Exemplary Outcomes Research Articles

Embedded piezoelectric actuation method for enhanced solar wings vibration control

The solar wing is a vital energy component of spacecraft. It often faces challenges from vibrations and deformations during orbit, impacting spacecraft pointing accuracy and operational performance. To address these issues, a novel actuation method based on embedded piezoelectric actuator (EPA) is proposed in this study, which overcomes the technical difficulties of large additional mass and volume, and low control effectiveness. Firstly, a sandwich stacked EPA is meticulously designed and embedded into the connecting rod based on comprehensive analysis. Secondly, a novel modeling using the transfer matrix method improves the computational accuracy and the evaluation efficiency. Finally, a prototype of the EPA is fabricated, and the measurement system is constructed. The correctness of the modeling and the feasibility of the design are verified by case studies. The applications of the EPA for active vibration control are verified by additional case studies of the connecting rod and the scaled solar wing prototype, respectively. The results reveal the amplitude reduction rates at the natural frequency are 97.36% and 97.48% in the XOZ plane and YOZ plane, respectively, with residual disturbances limited to only 0.03 mm. The exemplary outcomes solidify the exceptional performance of the proposed embedded piezoelectric actuation method for the active vibration control of solar wings. This novel method holds great promise for enhancing spacecraft stability and performance.

The role of mesolevel characteristics of the health care system and socioeconomic factors on health care use – results of a scoping review

BackgroundBesides macrolevel characteristics of a health care system, mesolevel access characteristics can exert influence on socioeconomic inequalities in healthcare use. These reflect access to healthcare, which is shaped on a smaller scale than the national level, by the institutions and establishments of a health system that individuals interact with on a regular basis. This scoping review maps the existing evidence about the influence of mesolevel access characteristics and socioeconomic position on healthcare use. Furthermore, it summarizes the evidence on the interaction between mesolevel access characteristics and socioeconomic inequalities in healthcare use.MethodsWe used the databases MEDLINE (PubMed), Web of Science, Scopus, and PsycINFO and followed the ‘Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols extension for scoping reviews (PRISMA-ScR)’ recommendations. The included quantitative studies used a measure of socioeconomic position, a mesolevel access characteristic, and a measure of individual healthcare utilisation. Studies published between 2000 and 2020 in high income countries were considered.ResultsOf the 9501 potentially eligible manuscripts, 158 studies were included after a two-stage screening process. The included studies contained a wide spectrum of outcomes and were thus summarised to the overarching categories: use of preventive services, use of curative services, and potentially avoidable service use. Exemplary outcomes were screening uptake, physician visits and avoidable hospitalisations. Access variables included healthcare system characteristics such as physician density or distance to physician. The effects of socioeconomic position on healthcare use as well as of mesolevel access characteristics were investigated by most studies. The results show that socioeconomic and access factors play a crucial role in healthcare use. However, the interaction between socioeconomic position and mesolevel access characteristics is addressed in only few studies.ConclusionsSocioeconomic position and mesolevel access characteristics are important when examining variation in healthcare use. Additionally, studies provide initial evidence that moderation effects exist between the two factors, although research on this topic is sparse. Further research is needed to investigate whether adapting access characteristics at the mesolevel can reduce socioeconomic inequity in health care use.

System Dynamics Usage in The Development of Sustainable Fishermen Village A Capability Enhancement to the Policy Review and Implementation Team in Ministry of Marine Affairs and Fisheries

The Ministry of Maritime Affairs and Fisheries (KKP) through the Biak Numfor Regency Fisheries Service, is developing Samber-Binyeri Village, as a pilot fishing village in Papua to enhance the economy. A number of issues and factors, including inadequate fishing equipment, infrastructure, availability of fuel, and a lack of knowledge and skills on fishing technology and practice, have contributed to the low income and productivity of traditional fishermen. Furthermore, poor health facilities and coastal waste management make the villages unhygienic to live in, messy, and unattractive for visitors and tourists. However, implementing new policies and management practices requires a proper understanding of current practice, culture, and its impact on its ecosystem, should the change be made. Therefore, it requires proficient teams to evaluate the current model and develop a new model that yields exemplary outcomes aligned with the objectives at minimum risk. For this reason, equipping the KKP team with knowledge related to system thinking and system dynamics is very important. A four-day' workshop in system thinking and system dynamics has been carried out in Bandung in two stages: stage one, a basic understanding of system thinking and system dynamics, and stage two, modeling optimization using Vensim software. The output of this workshop programs is: to define problems and dynamic hypotheses in each field or section as a basis for Sustainable development of Kampung Nelayan Maju

