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A 71-year-old woman, who was a never-smoker, presented with low-grade fever, weakness, loss of appetite, chest pain, exertional dyspnea, and dry cough. Chest radiography showed lung opacity in the right upper pulmonary field. Symptoms persisted despite antibiotic therapy. Subsequent chest/abdominal computed tomography (CT) revealed a solid, round lesion in the right upper lobe and bilateral pleural effusion, with the majority on the right side. After discussing the possible diagnostic approach (including thoracentesis, bronchoscopy, transthoracic needle biopsy, thoracoscopy), doctors choose to start with the less invasive procedures. Thoracentesis was performed, and the result of cytology of the pleural fluid was positive for cancer cells, showing an immune-phenotypic pattern compatible with lung adenocarcinoma. The clinical course was soon complicated by severe hypoxemic respiratory failure caused by concomitant lower respiratory tract infection and bilateral pulmonary embolism (PE). The low amount of cancer cells in the pleural effusion did not allow for performance of further tests aimed at predicting patient response to targeted therapy or immunotherapy. Thus ultrasound-guided needle biopsy of a positron emission tomography (PET)–positive left supraclavicular lymph node was performed. However, neither mutation of the epidermal growth factor receptor (EGFR) gene nor rearrangements of anaplastic lymphoma kinase (ALK) and reactive oxygen species 1 (ROS1) was detected. Further staging tests revealed multimetastatic disease, with brain and bone involvement. The patient received the best supportive care possible. This chapter deals with molecular testing of advanced non-small cell lung cancer, venous thromboembolism in malignancy, and management of anticoagulant and antiplatelet agents in adults undergoing percutaneous interventions. A schematic for the optimal timing of drug withdrawal before procedures is provided.

This article discusses how to innovate school education. It provides a holistic framework for pupil-centered learning processes developed by an international research consortium. It is based on the findings from a literature review, three online survey and semi-structured interviews with participation of teachers (n=211), headmasters (n=21) and learners (n=337) from more than ten countries. The research results are used for a teacher training programme and an online course that the international research consortium is currently designing and implementing. This article presents the holistic pedagogical model Learn STEM as the first outcome of the Mixed Methods Research conducted by the international research consortium.

Learn STEM is the Pedagogical Model for Innovative STEM Learning and Teaching. It comprises a general framework for improving learning and teaching of Science, Technology, Engineering and Mathematics (STEM) in secondary schools. It has been developed by nine partners from six European countries (The Netherlands, Belgium, Germany, Italy, Lithuania and Portugal), including experts with professional background in the field of teaching STEM, secondary schools, research, vocational education institutions and developers with technical knowledge and expertise. Learners need to acquire strong mathematical and scientific abilities in order to be competitive in the 21st century work environment. Thus, development of profound knowledge and skill sets in team work, rational thinking and investigative and creative work which learners can use in all areas of life, is essential. Learn STEM addresses this need to improve the quality and efficiency of education and training as well as the need to enhance knowledge in STEM topics. It will prepare Europe’s residents to be actively engaged, responsible citizens as well as conversant with the complex challenges facing society in the future. The pedagogical model Learn STEM focuses on the learner who shall become the owner of their own learning processes. Thus, the role of teachers needs to change: teachers should facilitate such learning processes and act as coaches. However, teachers may also guide and supervise the learning process. Learn STEM can be combined with other approaches and methodologies to learn and teach STEM. Learn STEM is based on educational theories and positions and focuses mainly on the following five characteristics of the learning process: Complex Process-oriented Holistic Practical Social Learn STEM objectives comprise three elements: knowledge, skills and competences. Learners gain STEM knowledge and build STEM skills. Through reflection and repeated training, they build STEM competences based on assimilation and accommodation. The learning process should be interdisciplinary and holistic. Learning is considered a process going through iterative improvement cycles. Here, the model allows flexibility since the teacher can act more as a coach or as a tutor depending on the situation in the respective educational system. Practical courses are valuable tools during the learning process as they allow to expand knowledge, but also to develop practical skills. Learners will use and demonstrate their obtained knowledge and skills in everyday life problems and successfully apply their developed competences in new situations. Learn STEM incorporates the complexity of STEM learning activities related to the various STEM disciplines as well as to the interrelation with other areas: Learn STEM connects the world of learners with our society and provides insights into the complex relations between STEM and society.

