lesion to t...

2 ABSTRACT: As we all know the simple definition of Cloud computing means that the Service On Demand .The cloud computing and its work simple working concept is data stored in cloud for utilization .This data is used by cloud user at any time or in any place. In other word we can say that the cloud store the data these data is used by multiple user when they required .when data is store is in cloud server or cloud data center due to hardware failure , human failure and human mistake cloud data integrity is occur , the major problem is cloud computing is store a big amount of data in its server so it is not possible to retrieving entire file or data from the cloud server or solve this data integrity problem with proper high level security . so in this paper we are proposed a new cloud architecture for Third party auditor authentication with minimum auditing Time .

The aim of the present study was to investigate the nanoemulgel as transdermal delivery system for poorly water soluble drug, ketoprofen, in order to overcome the troubles associated with its oral delivery. Different nanoemulsion components (oil, surfactant, and cosurfactant) were selected on the basis of solubility and emulsification ability. Pseudoternary phase diagrams were constructed using titration method to figure out the concentration range of components. Carbomer 940 was added as gel matrix to convert nanoemulsion into nanoemulgel. Drug loaded nanoemulsions and nanoemulgels were characterized for particle size, TEM, viscosity, conductivity, spreadability, rheological behavior, and permeation studies using Wistar rat skin and stability studies. Transdermal permeation of ketoprofen from nanoemulgels was determined by using Franz diffusion cell. Nanoemulgel containing 6% oleic acid as oil, 35% Tween 80, and Transcutol P as surfactant cosurfactant mixture, 56.5% water, 2.5% drug, and 0.6% carbomer was concluded as optimized formulation (NG6). The ex vivo permeation profile of optimized formulation was compared with nanoemulsion and marketed formulation (Fastum). Nanoemulgel showed significantly higher (P<0.05) cumulative amount of drug permeated and flux along with lower lag time and skin retention than marketed formulation. Thus, the study substantiated that nanoemulgel formulation can be used as a feasible alternative to conventional formulations of ketoprofen with advanced permeation characteristics for transdermal application.

Power system is subjected to oscillations due to various disturbances that occur in the network. There are various techniques that can improve the power oscillations damping occurring in the network and hence improves the performance of the system. One method which is new and very much effective is the use of static series FACTS controller which are basically combination of power electronic components. FACTS devices are intended to enhance the power system reliability, power transfer capability, stability improvement (both transient and dynamic), congestion management etc. In series compensation, line impedance is modified (decreased), thus increasing the transmittable active power for the network under the uncertain conditions. The paper presents an immense review on the research and development in the area of robust control of power system using series FACTS devices. FACTS controllers and issues related to them are discussed. Paper also includes the application of Series FACTS devices to different Power system area.

Hair loss or alopecia in males is very common, and so is its treatment. Until now, platelet-rich plasma has been in use for hair regeneration, which has shown results but lacks regenerative potential as compared to platelet-rich fibrin (PRF). Injectable-PRF (i-PRF) is advanced version of PRF in liquid form which can be injected and contains stem cells with high regenerative potential. Hair regeneration in Type VI and Type VII was observed which are difficult to treat. Hair growth with i-PRF has better regenerative potential. All cases reported showed improvement in hair growth.

The purpose of this research work was to formulate and characterized the Terbinafine emulgel for the treatment of Superficial fungal infection and to avoid first pass metabolism of drug. Terbinafine is an allylamine antifungal agent used to treat dermatophyte infections. Emulgels have emerged as one of the most interesting topical drug delivery systems as it has dual release control i.e. emulsion and gel. The formulations were optimized by incorporating varying composition of Carbapol 934, Carbapol 940, HPMC E5, HPMC E15 as gelling agents. All the excipients were tested for compatibility study with drug, which revealed that there was no physical and chemical interaction occurred. Clove oil and Peppermint oil were used as penetration enhancers. All the prepared emulgels showed satisfactory physicochemical properties like color, homogeneity, consistency, spreadability and pH value. The drug release was found to be higher for formulations F1 (82.63 ± 0.24%) and F8 (95.88 ± 0.22%). Higuchi’s model was observed as the best fitting model for all formulations. HPMC E5 and HPMC E15 based emulgel formulations showed highest drug release in comparison with corresponding CP 934 and CP 940 based formulations. It was concluded that emulgel could be a promising formulation for effective treatment of fungal infections.

In Agriculture, leaf diseases have grown to be a dilemma as it can cause significant diminution in both quality and quantity of agricultural yields. Thus, automated recognition of diseases on leaves plays a crucial role in agriculture sector. This paper imparts a simple and computationally proficient method used for leaf disease identification and grading using digital image processing and machine vision technology. The proposed system is divided into two phases, in first phase the plant is recognized on the basis of the features of leaf, it includes pre-processing of leaf images, and feature extraction followed by Artificial Neural Network based training and classification for recognition of leaf. In second phase the disease present in the leaf is classified, this process includes K-Means based segmentation of defected area, feature extraction of defected portion and the ANN based classification of disease. Then the disease grading is done on the basis of the amount of disease present in the leaf.

With the explosive increase in in vitro fertilization (IVF) cycles worldwide, the morbidity and mortality associated with ovarian hyperstimulation syndrome (OHSS) cannot be ignored. Researchers and clinicians all over the world are moving toward newer modifications to achieve the goal of OHSS-free clinic and eliminating it as a complication [1]. Segmentation of the IVF cycle with a combination of GnRH-antagonist protocol with GnRH-agonist (GnRHa) trigger followed by embryo/oocyte freezing with subsequent embryo transfer can probably eliminate the risk of OHSS after controlled ovarian stimulation (COS). In case of embryo transfer in COS cycle, combined use of a GnRH-antagonist protocol with GnRHa trigger followed by single embryo transfer (SET), preferably blastocyst, favors reduction in the incidence of OHSS. But due to luteolytic action of agonist trigger, intensive luteal phase support (LPS) should be considered with adequate monitoring for signs of OHSS. Decision making based on patient characteristics, monitoring techniques, clinical experience, laboratory outcomes, and recent evidence is the key to maintain a balance between incidence and severity of OHSS and IVF cycle outcomes in terms of successful healthy pregnancy.

Traumatic or irritation fibroma is the healed end product of the inflammatory hyperplastic lesion which can occur at any age from almost any soft-tissue site, tongue, gingiva, and buccal mucosa being the most common. The aim of this case report is to present the clinical features and management of the benign lesion which was posteriorly positioned in the interdental papillary region of mandibular premolars. A female patient, 40 years old, reported to the department with a chief complaint of pain and swelling in the right lower back tooth region for the past 1 year. On examination, the lesion was found to be a well circumscribed, smooth, tender, firm and lobulated pink swelling measuring 2 cm × 2 cm in its greatest diameter in relation to right mandibular premolar region. Surgical therapy was carried out for the management of the same. There was no recurrence reported at the end of 2 months showing that treatment with electrocautery was highly effective as it was a relatively simple and safe method with easy handling of the electrodes without any bleeding or scarring. Irritation fibroma clinically resembles as pyogenic granuloma, peripheral giant cell granuloma, or odontogenic tumors, so radiographic and histopathological examination is essential for accurate diagnosis. Furthermore, complete excision is the choice of treatment as recurrence has been associated with incomplete removal of the lesion.

Periodontal surgery in a stage II Parkinson’s disease patient: Report of a case with special considerations