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Purpose To compare the effect of the probiotic lozenges and chlorhexidine (CHX) mouthwash on plaque index (PI) , salivary pH and Streptococcus mutans (S. mutans) 3 count among groups of Saudi children. Methods A total of 54 participants aged 8-12 years were randomly allocated into three groups, 18 children in each group. Children in the probiotic group consumed one probiotic lozenge (Biogaia prodentis) daily, while children in the CHX group were instructed to use CHX mouthwash twice daily. The control group was only instructed to follow regular oral hygiene measures. Saliva samples were taken at baseline, 15th and 30th days. PI scores, salivary pH values and S. mutans count were evaluated. Data were statistically analyzed using the ANOVA and the Tukey post-hoc test. Results Probiotic lozenges and CHX mouthwash significantly reduced PI and S. mutans count and increased the salivary pH values. However, there were no statistical differences between the effect of probiotic lozenges and CHX mouthwash on PI (p-value= 800) and pH values (p-value= 0.927) on the 30th day. Conversely a significant difference was reported among their effects on S. mutans count (p-value=0.014) on the 30th day. Greater acceptance and compliance of children to probiotic lozenges were reported. Conclusions Probiotic lozenges could be an alternative to CHX mouthwash and encouraged to be included with the daily oral hygiene measures.

Quran Inspired us best optimization algorithms within our universe

أدى رفض المكسيك التصويت على القرار الأمريكي لإدانة الشيوعية في مؤتمر كاركاس عام 1954، إلى تصاعد الضغوطات الامريكية على الحكومة المكسيكية التي لم تضع أي تشريع مناهض للشيوعية ولا برنامجاً لاستبعاد الشيوعيين من الأراضي المكسيكية وأصبحت ملجأً للمنفيين الشيوعيين من دول أمريكا اللاتينية الأخرى، الامر الذي أثار مخاوف الإدارة الامريكية من حدوث تغلغل شيوعي داخل النظام السياسي المكسيكي في الوقت الذي كانت فيه الولايات المتحدة حريصة على كسب الأنظمة السياسية إلى جانبها حتى لو كانت غير ديمقراطية، لا سيما مع أهم دولة تشترك معها في الحدود البرية والبحرية، وقد أدركت المكسيك أن مناهضة الشيوعية كان المعيار الذي قاست من خلاله الولايات المتحدة الامريكية ولاء حلفاؤها، كما أدركت أن الاستراتيجية الامريكية ضد التوسع الشيوعي في أمريكا اللاتينية قد تضطرها إلى التدخل في المكسيك، مما أدى إلى استسلام الحكومة المكسيكية للضغوطات الامريكية، لا سيما بعد التدخل الأمريكي في غواتيمالا عام 1954، إذ أعلنت المكسيك عن تضامنها مع الولايات المتحدة لمناهضة الشيوعية.

Background The development of powerful and flexible management addresses is due to the improvement of deeply reliable gadgets and the advancement of the concept of cellular. The cellular principle was a major way of solving the wavelength crowding problem and the user capacity. It offered high capacity without major technological changes with limited allocation in spectrum. Wireless communication is an innovation in media transmission that allows remote transmission in all types of terrain between convenient gadgets. For estimating a transmitter 's radio coverage area, propagation models that anticipate the mean signal strength for an arbitrary transmitter–receiver separation distance are crucial as they are called large-scale propagation models so even though they define the average signal strength over long periods of time and large distances from the transmitter. Results Developed propagation models are presented according to the measured path loss values in exemplary urban and suburban areas at the operating frequency of 3.5 ghz by using the regression analysis. The measurements are implemented by using a spectrum analyzer FSH6 to get the channel response as shown in the stated tables and graphs. Based on the obtained results, it was observed that the path loss could be calculated as a function of distance and during the practical measurements 32 m was precise as a presumption for the break point distance. The values of path loss exponent (n) are defined and calculated for both of urban and suburban regions. Measurements results are analyzed and compared in order to study their influence for every specific environment. It was noticed that any radio signal will suffer attenuation when it travels from the transmitter to the receiver as a variety of various phenomena give rise to this radio path loss. Conclusions The interaction between both the electromagnetic radiation and the environment tends to decrease the quality of the signal being sent from the transmitter to the destination which causes the loss of the path. Propagation models are the basis for channel estimation, as they attempt to identify how a radio transmission changes from the transmitter to the receiver throughout its path. The gained results from this research will be supportive for the arrangement of network planners and researchers as proof and directory materials before future location establishment.

