Introduction: Despite the availability of numerous treatment options, managing unstable proximal humeral fractures remains a significant surgical challenge. Utilizing a PHILOS plate is an effective surgical technique for addressing these fractures. This approach provides stability and support to the fracture site, promoting proper healing and potentially improving patient outcomes. Aim of the study: The aim of this study was to assess the functional outcome of PHILOS plate fixation in proximal humerus fractures. Methods: This prospective study was conducted in the the Department of Orthopedic Surgery, National Institute of Traumatology and Orthopedic Rehabilitation (NITOR), Sher-e-Bangla Nagar, Dhaka, Bangladesh during the period from January 2009 to December 2010. A total of 80 patients aged over 18 years were included in the study. Patients with open, pathological and ipsilateral distal fractures in the same limb were excluded from the study. Result: The youngest and the oldest one were 23 and 78 years respectively. Majority of the patients were male and business was their main occupation. Fifty patients (62.5%) presented with 3-part fractures, ten (12.5%) with four-part fractures and twenty (25%) with fracture dislocation. The interval between injury and plate fixation was 18 days and minimum and maximum interval was 2 and 78 days respectively. Majority (92.5%) of the injury was caused by high-velocity accident. Evaluation of the outcome at 6 months showed that 62.5 percent of patients had good outcome, 25 percent patients had fair outcome. Conclusion: PHILOS plate fixation for proximal humeral fractures provides stable fixation and good functional outcomes, particularly in elderly patients.

Neurofibromatosis type 1 (NF1) is an autosomal dominant neurocutaneous disorder, while multiple sclerosis (MS) is a prevalent chronic inflammatory demyelinating disease of the central nervous system. The coexistence of these two conditions is rare. Thus, patients with NF1 may exhibit signal abnormalities on brain imaging, referred to as focal areas of signal intensity (FASI), which can mimic lesions seen in MS and complicate the differential diagnosis. We present the case of a female patient suffering from progressive paraparesis, accompanied by urinary disorders and coordination disorders of the upper limbs. Neurological examination revealed a pyramidal syndrome and a cerebellar syndrome, with an Expanded Disability Status Scale (EDSS) score of 7.5. Additionally, the skin examination showed multiple café-au-lait spots larger than 15 mm and numerous diffuse neurofibromas. Brain magnetic resonance imaging showed white matter lesions typical of MS, and isoelectrofocalization of cerebrospinal fluid proteins revealed positive oligoclonal bands. The diagnosis was primary progressive multiple sclerosis associated with neurofibromatosis type 1. The aim of this case report is to document the association of these two conditions and discuss the challenges in differential diagnosis and treatment, as early diagnosis of MS is crucial to prevent further disability in patients with NF1.

Education passages are a frequent focus in the “Careful Reading” section of CET-4, posing significant challenges for examinees. As an important aspect of sentence structure and discourse analysis, thematic progression patterns are crucial for understanding passages and solving test questions. This article, using the six thematic progression patterns proposed by Huang Guowen as a framework, explores the distribution characteristics, ways of their realization, and practical assistance of these patterns for examinees in education passages in the CET-4’s “Careful Reading”. This article finds that: (1) centralized pattern and extending pattern appear with higher frequency in education passages of CET-4’s “Careful Reading”, making them the two primary patterns; (2) the realization of thematic progression patterns in these passages are diverse and often used in combination, enhancing the coherence and logic of the passage, enriching expression, highlighting key points, and improving the overall quality and readability of the passage; (3) this study uses examples of detail question and inference question to demonstrate that thematic progression patterns can help examinees efficiently solve questions, aiming to provide targeted reading and answering strategies for examinees, thereby improving their reading comprehension and exam performance.

Aquasomes are considered an excellent and efficient carrier system for the transport of drugs or biochemically active long chain macromolecules such as proteins and peptides, various hormones, antigens, enzymes, and genes in the recently burgeoning field of nanobiotechnology research. These are three-layer self-collecting structures composed of an oligomeric film covering a strong stage nanocrystalline centre to which biochemically dynamic particles adhere to, independent of changes in the environment and which self-assembles through non-covalent or ionic connections. Aquasomes are circular particles, 60–300 nm in size, that are used to deliver antigens and medications. The structural stability is provided by the solid core, while the active drug molecules are stabilized and protected from dehydration by the polyhydroxy oligomer covering. The most common way to distribute aquasome formulations is parenterally, however recent research indicates that there may be additional, oral, ways as well. A combination of targeted molecular shielding and prolonged release mechanism is used by aquasome to deliver their bioactive chemicals. The present paper offers an overview of the aquasome as a potentially useful medication delivery technique. It covers every facet of aquasome, such as their structure, the processes for preparing them, ways to characterize them, and medical uses as a drug delivery system.

