Search results for: operative approach

Authors: R. K. Chaurasiya, N. D. Londhe, S. Ghosh

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The study of the electrical signals produced by neural activities of human brain is called Electroencephalography. In this paper, we propose an automatic and efficient EEG signal classification approach. The proposed approach is used to classify the EEG signal into two classes: epileptic seizure or not. In the proposed approach, we start with extracting the features by applying Discrete Wavelet Transform (DWT) in order to decompose the EEG signals into sub-bands. These features, extracted from details and approximation coefficients of DWT sub-bands, are used as input to Principal Component Analysis (PCA). The classification is based on reducing the feature dimension using PCA and deriving the support-vectors using Support Vector Machine (SVM). The experimental are performed on real and standard dataset. A very high level of classification accuracy is obtained in the result of classification.

Keywords: discrete wavelet transform, electroencephalogram, pattern recognition, principal component analysis, support vector machine

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Authors: Anduela Lile

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The purpose of this cross sectional study was to investigate the effectiveness of teaching and learning Statistics from a student centered perspective in higher education institutions. Statistics education has emphasized the application of tangible and interesting examples in order to motivate students learning about statistical concepts. Participants in this study were 112 bachelor students enrolled in the ‘Applied Statistics’ course in Sports University of Tirana. Experimental group students received a student-centered teaching approach; Control group students received an instructor-centered teaching approach. This study found student-centered approach student group had statistically significantly higher assessments scores (52.1 ± 18.9) at the end of the evaluation compared to instructor-centered approach student group (61.8 ± 16.4), (t (108) = 2.848, p = 0.005). Results concluded that student-centered perspective can improve student positive attitude to statistical methods and to motivate project work. Therefore, findings of this study may be very useful to the higher education institutions to establish their learning strategies especially for courses related to Statistics.

Keywords: student-centered, instructor-centered, course assessment, learning outcomes, applied statistics

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Authors: Bar Y. Ainuz, Harry M. Salinas, Aleeza Ali, Eli B. Levitt, Austin J. Pourmoussa, Antoun Bouz, Miguel A. Medina

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Introduction: Breast conservation therapy remains the mainstay surgical treatment for early breast cancer. Oncoplastic techniques, in conjunction with lumpectomy and adjuvant radiotherapy, have been demonstrated to achieve good aesthetic results without adversely affecting cancer outcomes in the treatment of patients with macromastia or significant ptosis. In our patient population, many women present for breast conservation with pre-existing cosmetic implants or with breast volumes too small for soft tissue, only oncoplastic techniques. Our study evaluated a consecutive series of patients presenting for breast conservation undergoing concomitant oncoplastic-augmentation-mastopexy (OAM) with a contralateral augmentation-mastopexy for symmetry. Methods: OAM surgical technique involves simultaneous lumpectomy with exchange or placement of implants, oncoplastic mastopexy, and concomitant contralateral augmentation mastopexy for symmetry. Patients undergoing lumpectomy for breast conservation as outpatients were identified via retrospective chart review at a high volume private academic affiliated community-based cancer center. Patients with ptosis and either pre-existing breast implants or insufficient breast volume undergoing oncoplastic implant placement (or exchange) and mastopexy were included in the study. Operative details, aesthetic outcomes, and complications were assessed. Results: Over a continuous three-year period, with a two-surgeon cohort, 30 consecutive patients (56 breasts, 4 unilateral procedures) were identified. Patients had an average age of 52.5 years and an average BMI of 27.5, with 40% smokers or former smokers. The average operative time was 2.5 hours, the average implant size removed was 352 cc, and the average implant size placed was 300 cc. All new implants were smooth silicone, with the majority (92%) placed in a retropectoral fashion. 40% of patients received chemotherapy, and 80% of patients received whole breast adjuvant photon radiotherapy with a total radiation dose of either 42.56 or 52.56 Gy. The average and median length of follow-up were both 8.2 months. Of the 24 patients that received radiotherapy, 21% had asymmetry due to capsular contracture. A total of 7 patients (29.2%) underwent revisions for either positive margins (12.5%), capsular contracture (8.3%), implant loss (4.2%), or cosmetic concerns (4.2%). One patient developed a pulmonary embolism in the acute postoperative period and was treated with anticoagulant therapy. Conclusion: Oncoplastic augmentation mastopexy is a safe technique with good aesthetic outcomes and acceptable complication rates for ptotic patients with breast cancer and a paucity of breast volume or pre-existing implants who wish to pursue breast-conserving therapy. The revision rates compare favorably with single-stage cosmetic augmentation procedures as well as other oncoplastic techniques described in the literature. The short-term capsular contracture rates seem lower than the rates in patients undergoing radiation after mastectomy and implant-based reconstruction. Long term capsular contractures and revision rates are too early to know in this cohort.

