Skin-sparing (SSM) and nipple-sparing (NSM) mastectomies are relatively new conservative surgical approaches to breast cancer. In SSM most of the breast skin is conserved to create a pocket that ...facilitates immediate breast reconstruction with implant or autologous graft to achieve a quality cosmetic outcome. NSM is closely similar except that the nipple-areola complex (NAC) is also conserved. Meta-analyses indicate that outcomes for SSM and NSM do not differ from those for non-conservative mastectomies. Recurrence rates in the NAC after NSM are acceptably low (0–3.7%). Other studies indicate that NSM is associated with high patient satisfaction and good psychological adjustment.
Indications are carcinoma or DCIS that require mastectomy (including after neoadjuvant chemotherapy). NSM is also suitable for women undergoing risk-reducing bilateral mastectomy.
Tumor not less than 2 cm from the NAC is recommended, but may be less important than no evidence of nipple involvement on mandatory intraoperative nipple margin assessment. A positive margin is an absolute contraindication for nipple preservation. Other contraindications are microcalcifications close to the subareolar region and a positive nipple discharge.
Complication rates are similar to those for other types of post-mastectomy reconstructions. The main complication of NSM is NAC necrosis, however as surgeon experience matures, frequency declines. Factors associated with complications are voluminous breast, ptosis, smoking, obesity, and radiotherapy.
Since the access incision is small, breast tissue may be left behind, so only experienced breast surgeons should do these operations in close collaboration with the plastic surgeon. For breast cancer patients requiring mastectomy, NSM should be the option of choice.
This research explores basic and secondary colors in Indonesia. This research attempts to explicate the meaning of colors by using the semantic theory of Natural Semantic Metalanguage Theory. This ...research applied qualitative method. The paradigm of qualitative research revolves around the observation from the surrounding. The data were collected from various sources such as Indonesian Dictionary, Indonesian Corpus, and the data created by the researcher as the native speaker. The researcher explicates primary or basic colors as well as the secondary. Further, these Indonesian colors were being explicated by applying the features of Natural Semantic Metalanguage (NSM). The colors in Indonesian were gathered and classified. The researcher then analyzed the colors based on the explication of NSM theory and the approach of Basic Color Term initiated by Berlin and Kay. This research discovers that the basic or primary colors in Indonesian are Black, White, Red, Yellow, Green and Blue. The application of this research is apparently vivid in the advancement of colors study in the realm of semantics. This research also exposes the difference of explication in English and Indonesian. This occurred due to the difference of the usage of semantic atom to explain the meaning of color. To explicate the color of black, Indonesian uses charcoal. Meanwhile English uses the night sky. In Indonesian, colors that come after Green and Blue according to Berlin and Kay’s color terms are Brown, Purple, Orange, Pink, and Grey are not basics but secondary colors. Meanwhile, in English the aforementioned colors are basics.
This research explores basic and secondary colors in Indonesia. This research attempts to explicate the meaning of colors by using the semantic theory of Natural Semantic Metalanguage Theory. This ...research applied qualitative method. The paradigm of qualitative research revolves around the observation from the surrounding. The data were collected from various sources such as Indonesian Dictionary, Indonesian Corpus, and the data created by the researcher as the native speaker. The researcher explicates primary or basic colors as well as the secondary. Further, these Indonesian colors were being explicated by applying the features of Natural Semantic Metalanguage (NSM). The colors in Indonesian were gathered and classified. The researcher then analyzed the colors based on the explication of NSM theory and the approach of Basic Color Term initiated by Berlin and Kay. This research discovers that the basic or primary colors in Indonesian are Black, White, Red, Yellow, Green and Blue. The application of this research is apparently vivid in the advancement of colors study in the realm of semantics. This research also exposes the difference of explication in English and Indonesian. This occurred due to the difference of the usage of semantic atom to explain the meaning of color. To explicate the color of black, Indonesian uses charcoal. Meanwhile English uses the night sky. In Indonesian, colors that come after Green and Blue according to Berlin and Kay’s color terms are Brown, Purple, Orange, Pink, and Grey are not basics but secondary colors. Meanwhile, in English the aforementioned colors are basics.
This research explores basic and secondary colors in Indonesia. This research attempts to explicate the meaning of colors by using the semantic theory of Natural Semantic Metalanguage Theory. This ...research applied qualitative method. The paradigm of qualitative research revolves around the observation from the surrounding. The data were collected from various sources such as Indonesian Dictionary, Indonesian Corpus, and the data created by the researcher as the native speaker. The researcher explicates primary or basic colors as well as the secondary. Further, these Indonesian colors were being explicated by applying the features of Natural Semantic Metalanguage (NSM). The colors in Indonesian were gathered and classified. The researcher then analyzed the colors based on the explication of NSM theory and the approach of Basic Color Term initiated by Berlin and Kay. This research discovers that the basic or primary colors in Indonesian are Black, White, Red, Yellow, Green and Blue. The application of this research is apparently vivid in the advancement of colors study in the realm of semantics. This research also exposes the difference of explication in English and Indonesian. This occurred due to the difference of the usage of semantic atom to explain the meaning of color. To explicate the color of black, Indonesian uses charcoal. Meanwhile English uses the night sky. In Indonesian, colors that come after Green and Blue according to Berlin and Kay’s color terms are Brown, Purple, Orange, Pink, and Grey are not basics but secondary colors. Meanwhile, in English the aforementioned colors are basics.
