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The context for this study is the volatile, turbulent, and disruptive environment that affects higher education everywhere. A plethora of key problems facing higher education are identified. Among these are escalating costs and declining public support for higher education. This means that international education must compete with other possible priorities, such as strengthening disciplines or making campuses more attractive to prospective students. The basic aim of this paper is to develop a set of best practices to promote excellence and rigor in international higher education. In that sense, this could be called action research. This could also be considered the story of how to develop excellence and rigor in international higher education. The major methodology for this study is multiple case studies research and mixed methods research. Another method is reflective participant experience based on the author’s seven decades of engagement with the internationalization of higher education. Both value premises and positionality, which might influence the research are openly shared. In terms of theoretical foundations, key genres of internationalization are identified and described, such as critical, comparative, and comprehensive internationalization. Then, in terms of results, in the next quantitative section of the paper, eight statistical tables are shared that show the current status of international higher education, primarily in the U.S., while also including a table showing the most international universities in the world. Then, in the next qualitative part of the study, 11 exemplary cases are presented, such as CAMPUS Asia, Volunteers in Asia (VIA), and the International Cooperative Learning Project. These projects involve a total of about 20 countries. The criteria for selection were factors such as depth, sustainability, and impactful, transformative learning. The paper concludes with an articulation of the best practices to achieve excellence in international education and the principle that true liberal education is inherently international and intercultural. Full article

To compare the diagnostic performance of routine CT (rCT), CT enterography (CTE) and intraoperative quantification of PCI to surgical and pathological reference standards in patients with advanced ovarian cancer, a retrospective study of 122 patients who underwent cytoreduction surgery for ovarian peritoneal carcinomatosis was conducted. Radiological, surgical, and pathological PCIs were obtained from the corresponding reports, and the latter two were considered reference standards. The radiological techniques used were rCT: 64 MDCT (32 × 1 mm) (100 mL iopromide 370 i.v., 800 mL water p.o.), and CTE: 64 MDCT (64 × 0.5 mm) (130 mL iopromide 370 i.v., 1800 mL mannitol solution p.o., 20 mg buscopan i.v.). Data were grouped by imaging technique and analyzed using total PCI and stratified by tumor burden (low-PCI < 10, high-PCI > 20). Agreement, diagnostic performance and degree of cytoreduction were evaluated. Disappointing results for rCT and CTE were obtained when using a surgical referent, but better diagnostic performance and concordance (0.86 vs. 0.78 vs. 0.62, p < 0.05) was observed when using a pathological referent—surgical PCI overestimates and overstaged patients. PCI is underestimated by rCT rather than CTE. For high-PCI, the ROC curve was mediocre for CTE and useless for rCT, as it failed to identify any cases. For low-PCI, the ROC was excellent (86% CTE vs. 75% rCT). In four cases with low-PCI as determined by rCT, cytoreduction was suboptimal. CTE has a better diagnostic performance than rCT in quantifying PCI in patients with advanced ovarian cancer, suggesting that CTE should be used as the initial technique. Surgical-PCI could be considered as an imperfect standard reference. Full article