This paper explores the Head teachers’ motivational skills on learners and teachers in influencing performance in Public Primary Schools in Uriri Sub-County. Using correlational methodology and survey techniques, the study investigates how motivational practices of School Head teachers’ influence learners’ motivation, subsequently affecting the performance outcomes of pupils within the school. The study population comprises of Head teachers and teachers from Public Primary Schools in Uriri Sub-County, Kenya. Questionnaires were developed and validated for both Head teachers and teachers, focusing on motivational approaches. Data analysis involved descriptive statistics and Pearson correlation. Findings indicate a positive correlation between effective practices by Head teachers and teacher motivation levels on learners’ academic. Additionally, teacher motivation has been linked to improved performance outcomes among both educators and students. This research contributes to understanding the critical role of school Head teachers’ motivational approaches in shaping educational outcomes. By elucidating the dynamics of motivational approaches, insights for better educational practices are enhanced for a conducive learning environment.

The aim of the research is to identify land that can be designated as abandoned land and analyze the form of management that can be carried out on land that has been designated as abandoned land so that it has useful value. The method used in this research is a qualitative descriptive research type with an empirical normative approach using secondary data through descriptive study and analysis of statutory regulations and related literature. The land rights that are the object of abandoned land are land ownership rights, building use rights, business use rights, use rights, management rights, and land obtained based on the basis of land control. These rights lands have criteria to be identified as abandoned land, namely Freehold land becomes the object of control over Abandoned Land if it is intentionally not used, not exploited, and/or not maintained so that: a) it is controlled by the community and becomes a village area; b) controlled by another party continuously for 20 (twenty) years without any legal relationship with the Rights Holder; or the social function of Land Rights is not fulfilled, whether the Rights Holder still exists or no longer exists. Land with building use rights, use rights and management rights becomes the object of control over abandoned land if it is intentionally not cultivated, not used, not exploited and/or not maintained starting 2 (two) years from the issuance of the rights. Then land with land use rights becomes the object of controlling abandoned land if it is intentionally not cultivated, not used, and/or not exploited starting from 2 (two) years from the issuance of the right. And land obtained based on the Land Tenure Basis becomes the object of controlling abandoned land if it is intentionally not cultivated, no used, not used, and/or not maintained starting from 2 (two) years from the issuance of the Basic Land Control. Management of abandoned land that has been designated as State land is carried out through the utilization of abandoned land. Article 35 of PP Number 20 of 2021 regulates that the utilization of TCUN is intended for agricultural and non-agricultural purposes in the interests of society and the State. Utilization of abandoned land through agrarian reform, national strategic projects, land banks and other state reserves.

Agricultural crops face a major issue in the form of salinity. It causes injuries to plants by causing accumulation of Na+ and Cl- ions, which leads to nutrient imbalance and ultimately low yield. It also causes fluctuations in physiological processes, which destabilize the uptake and distribution of nutrients in crops. Sunflower (Helianthus annuus L.) is the 2nd ranked oilseed crop after soybean. Sunflower possesses high oil content (42-50%) and protein content (15-20%), which makes it one of the most valuable oil crops. Exogenously applied K+ significantly enhance all morphological and physiological parameters. K+ is also member of triad group of nutrients for plants including N and P. In current study effect of foliar application of K at 500 ppm were examined on growth, biochemical and physiological attributes of sunflower hybrid L-16003 grown under saline conditions. Data was recorded for various growth, biochemical and physiological parameters of plants. Analysis of data revealed that salinity adversely affected gas exchange parameters which resulted in reduced growth and yield of sunflower. Exogenous foliar application of K significantly improved gas exchange attributes such as stomatal conductance, CO2 assimilation, transpiration rate and water use efficiency. It also enhanced chlorophyll pigments which resulted in increase of photosynthetic rate ultimately leading to healthy growth of plants grown under saline conditions. Root length, shoot length, plant fresh weight, dry weight and achenes weight were also increased by foliar application of K. Overall, foliar application of K significantly improved all attributes of sunflower and helped to alleviate harmful effects of salinity.

This article explores the concept of out-of-field teaching in rural schools with specific focus on its occurrence, implications, and the role of school leadership in dealing with this approach to teaching in the face of the challenges posed by COVID-19. An extensive literature review was conducted to provide a clearer conceptual understanding of this practice and the role of leadership in its execution in rural schools. Out-of-field teaching is increasingly becoming common practice around the world and it is not widely researched. There is lack of adequate research-based information and empirical data on the prevalence of this practice in third-world rural contexts. In this paper, the researchers set out to describe, document, and provide a theoretical perspective regarding the occurrence of this practice in South African rural schools. They conceptualise it against the challenge of curriculum reforms, post provisioning, rationalisation, and the redeployment processes in schools. This paper will contribute to policy and practice by exposing the centrality and fluidity of leadership in dealing with the above challenges which lead to the enactment of the out-of-field teaching approach in order to cushion the processes of teaching and learning against the external threats posed by pandemics on the system.