HF02-13 A BOHNE FIDE TITAN OF UROLOGY

You have accessJournal of UrologyCME1 May 2022HF02-13 A BOHNE FIDE TITAN OF UROLOGY Isaac Palma-Zamora, Craig Rogers, James Peabody, and Naveen Kachroo Isaac Palma-ZamoraIsaac Palma-Zamora More articles by this author , Craig RogersCraig Rogers More articles by this author , James PeabodyJames Peabody More articles by this author , and Naveen KachrooNaveen Kachroo More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002540.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In the centennial year of the Henry Ford Urology Department we examined the many contributions of former Chairman, Dr Arthur Waite Bohne, a progressive surgeon-scientist, in advancing the field of urology. METHODS: A comprehensive literature review concerning the life and works of Dr Arthur Waite Bohne was performed via online search, review of published historical texts and published material on PubMed. Contemporary records held by The Conrad R. Lam medical archives at Henry Ford Hospital were also reviewed. RESULTS: Arthur Waite Bohne (1914-1998) obtained his MD degree from Washington University at St. Louis in 1939. He served as a captain in the Army Medical Corps during World War II in North Africa, Italy and Germany. Upon his return he trained with eminent urologist Dr. Reed Nesbit at the University of Michigan. He joined Henry Ford Hospital in 1950 and was named associate surgeon-in-charge after Dr Ormond Culp was recruited to the Mayo Clinic. In 1952, he succeeded Dr John Kelso Ormond (of ‘Ormond Syndrome’ fame) as Chief of Urology and held that position until 1970. His pioneering work in bladder regeneration models, initially in animal models (dogs) followed by 7 human ‘trials’ of his plastic mold (around which the new bladder could grow) and a novel distensible rubber bag, all of which could subsequently be removed transurethrally, received national acclaim with Bohne featured in TIME magazine in 1955 describing him as the urologist with the ability for “Muscle grown to order”. To this day his pivotal observations continue to be frequently cited in the tissue bioengineering literature. Bohne was an early adopter of the percutaneous needle kidney biopsy. His published series of 30 patients contributed to the refinement of the technique and understanding its role as a diagnostic tool. He was also among the first to champion the concept of ‘focal prostate therapy’. In 1969, he published a small series of the successful management of nodular prostate cancer via a small perineal incision and electrosurgical excision of the prostate nodule alone. All patients were continent, potent and recurrence free at 9 years of follow up – exemplary outcomes even by today’s standards. CONCLUSIONS: The legacy of Dr Arthur Waite Bohne cannot be overstated. His early contributions to urological innovation paved the way for prostate cancer focal therapy and diagnostic kidney biopsy. His pioneering establishment of bladder regeneration techniques from animal models to in vivo human trials provided the crucial cornerstone for bladder replacement technology, for which he deserves to be recognized for. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e210 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Isaac Palma-Zamora More articles by this author Craig Rogers More articles by this author James Peabody More articles by this author Naveen Kachroo More articles by this author Expand All Advertisement PDF DownloadLoading ...

أجـــــوبة الحافظ محمد البرزالي على سؤالات العز ابن الحاجب في الجرح والتعديل

Research title: Answers of Al-Hafiz Muhammad Al-Barzali to the questions of Al-Izz Ibn Al-Hajeb in Al-Jarh and Al-Ta’deel The goal of the Research: To gather the answers of Abee 'Abdillaah al-Birzaali pertaining to Al-Jarh wat-Ta'deel and the study of it. The Research consists of: An introduction, a preface, the text of the questions, a conclusion, and an index. The introduction: Naming the topic, the reason for choosing it, and its importance. The Preface: A short biography on Abee 'Abdillaah al-Birzaali, Al-Haafidh adh-Dhahabi and Al-’Izz ‘Umar ibn al-Haajib As well as the text of the answers along with a study of it, and a commentary on it. The Conclusion: And it contains the most exemplary outcomes and advice. The Index: In it are the sources and references, and an index of the topics. The importance of the Research shows through: The fact that it pertains to the knowledge of Al-Jarh wat-Ta'deel, and that which it contains from benefits in clarifying the condition of some of the narrators in the seventh century. And the researcher summarizes in the conclusion: The level of precision of the knowledge of Abee 'Abdillaah al-Birzaali, and the manifestation of his proficiency in making rulings on some of the narrators. The researcher advises: To gather that which was dispersed from the speech other than him from those who preserved the Prophetic narrations and the men [of Hadeeth]; from that which was not gathered in one place, and the study of it.

