Background: Thyroid cancers with pulmonary metastases have been well documented. However, malignant pleural effusion has rarely been reported. Case Report: We present a 77-year-old patient who had Hürthle cell carcinoma of the thyroid with contralateral malignant pleural effusion. The diagnosis was based on consistency in the histopathological and immunohistochemical features of pleural fluid cytology and the final pathology of the thyroid tumor. Results: The patient was treated with total thyroidectomy and postoperative radioactive-iodine ablation. Unfortunately, he died for recurrent pleural effusion and pulmonary complication 6 months later. Conclusion: Identifying the origin of malignant pleural effusion is important to provide treatment guidance. In this report, we review the literature on diagnosis and treatment of thyroid cancer with malignant pleural effusion.

This article is aimed at exploring students' learning achievement, motivation, and receptivity towards the flipped classroom in a university engineering mathematics course with a quasi-experimental design. Moreover, the study compared a half-semester flipped classroom and a traditional classroom whereby the experimental class reverted to the traditional format after the midterm for assessing students' receptivity towards two learning environments. Four assessments, two surveys, repeated semi-structured interviews, and two sets of open-ended questions were collected. The findings revealed that student learning achievement and motivation were improved according to assessment scores by the application of the flipped classroom. However, student's receptivity towards flipping varied because of the large amount of time and effort spent on the course. Students in the experimental group also showed insignificant differences after returning to a traditional classroom. The study suggests that blended flipped and traditional programs are scheduled together to increase student receptivity.

By using unified modeling language (UML), the researchers design a cloud-based video discussion platform, named Flipnote, for students to ask questions at any point in an instructional video. Based on the digital learning theory of connectivism, knowledge is generated by mass discussion and experience sharing via a social network. The purpose of this study is to administer a pilot study to explore students' experience and outcome of using Flipnote. The results demonstrate that the four dimensions (e.g., diversity, openness, interactivity, and autonomy) of the connectivism model play important roles for the first half of the flipped class, which is the preview at home. However, more empirical research and data are needed to validate the parts played by cognitivism and constructivism in the flipped classroom.

An online general education platform, e-Holistic (e-HO), was developed to support digital learning. Following Burnard's (2007) adoption of Activity Theory (AT) in designing music education to galvanize learners' creativity, the authors' study extended her theoretical framework through a hypothetical model they designed. From AT, this article investigates a number of elements—musical activities (tools), e-HO (community), emotional arousal (object), and musical creativity (outcome). Through the operation of the AT system, 733 students immersed in musical activities in e-HO were able to compose music even without any musical background. The purpose of this article is to report how an e-HO online activity helps arouse students' emotions and inspire their musical creativity. The structural equation modeling (SEM) analysis indicates that all research hypotheses were supported, and the musical activities on e-HO predicted 71.6% of students' self-assessed musical creativity. Finally, the implications of the authors' findings are reported for the future development of online musical education.

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