ObjectivesTo estimate the cost saving for utilisation of vaginal delivery (VD), antenatal care (ANC) and an intrauterine device (IUD) services at primary health level facilities (PHLF) instead of tertiary health level facilities (THLF) in Sana’a.DesignA comparative cross-sectional study.SettingEight PHLF in Sana’a governorate and three THLF in Sana’a city.ParticipantsA total of 180 women aged (15–45 years) were enrolled equally from PHLF and THLF. Sixty women attended for each reproductive health service (VD, ANC and IUD services).Primary and secondary outcome measuresThe direct and indirect costs of services at PHLF and THLF, and the cost saving for utilisation of PHLF instead of THLF.ResultsThe median of direct medical cost (DMC) of VD, ANC and IUD services were US$43.86, US$14.77 and US$9.07 at THLF compared with US$19.54, US$0.93 and US$11.17 at PHLF, respectively. The DMC difference of VD, ANC and IUD services between THLF and PHLF was US$24.32, US$13.84 and US$−2.1, respectively. Regarding the direct non-medical costs (DNMC), the median of VD, ANC and IUD services were US$43.05, US$19.07 and US$17.27 at THLF compared with US$13.96, US$0.00 and US$0.00 at PHLF, respectively. The DNMC difference of VD, ANC and IUD service between THLF and PHLF was US$29.09, US$18.07 and US$16.27, respectively. Moreover, the median of indirect cost (INDC) for VD, ANC and IUD services were US$23.93, US$9.49 and US$10.44 at THLF compared with US$7.90, US$1.59 and US$1.06 at PHLF, respectively. The INDC difference of VD, ANC and IUD service between THLF and PHLF was US$16.03, US$7.90 and US$9.38, respectively.ConclusionThe study found the utilisation of VD, ANC and IUD services at PHLF instead of THLF is a considerable cost saving for families. Therefore, shifting the utilisation of services from THLF to PHLF reduces the financial burden affecting individuals, families and their productivity.

The subject of green accounting is one of the modern topics in accounting science, which has received great attention by researchers and writers because of its great role in measuring and disclosing environmental activities and in line with the interests of internal and external users of accounting information. The research stems from a fundamental problem that taking into account the costs of green accounting within the financial statements of economic units would improve the quality of accounting information provided to users. To achieve the goal of the research, a questionnaire was designed and submitted to the stakeholders of users of information and employees of a number of economic units listed on the Iraq Stock Exchange, as well as the use of different statistical methods and methods to extract results related to the role of information on green accounting in improving the quality of accounting information provided by Before economic units. The research reached several results, the most important of which was the need to take into account the costs of green accounting and manifested within the financial statements of economic units, because of its role in improving the quality of accounting information and commensurate with the interests of users, so it should work to measure those costs and disclosed to contribute to Meet the wishes and interests of users of financial statements.