Keywords: breast conserving therapy, oncoplastic augmentation mastopexy, capsular contracture, breast reconstruction

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Authors: Eunice Tan

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The purpose of this presentation is to look at an alternative to the approach and methodologies of working with special needs. The strength-based approach to education embodies a paradigm shift. It is a strategy to move away from a deficit-based methodology which inadvertently may lead to an extensive list of things that the child cannot do or is unable to do. Today, many parents of individuals with special needs are focused on the child’s deficits rather than on his or her strengths. Even when parents Recognise and identify their child’s strengths to be valuable and wish to develop their abilities, they face the challenge that there are insufficient programs committed to supporting the development and improvement of such abilities. What is a strength-based approach in education? A strength-based approach in education focuses on students' positive qualities and contributions to class instead of the skills and abilities they may not have. Many schools are focused on the child’s special educational needs rather than the whole child. Parents interviewed have said that they have to engage external tutors to help hone in on their child’s interests and strengths.

Keywords: differential learning needs, special needs, instructional style, talents

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Authors: Nurwati Djaman, Suradi Tahmir, Nurdin Arsyad

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The major objective of this study was to implement and evaluate the use of the implementation of social responsibility with the approach of Indonesian Realistic Mathematics Education (PMRI) in teaching and learning mathematics on students’ engagement and learning. The research problems investigated in this research: 1) What were the effects of the implementation of social responsibility with PMRI approach to learning mathematics? 2) What were the effects of the approach to students’ engagement? An action research and grounded theory methodology were adopted for the study. This study used mixed methods to collect, describe, and interpret the data. The data were collected through focus group discussion, classroom observations, questionnaire, interview, and students’ work. The participants in this study consisted of 45 students. The study revealed that the approach has given students the opportunity to develop their understanding of concepts and procedures, problem-solving ability, and communication ability. Also, students’ involvement in the approach improved their engagement in learning mathematics in the three domains of cognitive engagement, effective engagement, and behavioral engagement. In particular, the data collection from the focus group, classroom observations, and interviews suggest that, during this study, the students became more active participants in the mathematics lessons.

Keywords: Indonesian Realistic Mathematics Education, PMRI, learning mathematics, social responsibility, students' engagement

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Authors: Gete Umbrey, Saifur Rahman

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Graphs are found to be most capable in computing, and its abstract structures have been applied in some specific computations and algorithms like in phase encoding controller, processor microcontroller, and synthesis of a CMOS switching network, etc. Being motivated by these works, we develop an independent approach to study semiring structures and various properties by defining the binary operations which in fact, seems analogous to an existing definition in some sense but with a different approach. This work emphasizes specifically on the construction of semigroup and semiring structures on the set of undirected graphs, and their properties are investigated therein. It is expected that the investigation done here may have some interesting applications in theoretical computer science, networking and decision making, and also on joining of two network systems.

Keywords: graphs, join and union of graphs, semiring, weighted graphs

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Authors: Carlos H. Ferreira, Joana R. Pereira

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In recent decades, calls for sustainable architecture based on environmental policies have been frequent. Despite a vast number of documents, technical procedures, and publications involving these themes, conceptions, and even architectural practice are often distanced from critical and methodological reflection on the relationship between environment and architecture. Among the various issues that we could consider in this relationship, we highlight in this article the relevance of water in the environment and in the architectural design. From documentary references and works carried out, we seek contributions to a better systematization and framing of water in architectural thinking. We distinguish, on the one hand, more conceptual issues that involve the environmental relationship of water, involving its cycle, relevance in the landscape, and infrastructural commitments. On the other hand, we highlight a more operative component, focusing on the place of water in the design process, from its perception in space-shape dimensions to more specific technical requirements that involve the interdisciplinary boundaries of architecture. In both approaches to water in architectural design, we seek to contribute to greater sensitivity and efficiency in the art of designing a more sustainable future.