Enhancing research practices in intellectual and developmental disabilities through person-centered outcome evaluation

BackgroundResearch practices in IDD need to align current values towards people with IDD, the current understanding of IDD, and best practices regarding change strategies and valued outcomes. AimsTo describe the components to—and application of—a person-centered outcome evaluation model that meets the above criteria. Methods and proceduresA person-centered evaluation logic model is used to identify and describe a conceptual framework (input), a change strategy (throughput), personal outcomes (outcome), and meaningful impacts (output). Outcomes and resultsSpecific person-centered outcomes and exemplary outcome indicators are presented for two outcome evaluation frameworks: human functioning dimensions, and the four theoretical perspectives on IDD: biomedical, psychoeducational, sociocultural, and justice. Conclusions and implicationsA person-centered approach to outcome evaluation enhances research practices in IDD by identifying and assessing valued personal outcomes that align current values, understanding, and best practices; increases transparency; facilitates accountability; and expands understanding.

Sequential Activity Patterns and Outcome-Specific, Real-Time, and Target Group-Specific Feedback: The SPORT Algorithm

Purpose:Physical activity (PA) is crucial for health, but there is insufficient evidence about PA patterns and their operationalization. The authors developed two algorithms (SPORTconstantand SPORTlinear) to quantify PA patterns and check whether pattern information yields additional explained variance (compared with a compositional data approach [CoDA]).Methods:To measure PA, 397 (218 females) adolescents with a mean age of 12.4 (SD = 0.6) years wore an ActiGraph on their lower back for 1 week. The SPORT algorithms are based on a running value, each day starting with 0 and minutely adapting depending on the behavior being performed. The authors used linear regression models with a behavior-dependent constant (SPORTconstant) and a function of time-in-bout (SPORTlinear) as predictors and body mass indexzscores (BMIz) and fat mass percentages (%FM) as exemplary outcomes. For generalizability, the models were validated using five-fold cross-validation where data were split up in five groups, and each of them was a test data set in one of five iterations.Results:The CoDA and the SPORTconstantmodels explained low variance in BMIz(2% and 1%) and low to moderate variance in %FM (both 5%). The variance being explained by the SPORTlinearmodels was 6% (BMIz) and 9% (%FM), which was significantly more than the CoDA models (p < .001) according to likelihood ratio tests.Conclusion:Among this group of adolescents, SPORTlinearexplained more variance of BMIzand %FM than CoDA. These results suggest a way to enable research about PA patterns. Future research should apply the SPORTlinearalgorithm in other target groups and with other health outcomes.

Financial risk protection of Thailand\u2019s universal health coverage: results from series of national household surveys between 1996 and 2015

