Thymoma and Thymic Carcinoma

Malignancies of the thymus are a rare entity and are often without local symptoms. However, paraneoplastic syndromes can give symptoms varying from very mild to life-threatening. The diagnostic workup and management of these tumors warrant a multidisciplinary approach. Treatment choice is mainly decided upon by pathological World Health Organization (WHO) subtype and clinical staging. In contrast to historical belief, biopsy could be considered when indicated. For resectable tumors, surgical approach is advised, with adjuvant radiotherapy for Masaoka-Koga stage III tumors. Whether Masaoka-Koga stage II tumors should be treated with radiotherapy is controversial given different outcomes in multiple studies. In Masaoka-Koga stage III, combinations with induction chemotherapy are the standard. A surgical approach should be considered even in stage IVa disease. If distant metastases are present, the patient can be treated with systemic chemotherapy. Despite many phase II studies having been published, there is no randomized controlled phase III data regarding optimal treatment available. In addition to chemotherapy, sunitinib and octreotide have been described to be effective. Immunotherapy is seen as Pandora’s box given the possibility of immune-related side effects in this immunological organ. All known data regarding immunotherapy will be discussed

Problem-based learning and the relevance of teaching and learning European Studies in times of crises

The succession of economic and financial crises, the migration crisis, and, of course, Brexit have raised many questions about the future of the European Union. Such crises present challenges for teaching and learning European Studies. This article discusses the question how to maintain a relevant study programme while taking into account ever-changing societal developments. Based on a survey conducted among students of a Bachelor in European Studies, and a subsequent focus group discussion, we look at programme relevance and programme capacity to deal with societal change in the context of a problem-based learning environment. Our study reveals that problem-based learning, when applied consistently and correctly, is a good educational approach to ensure that a study programme is relevant and capable of capturing societal change. At the same time, students seem to prefer a more guided version of problem-based learning, which presents challenges concerning its possible contribution to teaching and learning in times of crises. While we discuss the situation in one specific BA programme, we will do so in light of general challenges in the fields of European Studies, International Relations, and Politics

‘Brexit’ in transnational perspective: an analysis of newspapers in France, Germany and the Netherlands

The Brexit vote of 23 June 2016 is expected to have a profound impact, not only on Britain itself, but also on the remaining 27 member states of the European Union. This article looks at how the Brexit debate was perceived outside of Britain. Was there a sense of understanding for British concerns or was there rather a focus on maintaining unity in the face of British exceptionalism? Combining insights from European public sphere research and Euroscepticism research, we conduct a qualitative framing analysis of the discourse in leading centre-right newspapers in France, Germany and the Netherlands, as common ground with British Eurosceptics is most likely to be found here. Our analysis shows that initially there was some support for British calls for amending its relationship with the Union, in particular in Germany and the Netherlands. However, as the referendum drew nearer, the discourse shifted towards the need to maintain unity amongst the remaining member states

Factors influencing the relationship between the dose of amlodipine required for blood pressure control and change in blood pressure in hypertensive cats

BACKGROUND: Hypertension is a common problem in elderly cats. In most cats, systolic blood pressure (SBP) of <160 mmHg is achieved in response to amlodipine besylate at either 0.625 or 1.25 mg q24h. The individual cat factors determining dose requirement dose have not been explored. AIMS: To determine whether individual cat factors influence the dose of amlodipine required to achieve adequate blood pressure control and to determine whether factors other than the prescribed dose of drug alter the achieved plasma amlodipine concentrations. METHODS: Fifty‐nine hypertensive cats that required 0.625 mg (A) and 41 cats that required 1.25 mg (B) amlodipine to reach a target SBP of <160 mmHg were identified, and plasma amlodipine concentrations were determined. Comparisons were made between groups, and multivariable linear regression models were performed to investigate predictors of antihypertensive response. RESULTS: Cats that required a greater dose of amlodipine had significantly higher SBP at diagnosis of hypertension (A: (median [25th, 75th percentile]) 182 [175,192] mmHg; B: 207 [194,217] mmHg, P < .001), but comparable blood pressure was achieved after treatment. Plasma amlodipine concentrations were directly related to the dose of amlodipine administered. At diagnosis, cats in group B had significantly lower plasma potassium concentration (A: 4.1 [3.8,4.5]; B: 3.8 [3.6,4.2] mEq/L, P < .01). Weight did not differ between groups. The decrease in SBP was directly and independently associated with the SBP at diagnosis and the plasma amlodipine concentration. CONCLUSIONS AND CLINICAL IMPORTANCE: Cats with higher blood pressure at diagnosis might require a greater dose of amlodipine to control their blood pressure adequately. Differences in amlodipine pharmacokinetics between cats do not seem to play a role in the antihypertensive response

Internationalisation and study success: Class attendance and the delicate balance between collaborative learning and being lost in translation

The internationalisation of Higher Education is broadly seen as a positive development. It is a process that is said to contribute to intercultural skills acquisition, which is deemed crucial in today’s globalised society. Yet, research has shown that the benefits of being confronted with other ideas and viewpoints can get lost in translation due to different languages and academic cultures. We set out to explore the impact of the international classroom on study success and argue that there might be an optimum level of internationalisation. Based on a dataset that includes more than 2822 GPA scores for 836 students from four first-year cohorts of an international Bachelor in European Studies, we find strong empirical evidence that students’ study success is lower when there are few (below 3) or many (above 6) different nationalities in the classroom. We find the strongest effects of internationalisation for students who regularly attend class (i.e. 80–90%). Hence, we present strong evidence that internationalisation has a both a negative and a positive impact on students’ study success but students will only experience these beneficial and detrimental effects of learning in an international environment when they attend class.publishedVersio