We propose a non-monotone wedge trust region method for derivative-free optimization. Wedge trust region method based on traditional trust region is designed for derivative-free problems, and the non-monotone strategy is efficient to solve the trust region method. This paper combined the non-monotone strategy into wedge trust region methods, and the computational results proved the efficiency of the new composite strategy.

Abstract: Main objective of this study is to utilize Agro wastes instead of pure sugars for cellulases productions. It was noted that maximum fungal cell growth was obtained 0.936g/100ml of Aspergillus niger was observed at pH 4.11 in hydrolyzed rice husk used as carbon source. Aspergillus niger was isolated from the soil of Khairpur. The collection and utilization of suitable Agro wastes used as a carbon source for cellulases production by fungi requirements optimized fermentation process. Five agricultural wastes were measured for cellulolytic enzyme production using pretreatment methods acid. Acid pretreatment was found to be the most efficient and best method for higher enzyme production. Using this cheap and renewable residue, for cellulolytic enzyme production by Aspergillus niger boosts its economic value which is not comparable with its current use as animal feed. Agro wastes such as sugarcane peelar bagasse, sugarcane bagasse, banana fruit stalk, sorghum husk and rice husk were hydrolyzed with 0.6N HCl. Rice husk was found good substrate in comparison to other Agro wastes for the growth of Aspergillus niger and cellulases production. Maximum activity of cellulases were noted 4.811 (units/ml). The Cellobiase and salicinase maximum production 4.717 and 4.742 units per ml obtained at 240 hours respectively.

DSM V has removed OCD from Anxiety disorder group and classified the disorders with similar clinical picture together under obsessive compulsive and related disorders (OCRD). The following disorders fall under this group. Obsessive compulsive disorder, Body dysmorphic disorder, Hoarding disorder, Trichotillomania, excoriation disorder, substance/ medication induced obsessive compulsive and related disorders. This study aims to assess sociodemographic factors, sex-specific occurrence of OCRD and psychiatric and neurodevelopmental comorbidities of OCRD in children attending a child guidance clinic of R.G Kar Medical college, Kolkata. The study has been done based on the register used to record the patient related data in the child guidance clinic. All cases aged up to 12 years of age, of both sexes, registered with any diagnosis under obsessive compulsive and related disorders from July, 2009 to June 2015 (6 years) were included in the study. Results and statistical analysis were done using SPSS 23. Total 684 cases attended the clinic. Of them number of children diagnosed with obsessive compulsive and related disorders was 48 (7.02%). Most patients were in the age group 8 – 12 years. In all age groups males were more in number than females. Among males most common disorder among Obsessive compulsive and related disorder was Tic Disorder (TD) and among female most common disorder was OCD (44.4%) and next was OCD with Tic disorder (33.3%). Most common comorbidity was Attention deficit hyperactivity disorder

This study aims to determine and analyze the influence of work motivation, organizational culture, and career development either partially or simultaneously on employee performance at PT Titis Sampurna Inspection. The research used quantitative analysis approach, with data collection method through the questionnaire was given to 100 respondents from the total population of 133 employees. The method for data analysis in this study using multiple linear regression analysis. Results of research show that the work motivation, organizational culture, and career development have a positive and significant impact on employee performance, either partially or simultaneously. The result of the research also shows that there is a quite strong correlation between the dimension of social requirement on the variable of work motivation with the dimension of job quality on the variable of employee performance, then between the dimension of person orientation in the variable of organizational culture with the dimension of cooperation ability on the variable of employee performance also have correlation is quite strong , there is also a quite strong correlation between the dimension of mentor and support in the variabel of career development with the dimensions of cooperation ability in the variable of employee performance.

Calcitonin is a sensitive tumor marker for medullary thyroid cancer and is useful in preoperative diagnosis and postoperative surveillance for recurrent disease. Rare cases of medullary carcinomas with a normal or undetectable calcitonin levels have been reported in the literature. We present the case of a 46-year-old woman with a metastatic thyroid carcinoma non-secreting calcitonin

Research on Local Wisdom, Innovation and Talent of Management on SME Competitiveness by using quantitative approach and survey method. The sample of the research is 61 people. Data were collected using questionnaires with Likert scale 1-5. The data analysis technique is Generalized Structured Component Analysis. The results of this study prove that: 1) the Local wisdom has direct and positive impact on competitive advantage of SMEs, 2) innovation has direct and positive impact on the competitive advantage of SMEs, 3) Talent Management has directly and positively impact on competitive advantage of SMEs, 4) Local Wisdom has direct and positive impact on Talent Management, 5) Innovation has direct and positive Affect onTalent Management, 6) Local Wisdom has direct and positive impact on competitive advantage of SMEs through Talent Management mediation, and 7) Innovation has directly to competitive advantage of SMEs through Talent Management.