Keywords: sustainability, environment, water, resilience design

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Authors: L. Kashyap, S. Jha, D. Shende, V. K. Mohan, P. Khanna, A. Aravindan, S. Kashyap, L. Singh, S. Aggarwal

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Obesity is associated with a chronic inflammatory state. During surgery, there is an interplay between anaesthetic and surgical stress vis-a-vis the already present complex immune state. Moreover, the postoperative period is dictated by inflammation, which is crucial for wound healing and regeneration. An excess of inflammatory response might hamper recovery besides increasing the risk for infection and complications. There is definite evidence of the immunosuppressive role of inhaled anaesthetic agents. This immune modulation may be brought into effect directly by influencing the innate and adaptive immunity cells. The effects of propofol on immune mechanisms in has been widely elucidated because of its popularity. It reduces superoxide generation, elastase release, and chemotaxis. However, there is no unequivocal proof of one’s superiority over the other. Hence, an anaesthetic regimen with lesser inflammatory potential and specific to the obese patient is needed. OBESITA trial protocol (2019) by Sousa and co-workers in progress aims to test the hypothesis that anaesthesia with sevoflurane results in a weaker proinflammatory response compared to propofol, as evidenced by lower IL-6 and other biomarkers and an increased macrophage differentiation into M2 phenotype in adipose tissue. IL-6 was used as the objective parameter to evaluate inflammation as it is regulated by both surgery and anesthesia. It is the most sensitive marker of the inflammatory response to tissue damage since it is released within minutes by blood leukocytes. We hypothesized that maintenance of anaesthesia with propofol would lead to less inflammation than that with desflurane. Aims: The effect of two anaesthetic techniques, total intravenous anaesthesia (TIVA) with propofol and desflurane, on surgical stress response was evaluated. The primary objective was to compare serum interleukin-6 (IL-6) levels before and after surgery. Methods: In this prospective single-blinded randomized controlled trial undertaken, 30 obese patients (BMI>30 kg/m2) undergoing laparoscopic bariatric surgery under general anaesthesia were recruited. Patients were randomized to receive desflurane or TIVA using a target-controlled infusion for maintenance of anaesthesia. As a marker of inflammation, pre-and post-surgery IL-6 levels were compared. Results: After surgery, IL-6 levels increased significantly in both groups. The rise in IL-6 was less with TIVA than with desflurane; however, it did not reach significance. IL-6 rise post-surgery correlated positively with the complexity of procedure and duration of surgery and anaesthesia, rather than anaesthetic technique. Both groups did not differ in terms of intra-operative hemodynamic and respiratory variables, time to awakening, postoperative pulmonary complications, and duration of hospital stay. The incidence of nausea was significantly higher with desflurane than with TIVA. Conclusion: Inflammatory response did not differ as a function of anaesthetic technique when propofol and desflurane were compared. Also, patient and surgical variables dictated post-operative inflammation more than the anaesthetic factors. Further, larger sample size is needed to confirm or refute these findings.

Keywords: bariatric, biomarkers, inflammation, laparoscopy

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Authors: R. Latif, W. Jenkal, A. Toumanari, A. Hatim

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This paper presents an efficient method of electrocardiogram signal denoising based on a hybrid approach. Two techniques are brought together to create an efficient denoising process. The first is an Adaptive Dual Threshold Filter (ADTF) and the second is the Discrete Wavelet Transform (DWT). The presented approach is based on three steps of denoising, the DWT decomposition, the ADTF step and the highest peaks correction step. This paper presents some application of the approach on some electrocardiogram signals of the MIT-BIH database. The results of these applications are promising compared to other recently published techniques.

Keywords: hybrid technique, ADTF, DWT, thresholding, ECG signal

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Authors: Yassine Mohammed Benyoucef, Razin Andery Dionisovich

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Biomimicry is an old approach, but in the scientific conceptualization is new, as an approach of innovation based on the emulation of Nature, in recent years, this approach brings many potential theories and innovations in the architecture field. Indeed, these innovations have changed our view towards other Natural organisms also to the design processes in architecture, now the use of the biomimicry approach allows the application of a great sustainable development. The Sahara area is heading towards a sustainable policy with the desire to develop this rich context in terms of architecture, because of the rapid evolution of the architectural and urban concepts and the technology acceleration in one side, and under the pressure of the architectural crisis and the accelerated urbanization in the Saharan cities on the other side, the imperatives of sustainable development, ecology, climate adaptation, energy needs, are strongly imposed. Besides that, the new architectural and urban projects in the Saharan cities are not reliable in terms of energy efficiency and design and relationship with the environment. This article discusses the using of biomimetic strategy in the sustainable development of Saharan architecture. The aim of the article is to present a synthesis of biomimicry approach and propose the biomimicry as a solution for the development of Saharan architecture which can use this approach as a sustainable and innovation strategy. The biomimicry is the solution for effective strategies of development and can have a great potential point to meet the current challenges of designing efficient for forms or structures, energy efficiency, and climate issues. Moreover, the Sahara can be a favorable soil for great changes, the use of this approach is the key for the most optimal strategies and sustainable development of the Saharan architecture.