BackgroundThailand, an upper-middle income country, has demonstrated exemplary outcomes of Universal Health Coverage (UHC). The country achieved full population coverage and a high level of financial risk protection since 2002, through implementing three public health insurance schemes. UHC has two explicit goals of improved access to health services and financial protection where use of these services does not create financial hardship. Prior studies in Thailand do not provide evidence of long-term UHC financial risk protection. This study assessed financial risk protection as measured by the incidence of catastrophic health spending and impoverishment in Thai households prior to and after UHC in 2002.MethodsWe used data from a 15-year series of annual national household socioeconomic surveys (SES) between 1996 and 2015, which were conducted by the National Statistic Office (NSO). The survey covered about 52,000 nationally representative households in each round. Descriptive statistics were used to assess the incidence of catastrophic payment as measured by the share of out-of-pocket payment (OOP) for health by households exceeding 10 and 25% of household total consumption expenditure, and the incidence of impoverishment as determined by the additional number of non-poor households falling below the national and international poverty lines after making health payments.ResultsUsing the 10% threshold, the incidence of catastrophic spending dropped from 6.0% in 1996 to 2% in 2015. This incidence reduced more significantly when the 25% threshold was applied from 1.8 to 0.4% during the same period. The incidence of impoverishment against the national poverty line reduced considerably from 2.2% in 1996 to approximately 0.3% in 2015. When the international poverty line of US$ 3.1 per capita per day was applied, the incidence of impoverishment was 1.4 and 0.4% in 1996 and 2015 respectively; and when US$ 1.9 per day was applied, the incidence was negligibly low.ConclusionThe significant decline in the incidence of catastrophic health spending and impoverishment was attributed to the deliberate design of Thailand’s UHC, which provides a comprehensive benefits package and zero co-payment at point of services. The well-founded healthcare delivery system and favourable benefits package concertedly support the achievement of UHC goals of access and financial risk protection.

Integration of triaxial testing and pore-scale visualization of methane hydrate bearing sediments.

Understanding mechanical interactions between hydrate and hosting sediments is critical for evaluating formation stability and associated environmental impacts of hydrate-bearing sediments during gas production. While core-scale studies of hydrate-bearing sediments are readily available and some explanations of observed results rely on pore-scale behavior of hydrate, actual pore-scale observations supporting the larger-scale phenomena are rarely available for hydrate-bearing sediments, especially with methane as guest molecules. The primary reasons for the scarcity include the challenge of developing tools for small-scale testing apparatus and pore-scale visualization capability. We present a testing assembly that combines pore-scale visualization and triaxial test capability of methane hydrate-bearing sediments. This testing assembly allows temperature regulation and independent control of four pressures: influent and effluent pore pressure, confining pressure, and axial pressure. Axial and lateral effective stresses can be applied independently to a 9.5 mm diameter and 19 mm long specimen while the pore pressure and temperature are controlled to maintain the stability of methane hydrate. The testing assembly also includes an X-ray transparent beryllium core holder so that 3D computed tomography scanning can be conducted during the triaxial loading. This testing assembly permits pore-scale exploration of hydrate-sediment interaction in addition to the traditional stress-strain relationship. Exemplary outcomes are presented to demonstrate applications of the testing assembly on geomechanical property estimations of methane-hydrate bearing sediments.

Impact of Employee Empowerment on Productivity

When a key word of employee empowerment is searched on google, it results in .49 seconds about 4,47,00,000 links, which shows the significance of employee empowerment in present advanced economy. As indicated by an article of Harvard Business Review in 2018, when employees are empowered at work, there are exemplary outcomes appeared regarding work execution, work fulfillment and duty towards the organization It additionally motivates the employees to work additional hour, require an additional work to exta mile, start the accepted procedures at organizations, have clear correspondence channels and being proactive to the change. Be that as it may, this made the analyst to take up this examination to recognize the effect of worker strengthening on authoritative profitability. The research was conducted in the selected retail organizations in Mumbai. a structured questionnaire was administered to 320 employees at various levels. The results showed if the leaders were empowered, they could develop team to be more creative and helpful. It was also found out from the research that empowered employees don’t always boost the performance.

Voting Based Revocation Mechanism in MANET using Direct and Recommendation Trust

The growing use of mobile devices in MANET has influenced a lot of application in the field of wireless technology. To provide security to the network is a major challenge. Of all the goals of wireless network security, authentication is crucial. Communication among authenticated nodes is done with digital certificate. Nodes which misbehave in the cluster are eliminated from the network by revoking its certificate. Our proposed system uses voting based mechanism using trust of the node present in the black list. The trust value calculation is done for all the nodes in black list by cluster head using direct and recommendation trust. Total trust is the combination of 80% of direct trust and 20% of indirect trust. Revocation is done based on the threshold to reduce the false accusation. Simulation result of the proposed system using NS-2 shows improved results when compared with existing scheme in terms of malicious node revocation, false revocation, normalized time to revocation, revocation accuracy ratio and number of warned nodes. Simulation results articulate that the proposed mechanism yields an exemplary outcome for providing secure communication in MANETs.

