An asymptomatic 11 year child with ruptured sinus of Valsalva

Ruptured sinus of Valsalva (RSOV) is a rare lesion in a paediatric age group. A right sinus of Valsalva aneurysm usually ruptures into the right ventricle, while aneurysms of non-coronary sinus do so into the right atrium. RSOV usually presents in the third decade of life with congestive heart failure and is more common among Asians with male predominance. It may present as acute cardiogenic shock and sudden death or may remain completely asymptomatic with incidental detection by a murmur. Surgery is indicated as early as possible, once the diagnosis is made as without surgery, most cases will eventually succumb to uncontrollable congestive heart failure. This article reports an 11 year old child with the diagnosis of ruptured sinus of Valsalva.peer-reviewe

Inkjet-printed vertically emitting solid-state organic lasers

In this paper, we show that Inkjet Printing can be successfully applied to external-cavity vertically-emitting thin-film organic lasers, and can be used to generate a diffraction-limited output beam with an output energy as high as 33.6 uJ with a slope efficiency S of 34%. Laser emission shows to be continuously tunable from 570 to 670 nm using an intracavity polymer-based Fabry-Perot etalon. High-optical quality films with several um thicknesses are realized thanks to ink-jet printing. We introduce a new optical material where EMD6415 commercial ink constitutes the optical host matrix and exhibits a refractive index of 1.5 and an absorption coefficient of 0.66 cm-1 at 550-680 nm. Standard laser dyes like Pyromethene 597 and Rhodamine 640 are incorporated in solution to the EMD6415 ink. Such large size " printed pixels " of 50 mm 2 present uniform and flat surfaces, with roughness measured as low as 1.5 nm in different locations of a 50um x 50um AFM scan. Finally, as the gain capsules fabricated by Inkjet printing are simple and do not incorporate any tuning or cavity element, they are simple to make, have a negligible fabrication cost and can be used as fully disposable items. This works opens the way towards the fabrication of really low-cost tunable visible lasers with an affordable technology that has the potential to be widely disseminated

Optimization of a dynamic supply portfolio considering risks and discount’s constraints

Purpose: Nowadays finding reliable suppliers in the global supply chains has become so important for success, because reliable suppliers would lead to a reliable supply and besides that orders of customer are met effectively . Yet, there is little empirical evidence to support this view, hence the purpose of this paper is to fill this need by considering risk in order to find the optimum supply portfolio. Design/methodology/approach: This paper proposes a multi objective model for the supplier selection portfolio problem that uses conditional value at risk (CVaR) criteria to control the risks of delayed, disrupted and defected supplies via scenario analysis. Also we consider discount’s constraints which are common assumptions in supplier selection problems. The proposed approach is capable of determining the optimal supply portfolio by calculating value-at-risk and minimizing conditional value-at-risk. In this study the Reservation Level driven Tchebycheff Procedure (RLTP) which is one of the reference point methods, is used to solve small size of our model through coding in GAMS. As our model is NP-hard; a meta-heuristic approach, Non-dominated Sorting Genetic Algorithm (NSGA) which is one of the most efficient methods for optimizing multi objective models, is applied to solve large scales of our model. Findings and Originality/value: In order to find a dynamic supply portfolio, we developed a Mixed Integer Linear Programming (MILP) model which contains two objectives. One objective minimizes the cost and the other minimizes the risks of delayed, disrupted and defected supplies. CVaR is used as the risk controlling method which emphases on low-probability, high-consequence events. Discount option as a common offer from suppliers is also implanted in the proposed model. Our findings show that the proposed model can help in optimization of a dynamic supplier selection portfolio with controlling the corresponding risks for large scales of real word problems. Practical implications: To approve the capability of our model various numerical examples are made and non-dominated solutions are generated. Sensitive analysis is made for determination of the most important factors. The results shows that how a dynamic supply portfolio would disperse the allocation of orders among the suppliers combined with the allocation of orders among the planning periods, in order to hedge against the risks of delayed, disrupted and defected supplies. Originality/value: This paper provides a novel multi objective model for supplier selection portfolio problem that is capable of controlling delayed, disrupted and defected supplies via scenario analysis. Also discounts, as an option offered from suppliers, are embedded in the model. Due to the large size of the real problems in the field of supplier selection portfolio a meta-heuristic method, NSGA II, is presented for solving the multi objective model. The chromosome represented for the proposed solving methodology is unique and is another contribution of this paper which showed to be adaptive with the essence of supplier selection portfolio problemPeer Reviewe

RCC prolapse causing Aortic regurgitation in a restrictive VSD

The incidence of aortic right coronary cusp (RCC) prolapse in outlet ventricular septal defect (VSD) is reported at 5%- 16%. Detection of RCC prolapse is critical in patients with outlet VSD because this complication may cause permanent aortic regurgitation. Aortic regurgitation occurs due to a poorly supported RCC combined with the venturi effect due to the VSD jet resulting in cusp prolapse. This is an indication for VSD closure even if VSD is small and restrictive.peer-reviewe

THE PSYCHOPATHIC BEHAVIOR OF THE ANTAGONIST IN THE NOVEL THE CUCKOOS CALLING BY ROBERT GALBRAITH

AbstractThis research discusses the psychopathic behaviour of the antagonist, John Bristow, in the novel The Cuckoo`s Calling by Robert Galbraith. This research aims at identifying the characteristics and causes of  psychopathic  behavior of the  antagonist and the impact on others and himself. The research was conducted using descriptive analysis method and psychoanalysis approach. John, who has hurt others without remorse, is not afraid of repeating his crime. He is able to deceive and manipulate others, not to mention coldhearted, and has a lack of emphaty. Strong id and weak superego originating from John's lack of attention and affection from his parents and closest people are the causes of John`s psychophatic behaviour. John`s psychopathic behaviour in turn causes others to suffer and causes himself to lose his family.Keywords : The Cuckoo`s Calling, Psychopathic Behaviour, Superego, Id, Family