The high efficiency of the near-surface mounted (NSM) fibre-reinforced polymer (FRP) technique for improving the shear capacities of reinforced concrete (RC) beams has been proved by numerous ...studies. However, premature debonding failures including interfacial debonding and concrete cover separation, which could largely limit the utilization of FRP strength, were frequently observed in RC beams strengthened in shear with NSM FRP. Proper anchoring measures of NSM FRPs can mitigate or even prevent such debonding failures and thus enhance the FRP strengthening efficiency, but relevant research on anchoring measures for NSM FRP shear-strengthened beams is still limited. Against the above background, a novel FRP anchor for NSM FRP shear-strengthened beams is proposed in this paper. A test program consisting of eight full-scale RC beams is carried out to investigate the effectiveness of the proposed FRP anchor system. It can be seen from the test results that the proposed FRP anchor is capable of mitigating or preventing the FRP debonding failures and thus significantly enhancing the load-carrying and deformation capacities of RC beams strengthened in shear with NSM FRP strips, and the configuration of the anchor can largely influence the performance of strengthened beams.
The characteristic parameters of renewable energy sources (RESs) are changes over time under changing operating conditions. Therefore, the accuracy of the model is important in order to establish ...appropriate control and operating plans for the stable operation of such systems. Determining the parameters of RESs and creating an accurate model of them is an inevitable reality and plays an important role in the success of system modeling. Many methods have been used to determine these parameters in the literature. Furthermore, optimization algorithms are now considered to be among the most significant approaches for resolving problems pertaining to system parameter extraction in many scientific areas. In the study, this parameter extraction is done by a new optimization method called stochastic fractal search algorithm (FDB-NSM-SFS-OBLs), which includes natural survivor updating (NSM) and fitness distance balance (FDB) guiding mechanisms, and opposite based learning (OBL) methods. The performance of the proposed FDB-NSM-SFS-OBL algorithm has been tested in two different experimental studies. In the first experimental study, the proposed approach is tested on CEC2020 benchmark test functions and the algorithm structure containing the best OBL approach is determined using nonparametric Wilcoxon and Friedman statistical analysis methods. The second experimental study is carried out with the proposed optimization algorithm to estimate the parameters of the photovoltaic cell used in the modeling, which is the building block of photovoltaic panels used in renewable energy systems, proton-exchange membrane fuel cell (PEMFC) that is another renewable energy source, and Li-Ion battery used as a backup power unit. The FDB-NSM-SFS-OBL algorithm, which is used both in the CEC2020 benchmark test functions and in determining the parameters of photovoltaic (PV) cells, PEMFC and Li-Ion batteries, performed better in searching and finding the global solution point during the optimization process.
•FDB-NSM-SFS-OBL algorithm was introduced to the literature.•FDB, NSM and OBL design operators were combined for the first time in this study.•The benchmark and parameter extraction problems were solved by FDB-NSM-SFS-OBL.•The performance of algorithm was proved using non-parametric statistical methods.
•The FRP is bonded using a cementitious grout rather than an epoxy adhesive.•The flexural tests demonstrated good performance of the novel FRP strengthening system.•Thermo-structural response was ...investigated under typical serviceability loads.•Internal temperatures, beam displacements, and slip of the FRP strengthening were measured.•Digital image correlation (DIC) was also used to study displacements.
This paper presents the results of 12 tests on small-scale reinforced concrete beams strengthened in flexure with a single NSM carbon FRP bar. The used FRP bar is a novel commercial bar with high values of glass transition Tg and decomposition Td temperature to improve the performance of the strengthening system at elevated temperature. The FRP is bonded using a cementitious grout rather than an epoxy adhesive. Flexural tests were performed at both ambient and elevated temperatures on both un-strengthened and strengthened beams. Tests at elevated temperature were performed using propane-fired radiant panels, rather than a fire testing furnace, in two heating configurations (localised heating near midspan only and global heating over the entire bonded length of the FRP systems).
This paper also shows the results of Dynamic Mechanic Analysis (DMA), Thermogravimetric Analysis (TGA) and Differential Scanning Calorimetry (DSC) tests conducted on the CFRP. The results of thermal conductivity tests of CFRP and cementitious grout, and tests conducted to define the mechanical properties of concrete, steel bars, cementitious grout and CFRP bar are discussed herein.
The flexural tests demonstrated the grout-bonded NSM CFRP strengthening system’s ability to maintain structural effectiveness at temperatures up to about 600 °C with adequate anchorage. However, similar tests with an epoxy adhesive are needed before the novel system can be confidently stated as being vastly superior to epoxy-adhered NSM systems.