The impact of strategic inventory and procurement strategies on green product design in a two-period supply chain

This study analyses the impact of power structures and strategic inventory on the development-intensive and marginal-cost-intensive green product types under three procurement strategies. The results suggest that (i) in the manufacturer-Stackelberg game, the retailer retains strategic inventory to earn higher profits. The retailer's decision improves profit for the manufacturer and greening level of the product; (ii) for the marginal-cost-intensive green product, the power structures and procurement strategies cannot make any impact on the greening level and the retailer cannot build up strategic inventory under retailer-Stackelberg game; (iii) under the Nash game, the procurement decision creates conflict between the supply chain members for marginal-cost-intensive green products; (iv) if the retailer does not maintain strategic inventory or procures product in a single lot, then the manufacturer prefers to produce marginal-cost-intensive products and retailer prefers to sale development-intensive products to receive maximum profits under manufacturer-Stackelberg game. The optimal preferences are concurrent under retailer-Stackelberg game, but not under the Nash game; (v) single-period equilibrium solutions may exhibit sub-optimal characteristics, but two-period planning can lead to exemplary outcomes in the perspective of the greening level and profits of the supply chain members.

Surgery- vs Radiation-Based Therapy for p16+/HPV-Related Oropharyngeal Cancers

Oropharyngeal cancer (OPC) has traditionally been managed by radiotherapy (RT)-based approaches. Minimally invasive surgery [transoral robotic surgery (TORS)/transoral laser microsurgery (TLMS)] is gaining popularity in T1-T2 HPV+ OPC. However, there is lack of high level evidence to guide practice. We summarize ongoing research regarding outcomes and investigational strategies for TORS/TLM- and RT-based treatments for this disease. Literature published in 2012–2017 demonstrated comparable exemplary outcomes with TORS/TLM and IMRT for selected HPV+ T1-T2 OPC. However, many TORS/TLM-treated patients also require adjuvant treatment, which impacts quality of life. Emerging RT-based de-intensification trial data suggest promising results. Ongoing investigation include indications for postoperative (chemo-)radiotherapy following TORS/TLM- and optimal RT-based de-intensification strategies. A contemporary literature review demonstrates equal efficacy for TORS/TLM and IMRT as primary treatment for selected HPV+ T1-T2 OPC. TORS/TLM is an attractive approach when the opportunity for single modality treatment is high.

The Impact of Nurse Engagement on Quality, Safety, and the Experience of Care: What Nurse Leaders Should Know.

To lead others in achieving exemplary outcomes, nurse leaders need to understand the vital and interdependent connection between quality, safety, the patient and RN experience of care, and RN engagement. The triple aim of improving population health, enhancing patient experience, and reducing cost cannot be accomplished without a robust and engaged workforce that finds joy and meaning in its work. This is especially true for the nursing workforce. The vital connection of nurse engagement to the experience of care, and ultimately to nurse and patient outcomes, is clear. Quality improvement efforts that equally emphasize initiatives to improve patient experience and create and sustain a highly engaged nursing workforce are key to achieving desired outcomes.

Birds of a Feather Flock Together: An Inter-disciplinary Orthodontic Case Report

Use of orthodontics for tooth corrections has its own advantages with regards to the amount of tooth movement and the health of the supporting periodontal and alveolar bone. However, many times in cases that require a complex approach to treatment, only an orthodontist may not be able to accomplish the ultimate objectives unless associated with colleagues from other dental specialties. Thus, for an exemplary outcome, cooperation of other dental specialists working together is essential. Treatment carried out using periodontics, prosthodontics, and implant supported prosthesis for a patient undergoing orthodontic treatment and with congenitally missing maxillary lateral incisors, is presented as a case report.

Hypertrophic Cardiomyopathy-One Case per Year?: A Clarion Call to Do What Is Right.