Background: This systematic review aimed to evaluate the available clinical evidence on the plaque removal effectiveness of charcoal-infused toothbrushes in comparison to non-charcoal brushes. Methods: An online search was conducted in major scientific databases. Inclusion criteria were experimental clinical trials conducted on participants aged 18 years or older that evaluated the plaque removal effectiveness of charcoal-infused toothbrushes compared to non-charcoal brushes, with no limitations on the language or publication date. Results: Out of 147 studies, 2 met the inclusion criteria. The Risk of Bias in the included articles was determined as “high”. The findings were mixed regarding the plaque removal effectiveness. One of the studies showed higher efficacy for charcoal-infused toothbrushes. In contrast, the other study showed a similar effect for both types of brushes. The meta-analysis could not be performed due to the small number of eligible studies, with each utilizing different outcome measures. Conclusions: Within the context of this review, it is unclear whether charcoal-infused toothbrushes are better oral hygiene aids than non-charcoal brushes. Therefore, further research over a longer duration is needed to reach a conclusive statement. Healthcare professionals and the public should be cautious when recommending or utilizing such novel products that lack enough scientific support.

Background: Aligners, commonly used in orthodontic treatments, have shown varying degrees of effectiveness depending on the type of tooth movement required. This systematic review will outline recent findings and updates regarding the predictability of aligners in incisor extrusion and molar intrusion movements. Haut du formulaire. Objective: The purpose of this study was to systematically review the literature and evaluate the predictability of clear aligners in incisor extrusion and molar intrusion movements based on the available evidence. Materials and Methods: A total of three databases (Pubmed, Sciences Direct and Google Scholar) were searched until March 2023, in addition to a manual search in the following journals: the American Journal of Orthodontics and Dentofacial Orthopedics, The Angle Orthodontist, and the European Journal of Orthodontics. Finite elements studies assessing the ability of aligners in achieving incisor extrusion and molar intrusion movements published during the last 10 years in English were eligible to be selected. Study selection and data extraction were undertaken independently by two reviewers. Risk-of-bias (RoB) assessment was evaluated using the Methodological Quality of Single Subject Finite Element Analysis. The reporting of this review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Four pertinent articles were incorporated into the analysis, all of which are finite element studies. Among these, three studies assessed the efficacy of aligners in achieving incisor extrusion, while one solely examined their predictability in molar intrusion. The risk of bias was categorized moderate in all studies. All these studies have agreed that attachments are essential for achieving incisor extrusion and molar intrusion movements. In fact, the position of the attachment has a greater influence on the amount of movement than its shape. Conclusion: The use of attachments has proven to be crucial for successfully achieving vertical movements with aligners. Horizontal rectangular palatal attachments are essential for incisor extrusion, while a combination of buccal and palatal attachments is necessary for molar intrusion.

Anthocleista vogelii (Loganiaceae) is a plant used in traditional medicine in the Cameroon, Ghana, Togo, Nigeria and Guinea for the treatment diabetes. Hallea stipulosa (Rubuaceae) is a plant used in traditional medicine for the treatment of several illnesses such as hernia, metrorrhagia and dysmenorrhea, colic, psychosomatic disorder and diabetes. This study aims to determine the level of toxicity following the protocol of OECD guideline 423 after phytochemical analysis by using screening, High performance thin layer chromatography (HPTLC) and quantitative analysis of the extract’s total polyphenol contents (TPC) and total flavonoids contents (TFTs)were done using folin-ciocalteu and aluminiun trichloride test respectively. The evaluation of the hypoglycaemic activity and a hypoglycaemic activity of the aqueous extracts of the bark of Haleas stipulosa and Anthocleista vogelii. Combined at the concentrations 250mg / kg and 500mg / kg each at the respective proportions 50/50; 30/70; 70/30 using as a method the measurement of blood sugar every 30min for 3 hours. We obtained a yield of 11.65 for the extract of Hallea stipulosa and 10.2 for the extract of Anthocleista vogelii. The analysis of the phytochemical screening revealed the presence of tannins, flavonoids, antocyanins and terpenoids, alkanoids and phenols. The Haleas stipulosa and Anthocleista vogelii fractions have a relatively high TPC of 95,78 ± 0,02 (mg EAG/g de ES), 169,66 ± 0,03 (mg EAG/g de ES), respectively and the TFTs of 62,93 ± 0,06 (mg EQ/g d'ES), 73,45 ± 0,05 (mg EQ/g d'ES) respectively. Acute toxicity tests in female rats at doses of 2000mg / kg and 5000mg / kg revealed no behavioral disturbances and no death. The administration of the combination of the aqueous extracts of the bark of the trunks of Hallea stipulosa at the concentrations of 250 mg / kg BW and 500 mg / kg BW produced a significant hypoglycaemic effect (P ˂0.05) in rats compared to the batches of rats positive controls. These results suggest that the combination of the aqueous extracts of the bark of the trunks of Haléas stipulosa and Anthocleista vogelii exhibits hypoglycemic and antihyperglycemic activity at certaines concentrations.