Background The incidence of osteoarthritis of the medial compartment after ACL injury has been quoted to range from 33% to 70%. Medial osteoarthritis in ACL deficient knee is a challenge. Patients are mainly young and active. First reports highlighted a higher incidence of complications, in terms of tibial loosening and higher revision rate, when UKA were performed in ACL-deficient knees. They defined ACL deficiency is a contraindication to UKA. Objectives A systematic review and meta-analysis of literature to assess functional outcomes of combined unicompartmental knee arthroplasty with ACL reconstruction and revision rate. Data Sources The following electronic databases were searched up to 2019: PubMed, Google Scholar search engine, JBJS {Journal of bone and joint Surgery}, Cochrane database of systematic reviews, EMBASE and Science Direct. Results A total of 10 studies met the inclusion criteria encompassing 218 patients who were treated with simultaneous ACL reconstruction and unicompartmental knee arthroplasty. The mean age was 49.5 years (range from 36 to 71) with a mean follow-up of 49.3 months (range from 9 to 258). There was an improvement in mean Oxford Score from 29 to 42.5. The mean knee society score improved from 88.3 to 159. Complications reported included tibial inlay dislocation (n = 3), conversion to a total knee arthroplasty (n = 2), infection requiring two-stage revision (n = 2), stiffness requiring manipulation under anaesthesia (n = 1). Average revision rate was 1.8%. Conclusion Literature has strong evidence to support that combined UKA and ACL reconstruction show good functional outcomes and less revision rate. It is a valid treatment option for MOA more in young age group in whom MOA secondary to ACL tear and intact other knee compartments. there is no clinical trial or study suggest that UKA and ACL reconstruction is superior to UKA with tibial slope change or using fixed bearing prosthesis for MOA in ACL deficient knee with instability.

IntroductionIn Yemen, women tend to bypass the nearby primary health level facilities (PHLF) for using vaginal delivery (VD), antenatal care (ANC) and intrauterine device (IUD) services. This study aimed to estimate the cost saving for utilization of VD, ANC and IUD services at PHLF instead of tertiary health level facilities (THLF) in Sana’a.MethodsA comparative cross sectional study design was conducted in 2013. It was used to estimate the costs from the patient’s perspective. A structured questionnaire was used to collect data. Descriptive analyses were performed. P value ResultsA total of 180 women were found. The median of DMC of VD, ANC and IUD services were US$43.9, US$14.8 and US$9.1 at THLF compared with US$19.5, US$0.9 and US$11.2 at PHLF, respectively. The DMC difference of VD, ANC and IUD services between THLF and PHLF was US$24.4, US$13.9 and US$-2.1, respectively. Regarding the DNMC, the median of VD, ANC and IUD services were US$43.1, US$19.1 and US$17.3 at THLF compared with US$14.0, US$0.0 and US$0.0 at PHLF, respectively. The DNMC difference of VD, ANC and IUD service between THLF and PHLF was US$29.1, US$19.1 and US$17.3, respectively. Moreover, the median of INDC for VD, ANC and IUD services were US$23.9, US$9.5 and US$10.4 at THLF compared with US$7.9, US$1.6 and US$1.1 at PHLF, respectively. The INDC difference of VD, ANC and IUD service between THLF and PHLF was US$16.0, US$7.9 and US$9.3.ConclusionThe study found the utilization of VD, ANC and IUD services at PHLF instead of THLF is a considerable cost saving for families. Therefore, shifting the utilization of services from THLF to PHLF reduces the financial burden affecting individuals, families and their productivity. Implementation of the health referral system is recommended.Key questionsWhat is already known?➢Women tend remarkably to bypass the nearby primary reproductive health services that are rising the expenses and increasing the burden borne by individuals, families and their productivity.➢Few studies have estimated the cost saving for utilization of primary instead tertiary level of reproductive health services in the world, while no such study was conducted in Yemen.What are the new findings?➢A significant difference in the expenses on reproductive health services between the primary and tertiary health level facilities.➢A significant cost is saved for women and families as a result of utilization of primary instead tertiary level of reproductive health services.What do the new findings imply?➢The primary health level facilities reduce the financial burden affecting individuals, families and their productivity.➢This study provides evidence for decision-makers to implement the health referral system and protect the families from incurring the high expenditure.

In this research we present the measured path loss values in typical urban and suburban areas at the operating frequency of 3.5 GHz. The measurements are carried out using the spectrum analyzer FSH6 in order to record the channel response. The values of path loss exponent n are calculated for urban and suburban environments. We also compare and analyze the path loss predictions with the measured data. The results of this research confirm that in urban areas the path loss estimation is influenced according to the greater distances. At the beginning of the measurements in urban environment the losses are equal 23 dB after 18 m from the measurement survey. The analysis of measurements centers on anticipating the normal signal quality at the collector set at the given remove from the transmitter as well as the changeability of the signal quality in the specific environment. The acquired from this work results are salutary for planning and installation of any base station with similar to the thoughtful locations environments in order to supply rules for cell arranging of remote communication frameworks as path loss could be a key in calculations within the plan of any radio communications framework system.

