bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emergent carotid artery stenting for cervical internal carotid artery injury during carotid endarterectomy: A case report
Authors: Takahashi Toshihide , Ikeda Go , Igarashi Haruki , Konishi Takahiro , Araki Kota , Hara Kei , Akimoto Ken , Miyamoto Satoshi , Shiigai Masanari , Uemura Kazuya , Ishikawa Eiichi , Matsumaru Yuji 
Published: March 2021

Background:
Carotid endarterectomy (CEA) has been the standard preventive procedure for cerebral infarction due to cervical internal carotid artery stenosis, and internal shunt insertion during CEA is widely accepted. However, troubleshooting knowledge is essential because potentially life-threatening complications can occur. Herein, we report a case of cervical internal carotid artery injury caused by the insertion of a shunt device during CEA.

Case Description:
A 78-year-old man with a history of hypertension, diabetes, and hyperuricemia developed temporary left hemiplegia. A former physician had diagnosed the patient with a transient cerebral ischemic attack. The patient’s medical history was significant for the right internal carotid artery stenosis, which was severe due to a vulnerable plaque. We performed CEA to remove the plaque; however, there was active bleeding in the distal carotid artery of the cervical region after we removed the shunt tube. Hemostasis was achieved through compression using a cotton piece. Intraoperative digital subtraction angiography (DSA) revealed severe stenosis at the internal carotid artery distal to the injury site due to hematoma compression. The patient underwent urgent carotid artery stenting and had two carotid artery stents superimposed on the injury site. On DSA, extravascular pooling of contrast media decreased on postoperative day (POD) 1 and then disappeared on POD 14. The patient was discharged home without sequela on POD 21.

Conclusion:
In the case of cervical internal carotid artery injury during CEA, hemostasis can be achieved by superimposing a carotid artery stent on the injury site, which is considered an acceptable troubleshooting technique.
Development of electronic document management system in tax authorities
Authors: Bratarchuk T. V. , Milkina I. V. 
Published: March 2021

Currently, an electronic document management system has been widely implemented in the practice of tax authorities, which allows you to reduce time and labor costs for processing and preparing documents; to provide operational services to the population; to ensure the availability and openness of information to the public about the activities of tax authorities, as well as services provided by tax authorities; to reduce the cost of interaction between the population and tax authorities. However, despite the automation of office work, a number of unresolved problems remains in the field of document management of tax authorities.The relevance of this study is that the main problems of the tax authorities are a large number of routine manual operations performed by employees, as well as a large volume of incoming documents that are received by the tax authorities. The creation of documents, as well as their storage, transmission and search for such documents require significant labor, time and financial costs. That is why recently tax inspections have been working on a comprehensive automation of the inspection’s activities by introducing a system for processing and accounting documents, which will allow you after a while to abandon documents and information presented on paper.The study analyses the electronic document management systems used in the practice of public administration, describes the advantages and disadvantages of each system. The paper also analyses the features of the document management process in the tax authorities. Based on the conducted research, the authors propose the introduction of a modern domestic system built on the “Logic of SED”-platform. This system is aimed at improving the efficiency of work in various areas of joint activity of employees of the organization in terms of automation of project document flow and the possibility of collective work.
Percepción de los afrodescendientes e indígenas sobre inclusión y racismo en la televisión ecuatoriana
Authors: Estrella-Tutivén Ingrid Viviana 
Published: March 2021

