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The effectiveness of professional learning communities (PLCs) in schools depends significantly on the extent of fostering teacher learning. In this explanatory case study, 16 female teachers from a girls' high school in Saudi Arabia joined a reflective practice programme where they engaged in collaborative inquiry to solve a problem in their work. The study sought to understand how reflective practice enhances the cognitive presence levels, namely triggering event; exploration; integration and resolution, in a teacher's PLC. Data sources included transcripts of face-to-face and online discussions and focus group interviews. Analysis of discussions revealed that the participants were capable of movement through the four levels of cognitive presence, reaching the higher levels in which knowledge is built and applied. Interviews analyses generated four themes indicating factors that contribute to the emergence of higher levels of cognitive presence during the reflective practice programme. These factors comprise focus on experience and real practice, long-term training in the school context, social cohesion and the facilitator's role. This study provides evidence for the potential of reflective practice to support teachers' learning in PLCs. At the same time, it calls for further research on effective methods that facilitators of reflective practice use to prompt this learning.

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PURPOSEEstrogen receptors (ERs), progesterone receptors (PRs), and human epidermal growth factor receptor 2 (HER2) are the mainstay of breast cancer management, and their prevalence rates vary among different populations possibly related to ethnic/genetic and/or socioeconomic status. In a previous study conducted at the King Hussein Cancer Center (published 2006), Jordan ER/PR/HER2 rates for patients diagnosed in 2003-2004 were 50.8%/57.5%/17.5%, respectively. The aim of this study is to revisit the prevalence rates to see if they have changed over the years with changing socioeconomic status.MATERIALS AND METHODSWe retrieved clinicopathologic data of all patients (1,185) diagnosed with breast cancer during 2018. The data included age, histologic type, grade, and ER/PR/HER2 status as determined by immunohistochemistry and/or fluorescence in situ hybridization for HER2.RESULTSThe mean age of patients was 52 (median = 51, range = 25-92) years, and the majority (73.2%) had invasive carcinoma of no special type. ER/PR/HER2 were 77.0%/72.4%./23.8%, respectively. Triple-negative breast cancers were 10.1%. In comparison with previous results of 2006, the changes are statistically significant. Similar changes were seen in other Middle Eastern populations. The current rates are close to those of Western populations.CONCLUSIONRates of ER/PR/HER2 expression have significantly changed and are close to those of Western populations for ER/PR. We propose that such changes are secondary to the adoption of a westernized lifestyle and socioeconomic changes.

Introduction: Ankle arthrodesis using the Ilizarov technique provides high union rate with the added benefits of early weight-bearing, and the unique advantage of its ability to promote regeneration of soft tissue around the bone, including skin, muscle and neuro-vascular structures, and its versatility to allow correction of the position of the foot by adjusting the frame post-operatively as needed. We describe our experience with this technique and the functional outcomes in our patients. Materials and Methods: This retrospective study was conducted in 20 ankle fusion cases using the Ilizarov method between the years 2007 and 2017. We defined success in treatment by loss of preoperative symptoms and radiological union on plain radiographs of the ankle. Results: Fusion was achieved in all patients (100%). Immediate post-operative ambulation was with full weight bearing (FWB) in 16 (83%) of the participants and non-weight bearing (NWB) in 3 patients (17%). Postprocedure 11 patients (67%) of the participants who were full weight bearing required some form of support for walking for 2-3 weeks. Post-operatively three patients had pin tract infection requiring intravenous antibiotics. Radiological union took range of 6-12 weeks, mean union time was 8 weeks. Only one patient required bone grafting due to bone loss. Average follow-up period was 10-45 months. Conclusion: The Ilizarov technique has a high union rate and leads to general favourable clinical outcome and may be considered for any ankle arthrodesis but is especially useful in complex cases such as for revisions, soft-tissue compromise, infection and in patients with risk for non-union. Early weight bearing is an extra benefit.

This article discusses a study that aimed to prove the feasibility and safety of a minimally invasive aortic valve reimplantation procedure called the David procedure. The study included 122 patients who underwent the procedure between 2000 and 2023. The primary endpoints of the study were peri- and postoperative outcomes and long-term aortic valve performance. The results showed that the procedure can be performed safely, but it should be limited to centers with experience in minimally invasive cardiac surgery. The study also emphasized the importance of precise patient selection and preoperative planning. [Extracted from the article]

This article, titled "Coronary Plaque Quantification Using a New CT Imaging Software¿A Feasibility Study," discusses the potential benefits of using Cinematic Rendering (CR) visualization in detecting nonobstructive coronary plaques. The study included 26 patients who underwent cardiac surgery and had previous cardiac CT scans. The results showed that CR visualization correlated well with intraoperative palpation in quantifying the presence of plaques. The authors suggest that CR has the potential to improve the planning of coronary artery bypass surgery by allowing for easier interpretation of plaque localization. Further research will be conducted to validate these findings. [Extracted from the article]