In recent years, the decreased efficacy of existing antibiotics toward management of emergent drug-resistant strains has necessitated the search for novel antibiotics from natural products. In this regard, Bacillus sp is well known for producing variety of secondary metabolites of potential use. Therefore, we performed an investigation to isolate and identify Bacillus sp from oral cavity for production of novel antimicrobial compounds. We extracted, purified, and identified a novel bioactive compound by B. megaterium (KC246043.1). The optimal production of compound was observed on de Man Rogosa and Sharpe broth by incubating at 37 °C, and pH 7.0 for 4 days. The bioactive compound was extracted by using n-butanol (2:1 v/v), purified on TLC plates with detection at Rf 7.8 cm; further characterized and identified as a cyclic ploypeptide sharing structural similarity with bacitracin. Minimum inhibitory concentration of bioactive compound was found to be 0.25, 0.5, 1.0, 3.125 and 6.25 μg/ml against Micrococcus luteus ATCC10240, Salmonella typhi ATCC19430, Escherichia coli ATCC35218. Pseudomonas aeruginosa ATCC27853 and Staphylococcus aureus ATCC25923 respectively, with no activity against Candida albicans ATCC10231. Our findings have revealed a novel cyclic peptide compound from B. megaterium with broad spectrum antimicrobial activity against both Gram positive and Gram negative bacteria. Keywords: Antibacterial, Bacillus megaterium, Bacitracin, Drug discovery, Peptide antibiotics

This paper investigates the empirical mode decomposition (EMD)-based feature selection technique in identifying polymer electrolyte membrane fuel cell water management issue. In the study, EMD is applied to fuel cell voltage signals at various states, including fuel cell flooding and membrane drying out, from which intrinsic mode functions (IMFs) are obtained. Sensitivity index is used to determine the IMFs more sensitive to fuel cell fault, which are then used for the fault diagnosis. The effectiveness of the selected IMFs in discriminating flooding and drying out scenarios is validated using experimental data from a PEM fuel cell system. The results show that different faults can be distinguished effectively. From the findings, a generalized feature extraction and selection technique can be provided for fault diagnosis in practical PEM fuel cell applications.

This paper proposes an image processing-based approach for the fault diagnosis of polymer electrolyte membrane (PEM) fuel cells. As more abundant information is contained in the image than that that in 1D signal, features representing PEM fuel cell faults could be better highlighted with the image. Experimental data from a PEM fuel cell system at different states, including flooding and dehydration scenarios, is used to validate the proposed method. By converting the PEM fuel cell voltage signal into a 2D grey image, several features are extracted from the image, their performance in discriminating different PEM fuel cell states is investigated, and two optimal features are determined for fault diagnosis. Moreover, the diagnostic performance of optimal features from grey image is compared with features from PEM fuel cell voltage. Results demonstrate that better diagnostic performance could be obtained with the proposed method.

Introduction: Epilepsy associated stigma in Africa has been described largely in terms of enacted stigma or discrimination. We conducted a study of 157 original inhabitants. Stigma is known as a sign of disgrace or collection of wrong thoughts towards something. Objectives: The aim of this study is to study the social stigma associated with epilepsy in Alttondob Abukleioa village, Al-Jazeera state, Sudan. Methods: A community-based cross-sectional descriptive study involving 157 original inhabitants is designed to examine the knowledge, attitude, practice, and stigma of epilepsy in Alttondob Abukleioa. Results: A total of 157 participants were interviewed. The median age of respondents was 34 and were females (88.5%). Most (87%) of participants had a formal education. According to the impact of epilepsy, (64%) think that epileptic patients can't pose risk to others, and (53%) having a normal IQ. (53%) admitted they will not marry an epileptic patient, while (84%) of them are willing to participate with an epileptic patient in any social work, and (85%) said that they will admit their illness. Conclusion: The findings indicated a need to increase epilepsy awareness programs as a means of increasing public knowledge of epilepsy with the aim of reducing stigma.

