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.
Twitter is becoming an increasingly popular platform used by financial analysts to monitor and forecast financial markets. In this paper we investigate the impact of the sentiments expressed in Twitter on the subsequent market movement, specifically the bitcoin exchange rate. This study is divided into two phases, the first phase is sentiment analysis, and the second phase is correlation and regression. We analyzed tweets associated with the Bitcoin in order to determine if the user’s sentiment contained within those tweets reflects the exchange rate of the currency. The sentiment of users over a 2-month period is classified as having a positive or negative sentiment of the digital currency using the proposed CNN-LSTM
... Show MoreThe Innovation Of Knowledge Is An Important And A Key Element In The Progress And Business Excellence Organizations, Therefore Requires Several Elements To Help Create And Implement And Move The Innovation Process Of Knowledge, Including The Strategic Empowerment Associated With The Element Of The Process Of Strategic Momentum Engine Driven Wheel Continuous Dynamic Innovation, And Focused Research Problem By Measuring The Availability Of Strategic Empowerment When Individuals From By Senior Departments And Ways To Help Organizations To Provide Empowerment Commensurate With The Requirements Of Achieving The Goals Of Time And Place Appropriate For The Individual, And The Importance Of Research Stems From The Importance Of The Varia
... Show MoreIn Iraq, government contributions to the public companies have become a very important aspect which contributes to the survival and sustainability of these institutions as it consider one of the main sources of funding, if not it consider the basis of funding.
According to the vital roles assigned to these institutions to follow up, which usually include important activities in the national economy, the research focused on studying the field reality of the method used in evaluating the stock of total production and purchases of goods for the purpose of selling the strategic commodities of the General Company for Grain Trade. As a result, the aim of this study came to came to highlight&n
... Show MorePurpose – The main purpose of this research is to highlight the main role of strategic leadership skills for top managements in accessing to effective management in accordance with the (VUCA Prime) methodology in (VUCA) environment as Miniature virtual environment, which refers to (Volatility), (Uncertainty), (Complexity), and (Ambiguity).
methodology – To achieve the research objective, this study selected the quantitative approach in research design, Questionnaire was used as the main instrument for data collection, the sample comprised the opinion poll (106) individual who functions as a head department. (Structural equation modelling by (Smart Pls3)
... Show MoreThe research aims to identify the factors affecting the customer and their impact desire for market share in a competitive market National Insurance Company, where he was after the tremendous developments that have taken place in the insurance sector, crowded markets, private companies and the intensified competition among those companies on one side and public sector companies, including national insurance company on the other hand, increased attention and study in a big way the customer and the factors influencing the desire. As the national insurance company ascertains its targets once the sale of insurance documents only, but by knowing the tendencies and aspirations of current and prospective customers a way that helps to strengthen
... Show MoreThe aim of the research is to measure the relationship and effect of the application of total production maintenance TPM in the operational strategy, as it is considered one of the most important strategies for the process of restoring production losses because of inefficient equipment. Competitive edge in the global market by upgrading the operational strategies of OS in the application of TPM in those institutions that apply both H-OS-oriented and P-OS-oriented strategies where the strategy has been identified as a critical success factor. The aim of this study is to attempt to consider the application of comprehensive productive maintenance in industrial establishments
The aim of this research is to investigate the skills of the chemistry students from the Ibn Al-Haytham Education college of pure sciences in Baghdad in understanding and constructing graphical representations of data. The research sample consisted of (101) male and female students in their fourth year of study during the 2016-2017 academic year. This sample represents 71% of the total number of students in this group.The research methodology used consisted of two parts relating to 19 issues. The first part is an objective multi choice type of test to measure the student’s skill in selecting the right representation of specific subject graph amongst many provided. The second part concentrated on measuring the student’s skill in construc
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