Meta-heuristic search algorithms (MHSs) are methods that take their inspiration from nature. However, the fitness value information used in the design of the update mechanism in MHSs is insufficient ...to represent the concept of adaptation to the environment and the ability to survive in nature. This causes problems in the selection of survivors and the premature convergence in the search process. This article introduces the Natural Survivor Method (NSM), developed as a design for population management as it occurs in nature, depending on analytical relationships and environmental factors. In the NSM, scores representing the adaptability of individuals to nature are calculated in order to determine the survivors. In this proposed method, the update mechanism is designed using NSM scores instead of fitness values. The NSM is the first study presented to the literature on this subject since the 1980s, when the meta-heuristics was introduced. The NSM was used for survivor selection by applying it to three different types of MHS algorithms based on physics (SFS), biology (TLABC), and evolution (LSHADE-SPACMA). Thirty-nine global optimization problems in the IEEE CEC 2017/2020 benchmark suites and ten constrained real-world engineering problems were used in the experimental studies. Data obtained from experimental studies were analyzed by using non-parametric statistical test methods. Among the 25 competing algorithms according to Friedman scores, the rankings of the three algorithms with NSM and their original versions are as follows: While TLABC is 18th, NSM-TLABC is 9th, SFS is 10th, NSM-SFS is 6th, LSHADE-SPACMA is 3rd, NSM-LSHADE-SPACMA is 1st. According to the results of the Wilcoxon pairwise comparison test between the original and NSM versions of the algorithms, the NSM versions have a clear advantage in finding optimal solutions. However, the drawback of the proposed method is that it increases the computational complexity of the algorithms. The source codes of the NSM (NSM-LSHADE_SPACMA, NSM-TLABC and NSM-SFS) can be accessed at this link: https://www.mathworks.com/matlabcentral/fileexchange/126050-natural-survivor-method-nsm-for-metaheuristic-algorithms.
•The depth effect of NSM grooves of strengthened beams was studied.•The effect of horizontal distance between two NSM grooves was studied.•An analytical model is proposed to predict the above ...effects.
In this paper, the effect of interaction between near surface mounted (NSM) strips and internal reinforcement on the structural behavior of upgrading RC beams has been studied. The position, arrangement and area of NSM glass fiber reinforced polymer (GFRP) strips have been examined experimentally. Six strengthened beams in addition to one control beam were tested in flexural until failure. The load carrying capacity, deflections and the mode of failure of strengthened beams were recorded. The experimental results showed that the installed NSM GFRP side by side has a lower interfacial stress than those installed separated. This improvement is more obvious in the case of NSM strips installed near the internal reinforcement. Furthermore, the installed NSM strips in deep groove experienced higher load carrying capacity than those installed in shallow groove for both patterns. The installation of the NSM GFRP strips in deep grooves using epoxy may be delay or prevent the peeling/debonding failure. The ultimate load of the beam upgraded with one NSM strip adjacent to the stirrups (in deeper groove) is about 1.5 times that of one NSM strip installed near the bottom surface of the beam. This ratio decreased with increasing the area of NSM GFRP strips.
Shoreline changes embrace alterations due to the physical features and location of the land-water boundary, which can arise from natural or human causes. Natural processes, like sea level ...fluctuations, erosion, and sediment deposition, impact coasts. Human activities also significantly influence shoreline changes. The study area's shoreline extends 59.80 km from Reduto de Sao Teodosio to Barra de Guaratiba. The study analyzed shoreline changes along a 60 km stretch of the southern coast of Rio de Janeiro (Reduto de Sao Teodosio to Barra de Guaratiba) from 1986 to 2018. This study examines historical shoreline positions, calculating change rates and predicting 2032 and 2042 positions using satellite imagery spanning 1972–2022. The historical shoreline was reconstructed using earlier satellite data. Digital Shoreline Analysis System (DSAS) tools (EPR, LRR, NSM) in ArcMap were then used to quantify change rates statistically. The EPR model reports a maximum annual accretion rate of 19.33 m and a maximum erosion rate of −4.91 m, while the LRR model indicates a maximum accretion rate of 21.31 m and a maximum erosion rate of −5.04 m. In contrast, the NSM model calculates a notably higher maximum accretion rate of 945.96 m and a much more substantial maximum erosion rate of −240.34 m. These findings informed the mapping of anticipated 2032 and 2042 shorelines, helping identify areas of gain and loss, highlighting the vulnerability of certain regions. It's important to note that human activities, such as alterations in beach topography, can influence these models. Protective measures, like those in Rio de Janeiro, Barra Da Tijuca, and Recreio Dos Bandeirantes, may affect erosion and accretion patterns. Additionally, coastal development activities, including seawall dredging, can disrupt natural processes. Effective management of shoreline changes is essential to safeguard ecosystems and communities, with strategies encompassing beach nourishment, vegetation restoration, and sustainable coastal development. Resilient, adaptive coastal management balances human needs and environmental protection amid ongoing changes.
•Spatio-temporal analysis of shoreline changes for Rio de Janeiro, Brazil.•Shoreline Future forecasting using Kalman filter model for next 2 decades.•EPR, LRR and NSM analysis for Rio de Janeiro, Brazil.
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