This paper investigates effectiveness of various features in fault diagnosis of polymer electrolyte membrane fuel cell (PEMFC) system, including RMSF (root mean square frequency), ACSD (autocorrelation standard deviation) and kurtosis. Test data is collected from a PEMFC system with various conditions, such as normal operation, flooding and drying out scenarios. By extracting selected features from PEMFC voltage, the performance of various features in isolating PEMFC states is investigated using k-means clustering. Results demonstrate that the combination of RMSF and ACSD could provide reliable fault diagnostic performance. Moreover, kurtosis might be used as a fast diagnostic indicator for various PEMFC degradation mechanisms.

Endoscopic submucosal dissection (ESD) and gastrectomy with lymph node dissection are considered acceptable treatment modalities for early gastric cancer (EGC). In the last decade, ESD has become more favorable than surgery as it offers faster recovery, lower costs, and a superior quality of life when compared to gastrectomy. The aim of this study is to compare the long-term outcome of ESD versus surgery in EGC. We performed a systematic and comprehensive search of major reference databases (Medline, Embase, CINHAL) for all studies that compared the outcome of EGC for patients underwent ESD or surgery in the same cohort. A systematic review was conducted through November 2017, using pooled analysis to calculate 5-year overall survival (OS) rate, disease-specific survival (DSS) rate, disease-free survival (DFS) rate, and recurrence-free survival (RFS) rate of ESD versus gastrectomy. Five-year OS and DSS were similar between ESD and gastrectomy groups 96 versus 96% and 99.4 versus 99.2%, respectively. Likewise, DFS was similar in both groups 95.9 versus 98.5% odds ratio 1.86 (0.57-6.0) P=0.3. However, ESD had a lower RFS compared to surgery 92.4 versus 98.3% odds ratio 0.17 (0.1-4.9) P=0.001. Overall, there was a higher recurrence rate in patients who underwent ESD compared to surgery [40/2943 (1.4%) vs. 12/3116 (0.4) risk ratio (RR) 2.5 (1.3-4.8) P=0.005]. Moreover, synchronous and metachronous cancers were more prevalent in the ESD group compared to the surgery group [1.5 vs. 0.1% RR 5.7 (1.5-21.9) P=0.01] [16/1082 (1.5%) vs. 1/1485 (0.1%) RR 10.1 (5.9-17.1) P=0.0001]. Five-year OS, DSS and DFS were similar between ESD and surgery groups. However, recurrent, synchronous and metachronous cancers were more prevalent in patients treated by ESD compared to patients treated by surgery, resulting in a lower RFS. Adequate surveillance with upper endoscopy is crucial after ESD to detect early recurrence and metachronous lesions.

لم تعد قراءة النص في الخطاب النقدي الحديث واحدة، بل أصبحت متعددة متنوعة، وانتقلت من قراءة النصوص في إطار الدلالة الضيقة، إلى قراءتها في إطار الدلالة العميقة المتشعبة، ومن هنا أصبحت العتبات المحيطة بالنص وسيلة قراءة نقدية فاعلة من خلال تأثيرها في النص، وقدرتها الواعية على استجلاء جوانبه وزواياه المختلفة. ولعل صفحة الغلاف هي أول مواجهة للقارئ مع النص، لذلك كان لها أهمية كبيرة في تشكيل الإنتاجية الدلالية، وتهيئة المتلقي للولوج في النص، وانطلاقا من هذا التصور تناول هذا البحث دراسة سيميائية المناص النشري، واتخذ من غلاف ديوان شرف على ذاك المطر للشاعر سليم النفار، أنموذجا للتحليل والدراسة، وقد توصل الباحث إلى مجموعة من النتائج كان أهمها أن غلاف الديوان وعنونته نجحت في التوفيق بين الشعرية والواقع، وبين الجماليات والأيدلوجيا، حيث حقق تناغما بين عالم الدوال والمدلولات، ليوصل القارئ إلى اكتشاف البنى الشكلية السطحية والعميقة للمتخيل والتي ظهرت من خلال تحليلنا لمضامين الخطاب الشعري.