Hypertrophic cardiomyopathy (HCM) has fascinated (and scared) cardiologists for years owing, in part, to the relatively fewcasesmostphysicianswill see intheirpractice,coupledwith increased risk for sudden death, complex yet incomplete genetic understanding, and enigmatic hemodynamics. The management of symptomatic patients with HCM evolved over the past (nearly) 6 decades owing to focusedefforts tounderstandthepathophysiologyandperfect the necessary skills to delivery exemplary outcomes.1 We have learned that it is entirelypossible forpatientswithHCMtohave excellent quality of life and normal lifespans, that most patients can be treatedwith pharmacologic therapy, and that for most patients who remain symptomatic, there are procedures that can deliver excellent benefit with low risk. The article by Kim et al2 using a national discharge database samplingmethod examines observed event rates among patients undergoing surgical septal myectomy or percutaneous septal ablation. Some of the findings are not surprising: there is a clear association between procedural volume and complications and there aredifferences in baseline characteristicsbetweenpatientsundergoing the2procedures.Thereare someshocking results: themediannumberofmyectomycases or ablation cases in this database is less than or equal to 1 case per year. Seriously, only 1 case per year? Why would we subject our patients to this? There is somecritical informationmissing as an artifact of the study design: specifically, there are no effectiveness data and thus, a comparison cannot be made between the results of surgical septal myectomy vs septal ablation. More importantly, there is no description of what can be expected if the procedures were performed not just at higher volume centers, but at Centers of Excellence. The study of Kim et al2 in this issue of JAMA Cardiology does go a long way to making an excellent case for having a few highly focused centers that specialize in the care of patients with HCM. The results achievable at major HCM centers are remarkable. In expert hands, surgical myectomy has a greater than 95% efficacy, with mortality rates that are approaching 0% (ie, thousands of cases performed without an operative death), normalization of long-term survival following theprocedure, anda reduction in sudden cardiacdeath.3-5 Similarly, among those patients who respond to septal ablation, the symptomatic improvement canmirror that ofmyectomy, with a procedural mortality rate that is only about 1%.6 Given that there are recognizable differences in complication rates and controversy regarding the association between septal ablation and subsequent sudden cardiac death/ implantable cardioverter defibrillator discharge rates, the American College of Cardiology Foundation/American Heart Association guidelines, as stated in the current article, recommendsurgicalmyectomyas thepreferredstrategy formostpatientswithHCMwith drug-refractory symptoms and that ablation isa reasonablealternative inselect cases.7Theguidelines emphasize that both procedures be performed by experienced centers and recommenda shareddecision-makingprocess, inwhich the fully informed patient is able to choose the procedure based on their own needs and preferences. Looking specifically at the data in the current report,2 regardless of the procedure type, there is an approximate 4-fold increase inmortality comparing the high-volume tertile to the low-volume tertile. Notably, the best mortality rates for myectomy as reported in this article, from their high-volume tertile, arestillnearly 10-foldhigher thanwhat is seenatHCMcenters.8 Thatevenhigher-volumecentersappear tohaveamortality rate that is 10 timesgreater thanwhat isobservedat centerswith focusedexpertise inHCMisanimportantobservationthat isworth seriousdiscussion. Indeed, thismayunderestimate themagnitude of the differences. Based on the data presented, the lowvolumecenterswould expect aprocedure-relateddeath for every 6 attempts, while the highest tertile reported here would expect a death for every 26 attempts. Yet,weknow frompreviouslypublisheddatathatHCMcenterscango1500ormorecases withoutaprocedure-relateddeath.8Sixvs26 is incremental improvement; 26 vs 1500 is improvement measured in magnitudes of order. There should be no debate. For years, the cardiology community has recommended andaccepted that adultswith congenital heart disease should receive their care from regional specialized centers for adults with congenital heart disease.9 Recently, given thewide variability in outcomes following operations for mitral valve disease, a disease and set of procedures that are far more prevalent than HCM, there has been a thoughtful call for these procedures to be restricted to those centers that can demonstrate excellence in benefit and safety.10 Hypertrophic cardiomyopathyhas a complexity andprevalence thatmore closely mimics that of adults with congenital heart disease, but HCM also has important abnormalities of mitral valve function. It is in the best interest of the patients then that they be informed they can expect to have a procedure with a vanishingmortality rateand95%chanceof significant,durable symptomatic benefit. No patient should have a complex procedure done where the volume is 1 per year. The data in this current report,2 coupledwith thewell-establisheddata fromHCMCenters of Excellence, make a clear case that for HCM, not every hospital or operator should be performing these procedures. The low-volume safety data are unacceptable. The middle volume data are not good enough. Even the highest-volume Editor's Note page 334