Este trabajo tiene como objetivo elaborar una propuesta comunicativa que contribuya a mejorar los comportamientos de la televisión nacional, respecto al tema de la inclusión e igualdad social, se tratará de analizar cómo la Ley Orgánica de Comunicación intenta que los mass media respeten los derechos de las minorías raciales conculcados por siglos. La investigación además aporta con la educación de las comunidades afroecuatorianas e indígenas, comunidades a las que va dirigida. Esta propuesta lo que ofrece es la inclusión de estas razas en espacios televisivos sin fomentar la discriminación ni el racismo y trata de buscar la unión de etnias y enseñar los sucesos del proceso de inclusión en la nación. A lo largo del estudio de este proyecto de titulación, el lector reconocerá de qué manera ha sido incluido gradualmente el afroecuatoriano y el indígena en el país, y cómo se forjó la historia de los comunicadores, periodistas o reporteros afros e indígenas en otras partes del mundo. Para realizar el presente estudio se tomó una muestra no probabilística por conveniencia compuesta por 15 personas indígenas, que trabajan en mercados de la ciudad de Guayaquil; y, 15 personas afrodescendientes, que viven en Guayaquil, por diferentes motivos. Ellos fueron encuestados con el fin de saber si perciben que en la televisión ecuatoriana discriminan a las personas de sus razas. Además, se les preguntó si la Ley Orgánica de Comunicación ha contribuido para que esta discriminación vaya disminuyendo progresivamente. Sus respuestas son valiosas aportaciones en la lucha contra la marginación social que sufren indígenas y afrodescendientes en el Ecuador.
Importancia del branding para consolidar el posicionamiento de una marca corporativa
Authors: Maza-Maza Ronald Leodan , Guaman-Guaman Benito Danilo , Benítez-Chávez Alexandra Margarita , Solis-Mairongo Gustavo 
Published: March 2021

Este artículo realza la importancia del branding para consolidar el posicionamiento de una marca corporativa. El presente estudio fue aplicado a los usuarios del Consultorio Fisioterapéutico KAMB y a una muestra de habitantes cercanos a la entidad, con la finalidad de conocer los criterios de percepción que ellos tienen sobre la marca. La problemática consiste en que el consultorio tiene una identidad visual que se creó de manera empírica y bajo la presión de tener un nombre comercial, además hay un escaso profesionalismo en el manejo de la marca, puesto que su logotipo y estructura publicitaria no concibe la esencia de la empresa. Por ello, el objetivo general es analizar la importancia de la renovación de una marca corporativa para el Consultorio Fisioterapéutico KAMB de la ciudad de Manta, mediante el uso de recursos estratégicos de branding que permitirá proyectar su posicionamiento en el mercado. Por esta razón se realizó una investigación de tipo cuantitativa, aplicando la técnica de la encuesta que estuvo divida en dos secciones; una para los pacientes y otra para los ciudadanos. Según los resultados arrojados por la investigación, existe un mínimo posicionamiento donde la gran mayoría de personas encuestadas, dicen no reconocer la marca, a más de ello, los usuarios y la población consideran contundentemente que esta debe pasar por un proceso de renovación, para que se diferencie de la competencia y al mismo tiempo se convierta en algo fresco, innovador, expresivo e interactivo, que tenga presencia, reconocimiento y estética visual, puesto que la actual no representa estas características. Es necesario que se plantee una estrategia de branding para proyectar, fortalecer y darle valor a la marca.
La producción agrícola de la paja toquilla en Ecuador, el flujo productivo artesanal y la formación de precios
Authors: Mederos-Machado María Caridad , Balmaseda-Espinosa Carlos Eloy , Suárez-Yagual Denisse Tatiana , Paula-Chica Maritza Gisella 
Published: March 2021

La paja toquilla o Carludovica Palmata se cultiva en zonas montañosas como en la Costa y Oriente por ser zonas donde el clima es húmedo. Es una especie de palmera (de tejido fibroso), crece en forma silvestre en los bosques tropicales de las regiones Occidental y Oriente, y en zonas ubicadas a una altitud promedio de 100 a 180 metros. La diversidad de este cultivo no ha tenido expansión a otros lugares del país, por no poseer las características climáticas que este necesita. La paja toquilla, juega un papel importante en la economía de diversos grupos o asociaciones establecidas a nivel nacional, constituyendo en una fuente de ingreso para cada una de las familias. El objetivo del presente artículo es realizar una caracterización socio-productiva de la producción de paja toquilla, especialmente el flujo productivo artesanal y análisis de los elementos que intervienen en la formación de los precios de esta materia prima usada en la confección del sombrero, patrimonio de la humanidad y otros productos de consumo. Mediante instrumentos de investigación como la encuesta, la observación y la entrevista se puso llegar a conclusiones logrando establecer los nuevos diagramas de flujo de la producción artesanal de la paja toquilla, así como la formación del precio. En conclusiones, se obtiene un diagnóstico que permite tomar decisiones en la comuna.
Use Of E-Learning To The Effectiveness Of Students In Coronavirus Pandemic
Authors: Fiddin Fachroh , Bustami Bustami 
Published: March 2021