There is an overall understanding that in a business environment that is serious, the performance of the company will extraordinarily rely upon its capacity to innovate. To shed light on how, when, and to what extent innovation has an effect on the market as well as the financial performance of the companies. The paper deploys regression equation models that seemingly look unrelated to examining different Portuguese firms. The results of this paper confirm that there is a positive effect of innovation on a firm’s development as well as its performance. However, the results also suggest that the opposite is also true. The innovation process is very complex and depends on the environment in which it is used.

This research analyzes the weaknesses of The Grondkaart Regulation As Ownership Evidence Of Land Asset Of Pt. Kereta Api Indonesia In The Inventory Process In Operation Area V Of Purwokerto in Indonesia currently and how to reconstruct the law Based On Justice Value in a constructivism paradigm where the type of research method used is normative juridical and the specifications of this research have a prescriptive analytical nature with the approach used by the author being a statutory approach. The research results found that the weaknesses of the Grondkaart regulation as evidence of ownership of land assets of PT. Kereta Api Indonesia in the inventory process in the operation area V of Purwokerto currently is in regard of the Types of Land Rights. According to the perspective of the various aspects of Land Rights, there are several periods of conflict between the principle of actual transfer and the principle of legal transfer, the Aspect of Government Capital Participation in the Form of Land to BUMN, Article 8 of PP Number 20 of 2021 concerning the Regulation of Abandoned Areas and Land makes the grandkaard object one of the objects of the regulation of abandoned land. Therefore the Reconstruction of the law must be done through the Construction of the dronkaart Regulation as evidence in the inventory of PT. Kereta Api Indonesia Operation area V of Purwokerto assets are based on the Pancasila justice value in addition to being in accordance with religious values, divine values, justice values, and humanitarian values contained in the philosophy of the State of Indonesia. and the reconstruction proposed was namely Article 8 of PP RI Number 20 of 2021 concerning the Regulation of Abandoned Areas and Land so that Article 8 becomes Land Management Rights that are excluded from the object of regulation of Abandoned Land including: a. land Management Rights of customary law communities; b. Rights to Grondkaart Land; and c. land Management Rights that are Land Bank Assets.

Polygamy is such an ugly term in various discourses. Many Africans have grown up hating the concept. This is because of the influences of the Africans. With colonialism came slavery and westernization. Polygamy became consigned to the past and all that was wrong with the past, like the killing of twins in some Nigerian communities prior to the coming of the British. Hence various people would be ashamed that their roots were ever associated with polygamy. It is simply a fact that polygamy has a lot of drawbacks. In recent times, however, people’s perceptions about it have begun to change. Part of the reason is the social problem created by the non-marital status of numerous young and old women who have attained marital age but are unable to get attached to male partners. The writer has observed this phenomenon for years and was prompted to conduct research on it. He is of the conviction that the practice may be reviewed. This is where writers have a role to play. Materials for the research were obtained mainly from journal articles and books on social issues.

This research analyzes the weaknesses of The Artificial Islands Regulations In International Law To Realize Territorial Jurisdiction currently and how to reconstruct the law Based On Justice Value in a constructivism paradigm where the type of research method used is normative juridical and the specifications of this research have a prescriptive analytical nature with the approach used by the author being a statutory approach. The research results found that the legal concept of artificial islands has been included in UNCLOS 1982 as a basic framework, although there are gaps and ambiguities in the existing regulations regarding artificial islands. Every country has the right to monopolize the construction of artificial islands and can explore and exploit all natural resources in its territory. However, countries that create artificial islands in accordance with their national interests and consider the status of artificial islands as legally valid artificial islands have caused many conflicts that have an impact on the sovereignty and jurisdiction of the country. This happens because there is still no detailed legal definition and regulation in UNCLOS 1982. Therefore, the reconstruction of regulations regarding artificial islands in international law needs to be carried out so that the determination of the status and criteria for the status of artificial islands can classify the rights and obligations of countries to determine the sovereignty of the country on artificial islands and jurisdiction over artificial islands in their country.