Excess free-radical formation has been hypothesized to contribute to cancer, atherosclerosis, aging, and exercise-associated muscle damage. Antioxidant supplements such as vitamin C, vitamin E, and beta-carotene have been touted as beneficial for enhancing exercise performance and for preventing certain diseases. Before physicians routinely recommend supplements to prevent exercise-associated damage, more study will be required. Recommendations for the prevention of cardiovascular disease and cancer are more complex. Because study results have been contradictory, individual supplement recommendations must be offered with caution. Physicians must be cognizant of which supplements patients are taking and be prepared to discuss risks and benefits. The most beneficial prescription is probably a daily diet containing five to seven servings of fruits and vegetables..Muscular exercise promotes the production of radicals and other reactive oxygen species in the working muscle. Growing evidence indicates that reactive oxygen species are responsible for exercise-induced protein oxidation and contribute to muscle fatigue. To protect against exercise-induced oxidative injury, muscle cells contain complex endogenous cellular defence mechanisms (enzymatic and non-enzymatic antioxidants) to eliminate reactive oxygen species. Furthermore, exogenous dietary antioxidants interact with endogenous antioxidants to form a cooperative network of cellular antioxidants. Knowledge that exercise-induced oxidant formation can contribute to muscle fatigue has resulted in numerous investigations examining the effects of antioxidant supplementation on human exercise performance. To date, there is limited evidence that dietary supplementation with antioxidants will improve human performance. Furthermore, it is currently unclear whether regular vigorous exercise increases the need for dietary intake of antioxidants. Clearly, additional research that analyses the antioxidant requirements of individual athletes is needed

Project Management in Guinea is growing rapidly such as in many developing countries. It’s heavily used now in diverse area such as in agriculture, construction, manufacturing, telecoms, IT, education, and so on. This high prevalence of making projects in various sectors determined the increasing importance of effective project management. Managing project rightly at a right time with multiple constraints (human and technical aspect) remains the main challenge for project managers. The relationship concerning successful project and the project success factors are topics of great interest in project management. The paper highlights the most Critical Success Factors (CSFs) through project planning, project top management support and stakeholder involvement in project implementation in Guinea.

Staphylococcus aureus is a common bacterium that affects humans and causes several syndromes and infections with fast evolution which can endanger the patient's life. Investigate the incidence of nasal carriers of S. aureus among graduation nursing students who attends to the hospital for at least one year. 122 samples from the nasal cavities were analyzed. The identification of the bacteria was performed by conventional bacteriological methods. The antimicrobial susceptibility tests were performed using the BioMerieux Vitek system in the Bacteriology Laboratory of the Brazilian Army Biology Institute - IBEx. Of the 122 examined students, 51 were carriers of S. aureus, corresponding to a prevalence of 41.8%. The results demonstrated that nursing students who attend the hospital environment are more susceptible to carry S. aureus antibiotic-resistant strains. We suggest periodic medical exams to these students for appropriated antibiotic therapy and adopt precautionary measures in order to avoid the interpersonal transmission of the bacteria in the relationship with health professionals and patients at the hospital environment

Content digitization is a current phenomenon that has had a huge impact on traditional media. The era of globalization has had significant effect on the way media houses the world over strive to reach their audience and especially given that the world is so interconnected to a point that any happening in one continent has a significant effect in the most remote location in another continent. This has led to innovations such as the use of E-Paper that’s geared towards reaching larger audiences by media houses as well as remain competitive in this era of great competition and liberalization of the economy. The purpose of this study was therefore to determine the effect of EPaper subscription on the revenue performance of the Standard Media Group Limited, Nairobi. The study was guided by the Schumpeter’s innovation theory of entrepreneurship. Descriptive survey research design was adopted. Both primary and secondary data were collected. Primary data was collected by the use of a questionnaire while Secondary data sought historical data on the organisational revenues by department and on the profitability of the organisation for the past twentyfive years between 1991 and 2016. The target population included all the 202 members of staff in the Commercial and Online departments at Standard Media Group, Nairobi. The researcher drew a proportional random sample of 30% of the respondents from the two departments who provided the information required. Data was processed and analysed using descriptive and inferential statistics with the help of the Statistical Package for Social Sciences version 22 and Microsoft’s Excel 2013 to generate Frequencies, percentages and regression that were used to answer the research questions. Findings were presented using appropriate tables and graphs that depicted the relationship between the dependent variable and the independent variables. It was established that the rate of revenue growth in the e-paper platform was exponential, and was highly co-related to the overall organizational revenue, and that the combined revenue from the e-paper, and other aspects of digital content provision had exponentially grown from nil in 2009 to over KES 120 million 2016. Further research is suggested on the effect of content digitization on the operational and revenue performance of print media at Standard Media Group, and on the effect of content digitization on revenue performance of the other media houses in Kenya.