Abstract. This research aims to determine the effectiveness of student learning in the coastal areas of the island of Sumatra at the time of the Covid-19 virus pandemic using e-learning. The respondent is an accounting student at the state Polytechnic in Bengkalis where almost all students live in the coastal areas of the island and differ from those in urban areas.
The variables examined the perception of benefits, perception of ease, and quality of service towards the use of e-learning and the effectiveness of student learning. The results showed a perception of benefits and quality of service impacting the use of e-learning and the effectiveness of student learning. While the perception of simplicity does not affect the use of e-learning and the effectiveness of student learning.
The results of research using track analysis show that variable perception of benefits and quality of service affects the effectiveness of learning through the use of e-learning as a mediation variable. While the variable perception of ease has no influence on the effectiveness of student learning through the use of e-learning as a mediation variable.
Sekolahku bukan pilihanku
Authors: Nugraha Aditya Dedy 
Published: March 2021

Sistem zonasi dirancang Kementerian Pendidikan agar penerimaan siswa didik baru merata, lebih terbuka, mengurangi diskriminasi dan meningkatkan kemudahan akses bagi semua siswa. Mekanisme yang telah dilaksanakan sejak 2017 ini, setiap tahun selalu menjadi sorotan. Pelaksanaan baik maupun secara daring maupun luring memunculkan celah kekhawatiran dan ketidakpuasan terhadap sistem penerimaan yang ada. Tidak jarang siswa yang berprestasi tidak bisa diterima di sekolah pilihannya akibat dampak sistem ini. Perasaan kecewa, sedih dan permasalahan psikologis yang dialami siswa akibat gagal masuk sekolah impiannya sering kali kurang mendapat penangan dari sekolah ataupun dinas terkait. Tujuan dari penelitian ini guna mengungkap bagaimana dinamika psikologis dan proses penerimaan diri (self acceptance) siswa yang belum berhasil masuk sekolah impiannya. Pengumpulan data menggunakan metode wawancara secara mendalam (indepth interview) terhadap subjek utama penelitian yaitu dua orang siswa serta beberapa significant others yang dapat memperkaya data penelitian. Analisis data menggunakan metode analisis isi didalam pendekatan kualitatif. Hasilnya menujukkan bahwa proses penerimaan diri pada siswa ini, membutuhkan dukungan dari orang tua dan teman sebaya. Peneliti berharap agar peneliti selanjutnya untuk memperluas ranah penelitian sampai dengan pengaruhnya terhadap prestasi belajar siswa tersebut.Kata kunci ; Penerimaan diri, zonasi, psikologi, pendidikan
The European Society for Clinical Nutrition and Metabolism practical guideline: Clinical nutrition in liver disease
Authors: Bischoff S. C. , Bernal W. , Dasarathy S. , Merli M. , Plank L. D. , Schütz T. , Plauth M. , Skrypnyk I. , Shvets O. 
Published: March 2021

The Practical guideline is based on the current scientific ESPEN guideline on Clinical Nutrition in Liver Disease (Plauth M., Bernal W., Dasarathy S., Merli M., Plank L. D., Schütz T., Bischoff S. C. ESPEN guideline on clinical nutrition in liver disease // Clin Nutr. — 2019. — 38. — Р. 485—521). It has been shortened and transformed into flow charts for easier use in clinical practice.
The guideline is dedicated to all professionals including physicians, dieticians, nutritionists and nurses working with patients with chronic liver disease. A total of 103 statements and recommendations are presented with short commentaries for the nutritional and metabolic management of patients with (i) acute liver failure, (ii) alcoholic steatohepatitis, (iii) non-alcoholic fatty liver disease, (iv) liver cirrhosis, and (v) liver surgery/transplantation. The disease-related recommendations are preceded by general recommendations on the diagnostics of nutritional status in liver patients and on liver complications associated with medical nutrition. This practical guideline gives guidance to health care providers involved in the management of liver disease to offer optimal nutritional care.
The mystery of Gogol’s death
Authors: Gubergrits N. B. , Borodiy K. M. , Lukashevich G. M. , Byelyayeva N. V. , Klochkov A. Ye. 
Published: March 2021