47% of the world population uses the internet daily, and access is growing also in less developed countries (LDCs). As a consequence, a total of almost 1 billion households in the world have internet access, of which 48 million belong from LDCs (ITU, 2016). A large proportion of internet users are teenagers, who often are not aware of all the risks related to sharing private information through the Internet using for instance social networks. This paper summarizes how much time students pass online, in what activities they prefer to be involved, which risks they are confronted with, and what can be done to reduce them. The solution we propose isan investment on the teacher level, recognized here as a key figure to be trained to become I (information) Secure Agent via an online course. The course will follow a gamified approach for empowering information security education. Our assumption is that gamification will have positive effects on participants’ engagement and goal achievement

Needs assessment analysis within the ISOLEARN project focused on under-researched topic of needs in education process of visually and hearing impaired students in HE in Europe. Applying a mixed-method design with desk research, a web survey with students and in-depth interviews with representatives of higher education institutions revealed valuable feedback for increasing the understanding on needs of this vulnerable group. These two groups need different adaptations as they have different needs. Also we can say they are not satisfied with current adaptations and there is a lot of room for improvement. From the interviews and also desk research we can conclude, that the institutions are trying to help students on their way to academic success, but results of the survey shows, that they (institutions) are successful only to a certain extent. ERASMUS+ info:eu-repo/semantics/publishedVersion

Projeto - ISOLearn for Higher Education Institutions (ERASMUS+) Considering the existing experiences and the concrete needs of the hearing - impaired and visually - impaired groups for accessing HEI programmes, this handboook brings some important innovations: 1. A functional approach, proposing the methods and procedures to be used for developing and delivering ICT based learning offer valid also for these target group (not specially done for them, but designed in such a way that correspond also to their specific needs). This is that will support the target groups in their education and also social inclusion. 2. A subsequent proposal of a kind of “Quality Label”, to establish quality standards and assessment procedures and instruments to be used for evaluating whether Higher Educational Institutions’ offers and training programmes correspond to the ISOLearn standards regarding the accessibility of these groups to their learning offer. 3. Both the Handbook and the “Quality Label” should be tested on a specific qualification which should become a benchmark for the HEI ICT based learning programmes. The concrete experience will demonstrate the benefits for all the stakeholders (e.g. HEI and disadvantaged groups) of promoting social learning approach in HEI. info:eu-repo/semantics/publishedVersion

We describe the case of an adolescent who was admitted to the hospital because of sudden occurrence of chest pain, dyspnea and subcutaneous emphysema. On admission, physical examination revealed subcutaneous crepitations in the superior part of the rib cage, and auscultation of the chest showed widespread wheezing. The radiological assessment confirmed the diagnosis of pneumomediastinum and pneumothorax. A follow-up CT scan performed one week after the admission showed almost complete resolution of the radiological alterations. At the following visits, the patient was asymptomatic, but reported to have suffered from frequent episodes of rhinorrea, sneezing, nasal blockage, and sometimes, chest tightness, especially during exposure to pets and/or windy weather. Skin prick testing showed sensitivities to dermatophagoides pteronyssinus and farinae, grass pollen and dog dander. Spirometry documented significant improvement in lung function after short-acting bronchodilator, allowing for the diagnosis of asthma to be made. Although pneumomediastinum may be a complication of various respiratory diseases, including asthma, it has never been reported as the first presentation of underlying bronchial asthma. Herein, the physiopathological mechanisms, the diagnostic procedures and treatment of pneumomediastinum in asthma are discussed. We suggest that the diagnosis of asthma should be considered in the differential diagnosis of pneumomediastinum in adolescence.