Keywords: biomimicry, Sahara, architecture, nature, innovation, technology

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Authors: Saeideh Salimpour, Sophie-Charlotte Viaux, Ahmed Azab, Mohammed Fazle Baki

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The Facility Layout Problem (FLP) is key to the efficient and cost-effective operation of a system. This paper presents a hybrid heuristic- and mathematical-programming-based approach that divides the problem conceptually into those of clustering and sequencing. First, clusters of vertically aligned facilities are formed, which are later on sequenced horizontally. The developed methodology provides promising results in comparison to its counterparts in the literature by minimizing the inter-distances for facilities which have more interactions amongst each other and aims at placing the facilities with more interactions at the centroid of the shop.

Keywords: clustering-sequencing approach, mathematical modeling, optimization, unequal facility layout problem

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Authors: S. Homrossukon, S. Sansureerungsigun

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This work aims to introduce an efficient and to standardize the measuring system analyses for automotive industrial. The study started by literature reviewing about the management and analyses measurement system. The approach of measuring system management, then, was constructed. Such approach was validated by collecting the current measuring system data using the equipments of interest including vernier caliper and micrometer. Their accuracy and precision of measurements were analyzed. Finally, the measuring system was improved and evaluated. The study showed that vernier did not meet its measuring characteristics based on the linearity whereas all equipment were lacking of the measuring precision characteristics. Consequently, the causes of measuring variation via the equipment of interest were declared. After the improvement, it was found that their measuring performance could be accepted as the standard required. Finally, the standardized approach for analyzing the measuring system of automotive was concluded.

Keywords: automotive part manufacturing measurement, measuring accuracy, measuring precision, measurement system analyses

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Authors: Paschal Ohalehi

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Purpose - The purpose of this paper, which is part of a PhD thesis is to examine the role of risk based approach in minimising financial crime in the charity sector as well as offer recommendations to improving the quality of charity regulation whilst still retaining risk based approach as a regulatory framework and also making a case for a new regulatory model. Increase in financial crimes in the charity sector has put the role of regulation in minimising financial crime up for debates amongst researchers and practitioners. Although previous research has addressed the regulation of charities, research on the role of risk based approach to minimising financial crime in the charity sector is limited. Financial crime is a concern for all organisation including charities. Design/methodology/approach - This research adopts a social constructionist’s epistemological position. This research is carried out using semi structured in-depth interviews amongst randomly selected 24 charity trustees divided into three classes: 10 small charities, 10 medium charities and 4 large charities. The researcher also interviewed 4 stakeholders (NFA, Charity Commission and two different police forces in terms of size and area of coverage) in the charity sector. Findings - The results of this research show that reliance on risk based approach to financial crime in the sector is weak and fragmented with the research pointing to a clear evidence of disconnect between the regulator and the regulated leading to little or lack of regulation of trustees’ activities, limited monitoring of charities and lack of training and awareness on financial crime in the sector. Originality – This paper shows how regulation of charities in general and risk based approach in particular can be improved in order to meet the expectations of the stakeholders, the public, the regulator and the regulated.

Keywords: risk, risk based approach, financial crime, fraud, self-regulation

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Authors: Prabhu Thangaraju, Manoj Deepak, A. Sivakumar

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Removal of inter vertebral disc along with spinal fusion has many disadvantages such as causing stress fractures. If it is possible regenerate the spine it would be possible avoid the complications of the surgery and achieve better results. Our study involves the use of mesenchymal stem cells in regenerating the discs. Our study involved 10 patients who presented with degenerative disc disease between 2008-2011 in our hospital. After adequate pre-operative check prepared mesenchymal stem cells were injected into the disc spaces. These patients were subjected to conservative therapy for a minimum of six weeks before they were accepted into the study. They were followed up regularly for a minimum of 2years with serial radiographs and MRI. 8 out of the 10 patients had completed reduction in the pain. The T2 weighted MRI images in 9 out of the 10 patients showed a bright signal compared the previous Images which indicated that there was improvement in the hydration levels. From the case study of 10 patients who were subjected to mesenchymal cell therapy in our hospital, we can conclude that the use of mesenchymal cells in treatment of intervertebral disc degeneration in a safe and effective option.

