La métaplasie malpighienne dans le carcinome papillaire de la thyroïde

Introduction : la métaplasie malpighienne est rare au niveau de la thyroïde. Elle peut être associée à un processus pathologique tumoral ou inflammatoire.Matériels et méthodes : les auteurs se proposent de rapporter une observation de métaplasie malpighienne de la thyroïde associée à un carcinome papillaire diagnostiqué au service d’Anatomie et de Cytologie pathologiques du CHU Farhat Hached de Sousse et d’en discuter la pathogénie de cette métaplasie, ses circonstances de survenue et ses difficultés diagnostiques.Résultats : il s’agissait d’une fille âgée de 9 ans ayant consulté pour un nodule de la thyroïde. Une cytoponction de ce nodule était pratiquée et avait montré la présence de cellules tumorales d’un carcinome papillaire. Une thyroïdectomie totale avec curage triangulaire fonctionnel a été réalisée. L’examen anatomo-pathologique de la pièce a confirmé la présence d’un carcinome papillaire de la thyroïde avec présence au voisinage de la tumeur de plages de cellules malpighiennes d’allure non tumorale.Conclusion : bien que rare, la métaplasie malpighienne peut se voir dans la thyroïde. Elle doit être distinguée d’un carcinome épidermoïde de la thyroïde par la recherche systématique, devant tout foyer de métaplasie malpighienne, des signes de malignité.Mots clés : métaplasie malpighienne, carcinome papillaire, glande thyroïde

Attribute and technology value mapping for conceptual product design phase

This is a pre-copyedited, author-produced PDF of an article accepted for publication in Journal of Mechanical Engineering Science following peer review. The final, definite version of this paper has been published in Journal of Mechanical Engineering Science, Aris Georgiou, George Haritos, Moyra Fowler, and Yasmin Imani, ‘Attribute and technology value mapping for conceptual product design phase’, Vol. 230(11): 1745-1756, May 2016, published by SAGE Publishing, available online at doi: https://doi.org/10.1177/0954406215585595. Copyright © 2016 The Author(s).The main focus of this paper is how the concept design phase of the product development process can be improved by using an objective data-driven approach in selecting a final concept design to progress further. A quantitative new test-bed ‘Product Optimisation Value Engineering’ (PROVEN) is presented to critically assess new and evolving powertrain technologies at the concept design phase. The new test-bed has the ability to define a technology value map to assess multiple technical options as a function of its attributes, whose precise values can be determined at a given cost. A mathematical model that incorporates a highly adaptable, data-driven and multi-attribute value approach to product specification and conceptual design is developed, novel to the concept design process. This creates a substantially optimised product offering to the market, reducing overall development costs while achieving customer satisfactionPeer reviewe

S-D logic-informed customer engagement: Integrative framework, revised fundamental propositions, and application to CRM

Advance online in 2016</p

New services screening decision making performance: a screening committee cognitive capabilities

Item does not contain fulltextRU Radboud Universiteit Nijmegen, 29 juni 2010Promotores : Riel, A.C.R. van, Mortanges, C.P. de Co-promotor : Sasovova, Z

Een onderzoek naar de kwaliteit van besluitvorming rond de evaluatie en selectie van nieuwe diensten: focus op de cognitieve competenties van de leden van het screeningcomite

Contains fulltext : 147024.pdf (Publisher’s version ) (Open Access)VII, 147 p

One Master and Many End Users: Coordination Practices in Managing a Portfolio of Public Service Innovation Projects

Contains fulltext : 147370.pdf (publisher's version ) (Open Access)2014 IPMA World Congress, 29 september 201

The use of gamification mechanics to increase employee and user engagement in participative healthcare services: A study of two cases

Purpose Gamification introduces game-like properties into routine service processes to make them more engaging for service employees and users alike. The purpose of this paper is to investigate the effects of gamification mechanics, or game design principles, on user engagement in gamified healthcare services. Design/methodology/approach Through observations, interviews and the study of desk materials, two cases of gamified healthcare services, each using different game mechanics, are analyzed. Findings Gamification mechanics produce four distinct experiential outcomes in patients: challenge, entertainment, social dynamics, and escapism. Patient engagement can be stimulated through these outcomes. However, to fully enjoy the benefits of gamified services, users are often expected to acquire and use new skills. The relative absence of these skills (or difficulties in acquiring them), depending on users’ medical predispositions and age, may defer or negatively moderate the positive effects of gamification on engagement. In the case of progressively decreasing capabilities (e.g. in the case of aging users or users with degenerative diseases, whose physical or mental disabilities may be emphasized by the mechanics), it is recommended that health professionals adapt the mechanics accordingly or search for alternative options to increase patient well-being. Research limitations/implications The study was conducted in healthcare, and caution must be exercised in generalizing the findings to other domains. However, the finding that gamified service users’ disabilities - or the lack of required abilities – may negatively impact the encouraging or engaging effects of the use of gamification appears to be relatively universal. Originality/value This study contributes to service research, specifically in the healthcare domain, by providing insight into employees’ and users’ motivations for using gamified service processes, the experiential impact of gamification mechanics, the individual factors that influence users’ gamified experience and multiple forms of cognitive, emotional and behavioral engagement outcomes. A research agenda is developed. </jats:sec