Background: Ruptured posterior communicating artery (PCoA) aneurysms are common; they usually present with subarachnoid haemorrhage (SAH) and oculomotor nerve palsy. The aneurysmal dome projection may influence the safety access and aneurysmal neck clipping. Here, we discuss additional intraoperative steps that may be required to widen the surgical field to ensure safe surgical clipping of a rupture pure posteriorly directed PCoA aneurysm. Case description: A previously healthy 38-year-old male reported sudden severe headache and disturbed level of consciousness with a Glasgow coma scale (GCS) of 13. His initial computed tomography (CT) scan of the head showed SAH in the basal cistern. 3D-constructed CT angiography (CTA) revealed a left pure posteriorly directed PCoA aneurysm. In the surgery, through the left pterional approach, all intraoperative steps were carried out. Additional steps were performed as well. Three additional intraoperative steps were contemplated because a pure posteriorly directed PCoA aneurysm is not well appreciated and is often hidden behind the supra cliniold internal carotid artery (ICA). First, the extension of Sylvian fissure dissection to include the distal part and the proximal. Second, temporal pole mobilization is performed by cutting small anterior temporal veins. Third, a brain retractor is placed on the temporal lobe to gently tract the superficial part of the lobe. All these steps widened the surgical corridor to ensure the aneurysm's safe clipping. Conclusion: Surgical clipping is influenced by the aneurysmal dome projection. In a ruptured pure posteriorly directed PCoA aneurysm, further intraoperative steps may facilitate complete access and safe clipping of the aneurysm.
This paper aims at studying the illocutionary speech acts: direct and indirect to show the most dominant ones in a presidential speech delivered by the USA president. The speech is about the most critical health issue in the world, COVID-19 outbreak. A descriptive qualitative study was conducted by observing the first speech delivered by president Trump concerning coronavirus outbreak and surveying the illocutionary acts: directive, declarative, commissive, expressive, and representative. Searle's (1985) classification of illocutionary speech acts is adopted in the analysis.
What are the main types of the illocutionary speech acts performed by Trump in his speech?; Why does
... Show MoreBackground: The problem of difficult gallbladder is not clearly defined and associated with real missing of therapeutic approaches that decreased morbidity. Moreover, the difficult gallbladder was reported as a contributing risk factor for biliary injury due to raised difficulty in surgical dissection within Calot’s triangle. The aim of this study is to determine the surgical outcomes of the open fundus-first cholecystectomy in lowering the rate of lethal intraoperative risks.
Subjects and Methods: Our prospective study conducted during the period of January 2019 to December 2022 at Ibn Sina specialized hospital, Khartoum, Sudan, for two hundred and fifty-three patients underw
... Show More<span lang="EN-US">In the last years, the self-balancing platform has become one of the most common candidates to use in many applications such as flight, biomedical fields, and industry. In this paper, the physical prototype of a proposed self-balancing platform that described the self-balancing attitude in the (X-axis, Y-axis, or biaxial) under the influence of road disturbance has been introduced. In the physical prototype, the inertial measurement unit (IMU) sensor will sense the disturbance in (X-axis, Y-axis, and biaxial). With the determined error, the corresponding electronic circuit, DC servo motors, and the Arduino software, the platform overcame the tilt angle(disturbance). Optimization of the proportional-integral-
... Show MoreThe consumption of fresh fruits has increased nowadays due to the lifestyle of the consumers. Maintaining the quality and nutritional value of cut fruits during storage is difficult compared to whole fruits. Deterioration of internal and external quality usually occurs in freshly harvested fruits. It is necessary to use different techniques to maintain the quality and increase the shelf life of the freshly cut product. This research studied the effect of treating apple slices with cold plasma once and with filtered water again on quality characteristics (hardness, moisture content, sugar content, carbohydrate content, and color) after being stored for five days. The best treatment was determined using two different pressures of the plasma j
... Show MoreIn this research, a study is introduced on the effect of several environmental factors on the performance of an already constructed quality inspection system, which was designed using a transfer learning approach based on convolutional neural networks. The system comprised two sets of layers, transferred layers set from an already trained model (DenseNet121) and a custom classification layers set. It was designed to discriminate between damaged and undamaged helical gears according to the configuration of the gear regardless to its dimensions, and the model showed good performance discriminating between the two products at ideal conditions of high-resolution images. So, this study aimed at testing the system performance at poo
... Show MoreIn this research, a study is introduced on the effect of several environmental factors on the performance of an already constructed quality inspection system, which was designed using a transfer learning approach based on convolutional neural networks. The system comprised two sets of layers, transferred layers set from an already trained model (DenseNet121) and a custom classification layers set. It was designed to discriminate between damaged and undamaged helical gears according to the configuration of the gear regardless to its dimensions, and the model showed good performance discriminating between the two products at ideal conditions of high-resolution images.
So, this study aimed at testing the system performance at poor s
... Show MoreAbstract
The current research problem includes a variety of research motivations to serve the private health sector, which is witnessing a great competition from internal and external environments. In this regard, private medical clinics are increasingly seeking to attract and retain customers through the quality of their service offerings represented by health services. Innovative and effective marketing methods to improve performance and stay in competition, by relying on the physical evidence of the product as a component of the marketing mix of services and its role in particular in packaging and supporting the health service with concrete evidence that affects the customer an
... Show MoreThe aim of the research is to measure the length between the variable the efficiency of the tax examiner with its dimensions represented by (scientific questions, practical process (experience), training and development, impartiality and independence, ethics of the profession) and the approved variable discovering the artificial adaptation of profits, and the degree of arrangement of those dimensions its importance and priority, and the research problem has been identified In a main question that is there any effect of copying the images of the image examiner in discovering the adaptation, the financial statements and reports of the companies (X, Y) and the banks (A, B) were relied on in the interpretation of the results, t
... Show More