Keywords: mesenchymal stem cells, intervertebral disc, the spine, disc degeneration

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Authors: Randa El Bedawy

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Exchanging best practices in the scope of entrepreneurship education and the use of experiential learning approaches are growing lately at a very fast pace. Educators should be challenged to promote such a learning approach to bridge the gap between entrepreneurship students and the actual business work environment. The study aims to share best practices, experiences, and knowledge to support entrepreneurship education. The study is exploratory qualitative research based on a case study approach to demonstrate how experiential learning can be used for supporting learning effectiveness in entrepreneurship education through demonstrating a set of fourteen tasks that were used to engage practically the students who were studying a course of entrepreneurship at the American University in Cairo. The study sheds the light on the rational process of using experiential learning to endorse entrepreneurship education through the illustration of each task along with its learning outcomes. The study explores the benefits and obstacles that educators may face when implementing such an experiential approach. The results of the study confirm that developing an experiential learning approach based on constructing a set of well designed practical tasks that complement the overall intended learning outcomes has proven very effective for promoting the students’ learning of entrepreneurship education. However, good preparation for both educators and students is needed primarily to ensure the effective implementation of such an experiential learning approach.

Keywords: business education, entrepreneurship, entrepreneurship education, experiential learning

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Authors: Paula Linna

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During the recent years interest in inclusive business has increased. Still, research on inclusive business development is at infancy. This study provides empirical evidence on inclusive business development of mini-grid solution for the rural African communities. This study tests how well the insights of creation theory can explain inclusive business development process which often occurs under uncertainty due to demands for developing new technology, new business model and establishing business in new market. These several uncertain elements of business development impact what kind of business strategies the entrepreneur can practice and what kind of decision making tools to use. In addition, community engagement is essential for the successful operative management of a mini-grid solution. This study advances the understanding of inclusive business development and can be used as the foundation for future work to facilitate the process of new business venture creation at the BOP particularly when developing community-operated entrepreneurship model.

Keywords: creation theory, base of the pyramid (BOP), community-operated entrepreneurship, rural African communities

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Authors: Ghodbane Azeddine, Saad Maarouf, Boland Jean-Francois, Thibeault Claude

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This paper proposes a new design of an active fault-tolerant flight control system against abrupt actuator faults. This overall system combines a multiple time scale sliding mode controller for fault compensation and a geometric approach for fault detection and diagnosis. The proposed control system is able to accommodate several kinds of partial and total actuator failures, by using available healthy redundancy actuators. The overall system first estimates the correct fault information using the geometric approach. Then, and based on that, a new reconfigurable control law is designed based on the multiple time scale sliding mode technique for on-line compensating the effect of such faults. This approach takes advantages of the fact that there are significant difference between the time scales of aircraft states that have a slow dynamics and those that have a fast dynamics. The closed-loop stability of the overall system is proved using Lyapunov technique. A case study of the non-linear model of the F16 fighter, subject to the rudder total loss of control confirms the effectiveness of the proposed approach.

Keywords: actuator faults, fault detection and diagnosis, fault tolerant flight control, sliding mode control, multiple time scale approximation, geometric approach for fault reconstruction, lyapunov stability

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Authors: Art Tsang

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In educational research, the scope of investigations has almost always been determined by researchers. As learners are at the forefront of education, it is essential to balance researchers’ and learners’ voices in educational studies. In this paper, a data collection method that helps partly address the dearth of learners’ voices in research design is introduced. Inspired by the repertory grid approach (RGA), the group RGA approach, created by the author and his doctoral student, was successfully piloted with learners in Hong Kong. This method will very likely be of interest and use to many researchers, teachers, and postgraduate students in the field of education and beyond.

Keywords: education, learners, repertory grids, research methods

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Authors: Teresita Lopez Joy, Jose A. Acevedo Suarez, Martha I. Gomez Acosta, Ana Julia Acevedo Urquiaga