Learning to Appraise the Quality of Qualitative Research Articles: A Contextualized Learning Object for Constructing Knowledge

Helping beginning qualitative researchers critically appraise qualitative research articles is a common learning objective for introductory methodology courses. To aid students in achieving competency in appraising the quality of qualitative research articles, a multi-part activity incorporating the Critical Appraisal Skills Programme's (CASP) Making Sense of Evidence Tool: 10 Questions to Help You Make Sense of Qualitative Research to evaluate the articles is shared. A Contextualized Learning Object for Constructing Knowledge or CLOCK approach is used to represent the appraising activity in terms of its context, content, evaluation components, exemplary outcomes, and options for customizing parts of the assignment.

Propensity-score matched pair comparison of accelerated partial breast irradiation (APBI) and whole breast irradiation (WBI) for ductal carcinoma in situ (DCIS).

1123 Background: DCIS remains a cautionary criterion for APBI by the ASTRO APBI consensus statement. We performed a matched analysis to compare the efficacy of WBI and APBI for patients with DCIS. Methods: Women with DCIS treated with APBI or WBI were reviewed. APBI (n=102) patients with ≥2 y follow-up were matched 1:3 to WBI (n=546) patients with ≥5 y follow-up by age, tumor size, nuclear grade, ER status, margin status, and laterality. Ipsilateral breast tumor recurrence (IBTR), distant metastasis (DM), contralateral breast cancer (CLBC) and cause-specific survival (CSS) were compared by cumulative incidence (Gray’s) and competing risks regression (Fine and Gray’s), and overall survival (OS) and disease-free survival (DFS) by Kaplan-Meier (log-rank test). Results: Median follow-up was 4.6 y (2.0-14.7) for APBI and 9.0 y (5.4-27.0) for WBI. Median (range) or percentages are shown (Table). Patients did not differ by match criteria. There were 17 LR, 1 DM, 19 CLBC, 2 CSS, 22 OS, and 19 DFS events during follow-up. The patient groups had similar rates of cancer-related events including ipsilateral and contralateral breast recurrences at both five and eight years. Treatment type, age, tumor size, nuclear grade, ER status, and hormone therapy (HT) were not prognostic of LR or CLBC on uni- and multi-variate analyses. Conclusions: APBI provides equivalent and exemplary outcomes compared to WBI following breast-conserving surgery for DCIS. These findings support previous reports on the efficacy of APBI in the treatment of noninvasive breast carcinoma. Prospective randomized comparison of APBI to WBI for DCIS is needed. [Table: see text]

The Influence of Fictional Narrative Experience on Work Outcomes: A Conceptual Analysis and Research Model

Fictional narrative experience is assumed to have a profound impact on human behavior, but the possible outcomes and the processes through which fictional narrative experience influence behaviors have rarely been studied. This paper introduces a model of the consequences of fictional narrative experience through transportation and transformation processes. We discuss a framework for understanding the effects of fictional narrative experience, distinguishing affective and behavioral effects, and temporality of effects (short-term or persistent). Exemplary outcomes of fictional narrative experience are presented, including recovery, creativity and interpersonal behavior. Finally, we propose that the effects of fictional narrative experience are dependent upon a person's frame of reference, as well the extent to which a reader can identify with the main characters, the perceived usefulness of a narrative, and degree of verisimilitude in the narrative.

The Curriculum Workshop: A Place for Deliberative Inquiry and Teacher Professional Learning

In this article, the curriculum workshop (CW) is elaborated as an approach to professional learning, deliberation and inquiry. It offers a comprehensive framework for school-based deliberation and inquiry, is rooted in curriculum theory, promises a broad range of applications in teacher education and provides tools to assess the trustworthiness of processes and outcomes. The first section of the article discusses the theoretical background of the CW by going back to Joseph Schwab's idea of ‘the practical’, of deliberative inquiry in curricular groups. Building on these ideas, Karl Frey's model of a ‘curriculum conference’ is presented. Elements of Schwab's and Frey's approaches are then modified and adapted to the CW. The second section asks how the CW was enacted in the framework of a European project on good practice in school-based teacher education, presents exemplary outcomes and critically discusses the trustworthiness of the approach. The final section provides a summary of the outcomes and indicates directions for further research.