The circumstances of the illness and death of the great writer Nikolai Vasilyevich Gogol are surrounded with riddles and mysticism. Gogol’s abdominal pain disturbed him throughout his life. He was referring to doctors with complaints of breakdown and pain in different parts of his abdomen. Doctors made assumptions of «catarrh of the intestines», which turned into «typhus», the unfavorable course of gastroenteritis and «indigestion» complicated by «inflammation». The writer himself believed that he had an incurable disease, calling it «the devil sitting in his belly». In his last days, Gogol refused food, water and communication, weakened to the limit both morally and physically. One of the doctors found only «catarrh of the intestines», another one diagnosed inanitione ex gastroenteritis (?). The invited doctors noted the state of extreme exhaustion in the absence of fever and any somatic disease. The consilium offered various medical manipulations — from bloodletting to hypnosis and forced feeding. However, leeches, dousing with cold water, mustard plasters, mercury preparation etc. didn’t help him. He lost consciousness and stopped breathing by morning. An autopsy was not performed, that’s why various hypotheses about his death appeared. Gogol’s death is shrouded in myths that the grave was opened twice; that his skull was removed from the coffin during the second burial; that the body in the coffin was in a half‑bent position, etc. The reason for the popular hypothesis of lethargic sleep was Gogol’s testament, in which he asked to bury him only after the appearance of obvious signs of decay. However, the lethargic sleep of the great writer was impossible, at least because of the technology for making the death mask. Many doctors were inclined to consider Gogol’s complaints as a manifestation of hypochondria. However, the renowned oncologist surgeon P. A. Herzen concluded by describing the symptoms of the disease: the writer died of pancreatic cancer. This explains Gogol’s sharp weight loss («the spine was palpated through the stomach») and a complete rejection of food due to the inability to swallow even a small piece. Severe cachexia is typical for patients with pancreatic cancer. Contemporary medical experts held several analytical meetings and drew conclusion that Gogol’s progressive disease with possible development of pancreatic cancer proceeded from pancreatitis.
Memorialising and Commemorating Traumatic Past: Diary of a Guerrilla Girl
Authors: Pokharel Badri Prasad 
Published: March 2021

This article makes an attempt to analyze Tara Rai’s Chhapamar Yubatiko Dayari (The Diary of a Guerrilla Girl) with the help of trauma theory. It is a memoir which unfolds many hidden parts of a combatant as his/her testimony to signify the traumatic memory. Past events related to war and conflicts always bring a horrible consequence to the survivors who, if anything can, remember these historical events as an act of witnessing the painful traumatic events as a psychological need and a social duty to reminisce those who died in the battle. Testimony, expressed about those events would bring afore the facts which, otherwise, may not be known. In doing so, I have used the critical insights of Caruth and other trauma theorists to illustrate the historical role in understanding the psychological response to war trauma in the form of testimony. It is important to elucidate the social factors which play a pivotal role in psychological understanding and building together to develop the concept of the personal narrative.
Clinical assessment of impacted lower third molars at Ekpan, Delta State in Nigeria
Authors: Etetafia Mabel Okiemute , Anibor Ese , Obaroefe Martins 
Published: March 2021

Introduction: Diagnosis and management of impacted mandibular third molars call for a cogent appraisal and treatment choice both for the sick person and the dental practitioner. This academic work scrutinized the pattern as well as treatment of impacted mandibular third molars at the Teem Clinic and Dental Centre, Ekpan, Delta State, in Nigeria.Materials and Methods: This cross-sectional survey involved 131 cases who reported impacted mandibular third molars. The age, gender, impacted tooth, type of impaction, pathological conditions, and treatment proffered were recorded.Results: The male to female ratio was 0.8:1, with an age range of 10 to 40 years. Of the lower third molar impactions 58 (42.0%) were mesioangular, 5 (3.6%) horizontal, 18 (13.0%) vertical and 57 (41.3%) were distoangular. A total of 47 (34.1%) quested for dental attention following varying degrees of pain induced by pericoronitis. Teeth removal was accomplished for 76 (55.0%) owing to carious lesions on the impacted teeth, proximate tooth, or both. Surgical extraction was the option taken in 69 (50.0 %) with caries on the impacted teeth while 3 (2.2%) had to pull out of their teeth done owing to carious lesions on the bordering second molars. In 3 (2.2%) both the impacted third molar and the proximate second molar were decayed. Conclusions: The prevailing indication for pulling out impacted mandibular third molars was acute pericoronitis. Mesioangular sort of impaction was most recurrent and ought to be considered for theplausibility of frequentness of complications.
Microbiome in Health: Establishment, Metabolism, Immunity and Neuronal Pathway
Authors: Ojezele Matthew Obaineh , Ovuakporaye Simon Irikefe , Adedapo Emmanuel Adesola 
Published: March 2021