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Current trends in business competitiveness indicate the need to manage businesses as supply chains and not in isolation. The use of strategies aimed at maximum satisfaction of customers in a network and based on inter-company cooperation; contribute to obtaining successful joint results. In the Cuban economic context, the development of productive linkages to achieve integrated management of supply chains is considering a key aspect. In order to achieve this jump, it is necessary to develop acting capabilities in the entities that make up the chains through a systematic procedure that allows arriving at a management model in consonance with the environment. The objective of the research focuses on: designing a model and procedure for the development of integrated management of supply chains in economic entities. The results obtained are: the Model and the Procedure for the Development of the Supply Chains Integrated Management (MP-SCIM). The Model is based on the development of logistics in the network actors, the joint work between companies, collaborative planning and the monitoring of a main indicator according to the end customers. The application Procedure starts from the well-founded need for development in a supply chain and focuses on training entrepreneurs as doers. The characterization and diagnosis is done to later define the design of the network and the relationships between the companies. It takes into account the feedback as a method of updating the conditions and way to focus the objectives according to the final customers. The MP-SCIM is the result of systematic work with a supply chain approach in companies that have consolidated as coordinators of their network. The cases of the edible oil chain and explosives for construction sector reflect results of more remarkable advances since they have applied this approach for more than 5 years and maintain it as a general strategy of successful development. The edible oil trading company experienced a jump in sales. In 2006, the company started the analysis in order to define the supply chain, apply diagnosis techniques, define problems and implement solutions. The involvement of the management and the progressive formation of performance capacities in the personnel allowed the application of tools according to the context. The company that coordinates the explosives chain for construction sector shows adequate training with independence and opportunity in the face of different situations and variations of their business environment. The appropriation of tools and techniques for the analysis and implementation of proposals is a characteristic feature of this case. The coordinating entity applies integrated supply chain management to its decisions based on the timely training of the necessary action capabilities for each situation. Other cases of study and application that validate these tools are also detailed in this paper, and they highlight the results of generalization in the quantitative and qualitative improvement according to the final clients. These cases are: teaching literature in universities, agricultural products of local scope and medicine supply chains.

Keywords: integrated management, logistic system, supply chain management, tactical-operative planning

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Authors: Diego Saqui, José H. Saito, José R. Campos, Lúcio A. de C. Jorge

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Hyperspectral images and remote sensing are important for many applications. A problem in the use of these images is the high volume of data to be processed, stored and transferred. Dimensionality reduction techniques can be used to reduce the volume of data. In this paper, an approach to band selection based on clustering algorithms is presented. This approach allows to reduce the volume of data. The proposed structure is based on Fuzzy C-Means (or K-Means) and NWHFC algorithms. New attributes in relation to other studies in the literature, such as kurtosis and low correlation, are also considered. A comparison of the results of the approach using the Fuzzy C-Means and K-Means with different attributes is performed. The use of both algorithms show similar good results but, particularly when used attributes variance and kurtosis in the clustering process, however applicable in hyperspectral images.

Keywords: band selection, fuzzy c-means, k-means, hyperspectral image

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Authors: A. Benbouali, H. Saidi, A. Derrouazin, T. Bessaad

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Aerial robotics is a very exciting research field dealing with a variety of subjects, including the attitude control. This paper deals with the control of a four rotor vertical take-off and landing (VTOL) Unmanned Aerial Vehicle. The paper presents a mathematical model based on the approach of Lagrange for the flight control of an autonomous quad-rotor. It also describes the controller architecture which is based on PID regulators. The control method has been simulated in closed loop in different situations. All the calculation stages and the simulation results have been detailed.

Keywords: quad-rotor, lagrange approach, proportional integral derivate (PID) controller, Matlab/Simulink

