Periarticular screws: what’s in and what’s out of the joint?

Periarticular hardware placement can be challenging and a source of angst for orthopaedic surgeons due to fear of penetrating the articular surface and causing undue harm to the joint. In recent years, many surgeons have turned to computed tomography (CT) and other intraoperative or postoperative modalities to determine whether hardware is truly extraarticular in areas of complex anatomy. Yet, these adjuncts are expensive, time consuming, and often unnecessary given the advancement in understanding of intraoperative fluoroscopy. We present a review article with the goal of empowering surgeons to leave the operating room, with fluoroscopy alone, assured that all hardware is beneath the articular surface that is being worked on. By understanding a simple concept, surgeons can extrapolate the information in this article to any joint and bony surface in the body. While targeted at both residents and surgeons who may not have completed a trauma fellowship, this review can benefit all orthopaedic surgeons alike.

Off-Label Medication: From a Simple Concept to Complex Practical Aspects

Off-label use of drugs is widely known as unapproved use of approved drugs, and it can be perceived as a relatively simple concept. Even though it has been in existence for many years, prescribing and dispensing of drugs in an off-label regimen is still a current issue, triggered especially by unmet clinical needs. Several therapeutic areas require off-label approaches; therefore, this practice is challenging for prescribing physicians. Meanwhile, the regulatory agencies are making efforts in order to ensure a safe practice. The present paper defines the off-label concept, and it describes its regulation, together with several complex aspects associated with clinical practices regarding rare diseases, oncology, pediatrics, psychiatry therapeutic areas, and the safety issues that arise. A systematic research of the literature was performed, using terms, such as “off-label”, ”prevalence”, ”rare diseases”, ”oncology”, ”psychiatry”, ”pediatrics”, and ”drug repurposing”. There are several reasons for which off-label practice remains indispensable in the present; therefore, efforts are made worldwide, by the regulatory agencies and governmental bodies, to raise awareness and to ensure safe practice, while also encouraging further research.

Pengembangan Titik Miquel Dalam Pada Sebarang Segilima

The Miquel theorem is a theorem that applies to a triangle, namely the inner Miquel theorem and the outer Miquel theorem triangles—then developed on the quadrilateral. As of this writing, it is developed in any of the pentagons. Miquel's theorem development in any pentagon is divided into two cases, namely in the convex and non-convex pentagons. This process begins with the construction of the inner Miquel point in any triangle using the GeoGebra application. While proving the internal Miquel theorem for any pentagon uses a simple concept, namely the concept of circles and cyclic rectangles so that five circles intersect at a point called the inner Miquel point at any pentagon.

Beyond First Love

The theme of this final chapter (no greater love) is the simple concept that, if the human species really cherishes this beautiful world, it will gladly give anything to save it. Instead, this species puts itself first, and holds that the “commercial prosperity” of just one vain and merciless species is more important than the biological survival of every other species. But imagine a people who sacrificed their kind to save life itself from perishing. Isn't that a purpose worth setting aside global differences? Imagine perhaps the idea of no greater love is about to find a place in an imprescriptible history that illiterate kinds will benefit from forever. This species, more than any other species, may join together as one humble and reverent kind and make every effort toward saving this beautiful planet from its longitudinal yet incidental myopia.

The psychology of regions

There exists today a large consensus among scholars of different disciplines that regions are more than a geographical concept and that they are socially constructed. This implies that somehow people must play a role in the emergence of a region as an entity of governance and as a source of identity. But the relation between regions and the socio-psychological processes that constitute them remains unclear. This article aims to clarify what the social construction process of a region means and what kind of psychological processes play a role in it as well how such social construction relates with how regions contribute to people’s identity formation. For this theoretical exercise, use will be made of the so-called Vygotsky scheme that distinguishes between four different conversational spaces.Resumen: Hoy en día existe un gran consenso entre los estudiosos de las diferentes disciplinas de que las regiones son más que un concepto geográfico y que están construidas socialmente. Esto implica que las personas deben desempeñar un papel en el surgimiento de una región como entidad de gobierno y como fuente de identidad. Pero la relación entre las regiones y sus procesos socio-psicológicos constituyentes sigue siendo vaga. Este artículo pretende aclarar qué significa el proceso de construcción social de una región y qué tipo de procesos psicológicos ocurren en él, y también cómo dicha construcción social se relaciona con cómo las regiones contribuyen a la formación de la identidad de las personas. Se utilizará el esquema de Vygotsky que distingue entre cuatro espacios de conversación.Résumé: Il est aujourd’hui largement reconnu au sein de différentes disciplines que les régions sont plus qu’un simple concept géographique et qu’elles sont socialement construites. Cela implique que les individus doivent jouer un rôle dans l’émergence d’une région en tant qu’entité de gouvernance et source d’identité. Mais la relation entre les régions et les processus socio-psychologiques qui les constituent reste floue. Cet article vise à clarifier le sens exact du processus de construction sociale d’une région et quels types de processus psychologiques y jouent un rôle, ainsi que la relation entre cette construction sociale et la façon dont les régions contribuent à la formation de l’identité des personnes. Pour cet exercice théorique, nous utiliserons le schéma dit de Vygotsky qui distingue quatre espaces conversationnels différents.