The studies on microbiome encountered a blast, lately, as scientists become mindful of the role of microbiota in the advancement of specifi c kinds of maladies. The human microbiome is described as a community of microorganisms of different taxa colonizing the human body; this includes the metagenomics and metabolomics of these organisms. Humans have customized microbiome in terms of distribution and composition which are partly determined by host genotype as well as the initial colonization which takes place after delivery. The human gut microbiome has a vital infl uence on immunity and how it responds to body signals, which is very important for the lymphoid tissue growth, maintenance, and regulation of intestinal immunity. This review aimed at providing an overview of the role of the human microbiome in health spanning the development of the microbiome in utero to postnatal period.
Audiology and Speech-Language Pathology Services in Pediatric Population During COVID Pandemic in Nepal
Authors: Bhatarai Prabuddha , Bhattarai Biraj , Karna Sureshwor Lal 
Published: March 2021

The pandemic has affected the daily working of people worldwide, including Audiology and speech languageservices. The Audiology and speech-language pathology services require proximity to the patients and hence increases the risk for transmission of the virus. These services are required during this time are immense to utilize a critical period of language development. Teleservices are a suitable option to assess and rehabilitate the client at this time. In a country like Nepal, where limited professionals are working in this fi eld, telehealth not only reduces transmission risk but also could be useful for patients who cannot attend clinics regularly due to the unavailability of services near their reach. The Speech and Hearing Association and all professionals working in this field should be ready to accept the changes that will eventually lead to the growth of the fi eld and the reach of the services for the patients in need.
Doctor-Patient Communication for Adherence to Hypertension Treatment in Nepal
Authors: Sah Ram Kishor , Khanal Hari Har , Shrestha Deepak Sundar , Paudel Bishnu Dutta , Gautam Roshani , Straus Andrea M , Love Richard R. 
Published: March 2021

Effective doctor-patient communication is key to addressing the signifi cant issue of nonadherence to hypertension treatment in Nepal. Common clinical messages about hypertension are evaluated utilizing the framework of the Common-Sense Model of Self-Regulation for their role in shaping the patient models that underlie nonadherent behavior. Clinical communications and practices are recommended: to respectfully elicit and address patient reliance on self-identifi ed symptoms; to accompany warnings of hypertension’s serious consequences with specifi c individual action-plans for durable effects; to emphasize the necessity of long-term continuous treatment without creating fears of dependence and withdrawal effects or burdensome monitoring and counseling; to inform of side-effects while presenting medication as nontoxic and necessary for the body’s maintenance of a healthy balance. By acknowledging the patient as an active agent engaged in self-regulation and by employing culturally consonant concepts (often Ayurvedic), we can encourage accurate patientillness and treatment representations that guide medication adherence.
Percutaneous Nephrolithotomy and Horseshoe Kidneys
Authors: Basnet Robin Bahadur , Shrestha Anil , Shrestha Parash Mani , Joshi Biswa Raj 
Published: March 2021

Introduction: The most common fusion anomaly, horseshoe kidney, is associated with vascular anomalies, malrotation, anterior displacement of the collecting system, superior insertion of ureter into the pelvis, and a higher rate of ureteropelvic junction obstruction; thus increasing the chances of nephrolithiasis. We present our experience with percutaneous nephrolithotomy in this anomaly.Materials and Methods: A retrospective study of all the percutaneous nephrolithotomy performed by standard technique within four years at Bir Hospital was made. A comparison was made with similar cases with the anatomically normal location of the kidney. Intraoperative variables were recorded and postoperative stonefree status and complications were evaluated.Results: Six hundred and twenty-seven patients out of 691 who had undergone percutaneous nephrolithotomy in this period were included. Patients with nephrolithiasis in horseshoe kidney were younger, the incidence of multiple stones was more; without full staghorn calculus and occupying fewer calyces. Upper pole access was easier, a stone clearance of 85.42 % was achieved with no major complications in the horseshoe kidney.Conclusions: Percutaneous access and nephrolithotomy are safe in horseshoe kidney with a good stone clearance rate.