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Authors: Neerja Gupta

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Objective-Reconstruction of large cavities of the breast without contralateral symmetrisation Background- Reconstruction of breast includes a wide spectrum of procedures from displacement to regional and distant flaps. The pedicled Perforator flaps cover a wide spectrum of reconstruction surgery for all quadrants of the breast, especially in patients with comorbidities. These axial flaps singly or adjunct are based on a near constant perforator vessel, a ratio of 2:1 at its entry in a flap is good to maintain vascularity. The perforators of lateral chest wall viz LICAP, LTAP have overlapping perfurosomes without clear demarcation. LTAP is localized in the narrow zone between the lateral breast fold and anterior axillary line,2.5-3.8cm from the fold. MICAP are localized at 1-2 cm from sternum. Being 1-2mm in diameter, a Single perforator is good to maintain the flap. LICAP has a dominant perforator in 6th-11th spaces, while LTAP has higher placed dominant perforators in 4th and 5th spaces. Methodology-Six consecutive patients who underwent reconstruction of the breast with pedicled perforator flaps were retrospectively analysed. Selections of the flap was done based on the size and locations of the tumour, anticipated volume loss, willingness to undergo contralateral symmetrisation, cosmetic expectations, and finances available.3 patients underwent vertical LTAP, the distal limit of the flap being the inframammary crease. 3 patients underwent MICAP, oriented along the axis of rib, the distal limit being the anterior axillary line. Preoperative identification was done using a unidirectional hand held doppler. The flap was raised caudal to cranial, the pivot point of rotation being the vessel entry into the skin. The donor area is determined by the skin pinch. Flap harvest time was 20-25 minutes. Intra operative vascularity was assessed with dermal bleed. The patient immediate pre, post-operative and follow up pics were compared independently by two breast surgeons. Patients were given a breast Q questionnaire (licensed) for scoring. Results-The median age of six patients was 46. Each patient had a hospital stay of 24 hours. None of the patients was willing for contralateral symmetrisation. The specimen dimensions were from 8x6.8x4 cm to 19x16x9 cm. The breast volume reconstructed range was 30 percent to 45 percent. All wide excision had free margins on frozen. The mean flap dimensions were 12x5x4.5 cm. One LTAP underwent marginal necrosis and delayed wound healing due to seroma. Three patients were phyllodes, of which one was borderline, and 2 were benign on final histopathology. All other 3 patients were invasive ductal cancer and have completed their radiation. The median follow up is 7 months the satisfaction scores at median follow of 7 months are 90 for physical wellbeing and 85 for surgical results. Surgeons scored fair to good in Harvard score. Conclusion- Pedicled perforator flaps are a valuable option for 3/8th volume of breast defects. LTAP is preferred for tumours at the Central, upper, and outer quadrants of the breast and MICAP for the inner and lower quadrant. The vascularity of the flap is dependent on the angiosomalterritories; adequate venous and cavity drainage.

Keywords: breast, oncoplasty, pedicled, perforator

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Authors: Christopher Oyediran, Nicola Ubayasiri, Christopher Gough

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Splenic artery aneurysms are often clinically occult, occasionally identified incidentally with imaging. The pathogenesis of aneurysms is complex, but certain factors are thought to contribute to their development. Given the potential fatal complications of rupture, a high index of suspicion is required to make an early diagnosis. We present a case of a 36-year-old female with a history of endometriosis and multiple sclerosis who presented to the Emergency Department with sudden onset epigastric pain and collapse. On arrival, she was pale and clammy with profound tachycardia and hypotension. An ultrasound done in the resuscitation department revealed abdominal free fluid. She was resuscitated with blood and transferred for emergent laparotomy. Laparotomy revealed massive haemoperitoneum from the spleen. She underwent emergency splenectomy and inspection of the spleen revealed a splenic artery aneurysm. She received our massive transfusion protocol followed by a short stay on ITU, making a good post-operative recovery and was discharged home a week later.

Keywords: aneurysm, human chorionic gonadotrophin (hCG), resuscitation, laparotomy

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Authors: V. Gareyan, Zh. Gevorkian

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We study oblique incident light absorption in opaque media with rough surfaces. An analytical approach with modified boundary conditions taking into account the surface roughness in metallic or dielectric films has been discussed. Our approach reveals interference-linked terms that modify the absorption dependence on different characteristics. We have discussed the limits of our approach that hold valid from the visible to the microwave region. Polarization and angular dependences of roughness-induced absorption are revealed. The existence of an incident angle or a wavelength for which the absorptance of a rough surface becomes equal to that of a flat surface is predicted. Based on this phenomenon, a method of determining roughness correlation length is suggested.

Keywords: light, absorption, surface, roughness

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Authors: Babatunde J. Falaye

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In this study, we obtain the approximate analytical solutions of the radial Schrödinger equation for the Deng-Fan diatomic molecular potential by using exact quantization rule approach. The wave functions have been expressed by hypergeometric functions via the functional analysis approach. An extension to rotational-vibrational energy eigenvalues of some diatomic molecules are also presented. It is shown that the calculated energy levels are in good agreement with the ones obtained previously E_nl-D (shifted Deng-Fan).

Keywords: Schrödinger equation, exact quantization rule, functional analysis, Deng-Fan potential

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Authors: Onwumere O. J.

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The teaching of stress at any level of education could be a daunting task for the second language teacher because most times, they are bereft of the right approach to use in teaching it even at the fact is that, teaching it. But the fact is that teaching stress even at the middle basic could be interesting if the right approach is employed. To this end, the researcher was of the view that grouping could be a very good strategy to employ in order to sustain the interest of the learner and that the use at drums would be a good way to concretise the teaching of stress at this level. He was able to do this by discussing stress, grouping as a good technique, and the use of drums in teaching stress. To establish the fact that the use of drums would be very effective, four research questions contained in a questionnaire were structured. Three hundred (300) teachers of English in four tertiary institutions, three secondary schools and three primary schools in Nigeria were used. Based on the data analysis and findings, suggestions were given on how teachers and learners could use drums to make the teaching and learning of stress enjoyable for both teachers and learners at the middle basic of education.