Diabetes mellitus (DM) is commonly referred to as a “sugar” and it is the most common endocrine disorder and usually occurs when there is deficiency or absence of insulin or rarely, impairment of insulin activity (insulin resistance). The powdered leaves phoenix dactylifera was extracted with 400ml of 70 % v/v of ethanol and water for 5 hour in soxhelet. Alloxan monohydrate at a dose of 150 mg/kg injected intraperitonally for induction of diabetes mellitus. The extract of Phoenix dactylifera leaves was subjected to anti-diabetic activity in rats. Group-IV & Group-V received the ethanolic & aqueous extract of phoenix dactylifera leaves(500mg/kg) shown a marked reduction in blood glucose level on day 4th i.e. in ethanolic extract it was 284.76±mg/dl while in aqueous extract it was 264.76±6.65. On 10th day of study the glucose level falls up to 264.40±7.72 in ethanolic extract rat & 254.05±9.18 in aqueous extract. The results of the present study indicate that Phoenix dactylifera leaf extract was found to reduce the glucose level in animals made diabetic with alloxan. In the present investigation ethanolic extract of Phoenix dactylifera leaf showed significant anti-diabetic activity

The study was conducted to determine the Etiological basis of dizziness in patients attending ENT clinics in Pakistan. It was a prospective, multicenter, observational, non-interventional, cross - sectional study conducted in five cities across Pakistan, between August, 2014 and March, 2015. The study population included male and female patients attending the outpatient clinics of ENT departments. The patient population was of 18 years of age or older presenting with dizziness. Based on the initial screening patients were diagnosed as vertiginous or non-vertiginous. Patients’ written authorization to use or disclose the patient’s personal or health data was obtained. Benign Paroxysmal Positional Vertigo was the commonest diagnosis (67%) followed by Meniere’s disease (16%) in patients who presented with vertigo attending outpatient departments in ENT Clinics. At baseline visit, 38.3% of the patients were categorized as moderately handicapped. Medication was offered to three quarter of the patient population (69%), while rest of the patients were offered maneuver and medication both (20.8%) and only maneuver (3.5%). DHI was used at the baseline visit and post treatment as well. It was observed in the study that the DHI score was significantly improved in all diagnosis groups after the treatment. At the end of four weeks majority of the patients were categorized mildly handicapped (91.3%). Majority of the patients diagnosed as BPPV were prescribed anti-vertiginous medicines (70%) followed by anti-emetics and pain killers. Amongst the patient reporting with dizziness the commonest diagnosis was Benign Positional Paroxysmal Vertigo followed by Meniere’s disease. Based on pre and post-treatment DHI scores, medication and medication with maneuver helped the patients presenting with dizziness in improvement of Quality of Life.

India is a tropical country where skin diseases like fungal infections, pyoderma, acne, scabies etc. are very common. A large number of dermatological preparations are available in Indian market but studies on the price variation between commonly used topical brands are lacking. Hence the present study was carried out to obtain information on the price variation among different brands of anti-infective, anti-acne & analgesic topical preparations present in India. Information about dosage forms and prices of different brands of commonly used topical preparations was obtained from Current Index of Medical Specialties & Drug Update. Number of brands, percentage price variation, cost ratio etc for various drugs and combinations were calculated. There were total 206 brands manufactured by 52 different pharmaceutical companies of 35 drugs, out of which 24 showed more than 50% cost variation. Largest price variations were seen with mupirocin 2% cream (408.33 %), tazarotene 0.05% gel (183.8%) and diclofenac diethylammonium 1% gel (650 %) in single drug categories & gentamicin 0.1% + clobetasol 0.05% cream (308.82 %) among all fixed dose combinations. Least variation was observed for salicylic acid 2% foam (4.76 %) and terbinafine 1% + ofloxacin 0.75% + ornidazole 2% + clobetasol 0.05% cream (5.69 %). Cost of drugs play a crucial role in treatment outcome by directly influencing the patient compliance. Hence, it is essential to train physicians about cost variations among different brands available in the market so that they can reduce financial burden of patients without compromising the effectiveness of therapy.

The objective of the study was to observe the various clinical features, histopathological and immunofluorescence findings in patients with autoimmune vesiculobullous disorders. The overall M: F ratio of autoimmune vesiculobullous disorders in the study was 1: 1.4. Trunk was the most common site of involvement in all types of autoimmune vesiculobullous disorders. Overall trunk was the most common site of onset of lesions in autoimmune vesiculobullous disorders but in pemphigus vulgaris mucosal onset is more common than trunk and extremities. Incidence of autoimmune vesiculobullous disorder was 0.11% of the total number of patients attending the skin OPD. Pemphigus vulgaris constituted the most common subtype of autoimmune vesiculobullous disorder in this study, followed by pemphigus foliaceus. Pemphigus group of diseases were most common in the 4th decade while bullous pemphigoid was most common in the 7th decade. Histopathological examination showed features typical of each subtype of autoimmune vesiculobullous disorder.

The roles of sex hormones have been under the scope of study for so long by physiologists as well as clinicians. Their actions on the cardiovascular system are undeniable and evidence is growing. Many research investigated the connection between the levels and the protective mechanisms on CVS physiology. It is a popular belief among clinicians that estrogens are powerful protectors of cardiovascular events; but, the notion that testosterone is as well was a novel concept. Testosterone was associated for the longest time with the bad and negative effects on the CVS, such as, increasing the risk for cardiac hypertrophy.