Keywords: concretise, grouping, right approach, second language

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Authors: Mohammad Mohammadi, Mojtaba Askari, Mohammad Farouq Hossaini

Abstract:

An intrinsic property of rock mass known as rock bolt supporting factor (RSF) or rock bolting capability of rock mass was developed and used for explanation of the mechanism of rock bolting practice. Based on the theory of RSF, numeral values can be assigned to each given rock mass to show the capability of that rock mass to be reinforced by rock bolting. For determination of shotcrete thickness, both safety and cost must be taken into account. The present paper introduces a scientific approach for determination of the necessary shotcrete thickness in underground structures for support purposes using the concept of rock bolt supporting factor (RSF). The proposed approach makes the outcome of shotcrete design one step more accurate than before. The actual dataset of 500 meters of Alborz Tunnel length is used as an example of the application of the approach.

Keywords: rock bolt supporting factor (RSF), shotcrete design, underground excavation, Alborz Tunnel

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Authors: Mohammad Ali Alavidoost, Hossein Bozorgian

Abstract:

Criterion-referenced tests (CRTs) are designed to measure student performance against a fixed set of predetermined criteria or learning standards. The reliability of such tests cannot be based on internal reliability. Threshold loss agreement is one way to calculate the reliability of CRTs. However, the selection of master and non-master in such agreement is determined by the threshold point. The problem is if the threshold point witnesses a minute change, the selection of master and non-master may have a drastic change, leading to the change in reliability results. Therefore, in this study, the Fuzzy logic approach is employed as a remedial procedure for data analysis to obviate the threshold point problem. Forty-one Iranian students were selected; the participants were all between 20 and 30 years old. A quantitative approach was used to address the research questions. In doing so, a quasi-experimental design was utilized since the selection of the participants was not randomized. Based on the Fuzzy logic approach, the threshold point would be more stable during the analysis, resulting in rather constant reliability results and more precise assessment.

Keywords: criterion-referenced tests, threshold loss agreement, threshold point, fuzzy logic approach

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Authors: Emrehan Ozcan, Dilek Beyazlı

Abstract:

The development of tourism depends on an accurate planning approach as well as on the right planning process. This dependency is also a key factor in ensuring sustainability of tourism. The types of tourism, social expectations, planning practice, the socio-economic and the cultural structure of the region are determinants of planning approaches for tourism development. The tourism plans prepared for the historic city centers are usually based on the revitalization of cultural and historical values. The preservation and development of the tourism potentials of the historic city centers are important for providing an economic contribution to the locality, creating livable solutions for local residents and also the sustainability of tourism. This research is about experiencing and discussing a planning approach that will provide tourism development based on historical and cultural values. Historical and cultural values in the historical city center of Trabzon -which has a settlement history of approximately 4000 years, is located on the Black Sea coast of Turkey- wear out over years and lose their tourism potential. A planning study has been experienced with strategic spatial planning approach for Trabzon, which has not done a tourism-oriented planning study until now. The stages of the planning process provided by strategic spatial planning approach are an assessment of the current situation; vision, strategies, and actions; action planning; designing and implementation of actions and monitoring-evaluation. In the discussion section, the advantages, planning process, methods and techniques of the approach are discussed for the possibilities and constraints in terms of tourism planning. In this context, it is aimed to put forth tourism planning process, stages, and implementation tools within the scope of strategic spatial planning approach by comparing approaches used in the tourism-oriented/priority planning of historical city centers. Suggestions on the position and effect of the preferred planning approach in the existing spatial planning practice are the outputs of the study.

Keywords: cultural heritage, tourism oriented planning, Trabzon, strategic spatial Planning

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Authors: Elleuch Imen

Abstract:

In this paper, it propose a new approach for learning Arabic as a foreign language via audio-visual translation, particularly subtitling. The approach consists of developing video sequences appropriate to different levels of learning (from A1 to C2) containing conversations, quizzes, games and others. Each video aims to achieve a specific objective, such as the correct pronunciation of Arabic words, the correct syntactic structuring of Arabic sentences, the recognition of the morphological characteristics of terms and the semantic understanding of statements. The subtitled videos obtained can be incorporated into different Arabic second language learning tools such as Moocs, websites, platforms, etc.

Keywords: arabic foreign language, learning, audio-visuel translation, subtitled videos

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