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Simple Summary: Colorectal cancer is the third most common cancer worldwide, with colon cancer accounting for approximately 60% of all cases. Robotic-assisted surgery has emerged as a promising minimally invasive technique for resection. This study evaluates and compares the outcomes of robotic-assisted surgery and laparoscopic-assisted surgery for stage I to III colon cancer, using data collected between 2018 and 2024. By analyzing matched patient groups, the findings demonstrate that robotic-assisted surgery leads to faster recovery, fewer cases of bowel obstruction in left-sided colectomies, greater lymph node retrieval in right-sided colectomies, and reduced postoperative pain compared to laparoscopic-assisted surgery. These results underscore the potential of robotic-assisted surgery to enhance recovery and improve surgical precision. The study provides valuable evidence that may influence surgical practices and promote the broader adoption of robotic technology, particularly in the treatment of colon cancer. Background and Objective: Colorectal cancer (CRC) is the third most common cancer worldwide, with colon cancer accounting for approximately 60% of all CRC cases. Surgery remains the primary and most effective treatment. Robotic-assisted surgery (RAS) has emerged as a promising approach for colon cancer resection. This retrospective study compares RAS and laparoscopic-assisted surgery (LSS) for stage I–III colon cancer resections at a single medical center in East Asia. Methods: Between 1 January 2018, and 29 February 2024, patients undergoing colectomy were classified into right-side and left-side colectomies. Propensity score matching was conducted based on age group, gender, ASA score, and BMI to ensure comparability between groups. After matching, there were 50 RAS and 200 LSS cases for right colectomy (RC), and 129 RAS and 258 LSS cases for left colectomy (LC). Perioperative outcomes were compared between the two surgical approaches. The primary outcomes were recovery milestones, while secondary outcomes included complications and postoperative pain scores. Results: RAS demonstrated faster recovery milestones compared to LSS (hospital stay: 6.5 vs. 10.2 days, p = 0.005 for RC; 5.5 vs. 8.2 days, p < 0.001 for LC). RAS also resulted in lower rates of ileus (14% vs. 26%, p = 0.064 for RC; 6.2% vs. 15.9%, p = 0.007 for LC) and higher lymph node yields (31.4 vs. 26.8, p = 0.028 for RC; 25.8 vs. 23.9, p = 0.066 for LC). Major complication rates showed no significant difference between RAS and LSS (4.0% vs. 7.0%, p = 0.746 for RC; 4.7% vs. 3.1%, p = 0.563 for LC). Patients in the RAS group experienced earlier diuretic phases and reported significantly lower postoperative pain scores (3.0 vs. 4.1, p = 0.011 for RC; 2.9 vs. 4.1, p < 0.001 for LC). Conclusions: Robotic-assisted surgery is associated with faster recovery, lower rates of ileus (LC), higher lymph node yield (RC) and reduced postoperative pain compared to laparoscopic-assisted surgery for colon cancer resection. [ABSTRACT FROM AUTHOR]

Studies investigating the use of mobile technologies when other options are available are still relatively rare in the literature, with the majority of studies requiring that learners use a particular technology, either using their own devices or devices provided by the institution. One exception to this was a study by Stockwell (2010) that examined how learners in Japan perceived the use of mobile phones for language learning and how willing they were to engage in the activities. This study, however, was conducted prior to the spread of smart phones and it focused exclusively on learners in Japan. Thus, the purpose of the current study was to replicate this study, but differed in two ways. First, although it was run in essentially the same environment as the original study, in the current study the majority of learners owned smart phones. Second, the same system was used not only in Japan but also with learners studying at a university in Taiwan. Data were collected through server logs, post-treatment surveys and semi-structured interviews. The results are discussed in terms of the ways in which learners engaged in the activities on their mobile phones, and the effect of the mobile platform on the time taken to complete the activities over the course of the semester. These results were correlated with those from the original 2010 study to identify the potential effect of the smart phone.

The teaching of translation has received considerable attention in recent years. Research on translation in collaborative learning contexts, however, has been less studied. In this study, we use a tool of synchronous collaboration to assist students in experiencing a peer translation process. Afterward, the unified theory of acceptance and use of technology (UTAUT) and a partial least squares regression approach are used to explore students' perspectives on the synchronous collaboration. Specifically, the study is constructed in a technical university in Tainan, Taiwan. A total of 27 participants enrolled in the study. The results show that most of the hypotheses we had developed before the study were supported by the data we collected, and further reveal that the construct of facilitating conditions is the most important determinant of students' intention to use the synchronous collaboration, followed by social influence and effort expectancy. The results indicate that the construct of facilitation conditions, such as the usage of new technology or problem solution, plays a significant role when integrating new technology since students will be more familiar with the new technology. Finally, both the implications and limitations of this study are discussed, and further research directions are proposed.

Background/Objectives: The potential and limitations of chatbots in medical education and clinical decision support, particularly in specialized fields like psychiatry, remain unknown. By using the Rasch model, our study aimed to evaluate the performance of various state-of-the-art chatbots on psychiatry licensing exam questions to explore their strengths and weaknesses. Methods: We assessed the performance of 22 leading chatbots, selected based on LMArena benchmark rankings, using 100 multiple-choice questions from the 2024 Taiwan psychiatry licensing examination, a nationally standardized test required for psychiatric licensure in Taiwan. Chatbot responses were scored for correctness, and we used the Rasch model to evaluate chatbot ability. Results: Chatbots released after February 2024 passed the exam, with ChatGPT-o1-preview achieving the highest score of 85. ChatGPT-o1-preview showed a statistically significant superiority in ability (p < 0.001), with a 1.92 logits improvement compared to the passing threshold. It demonstrated strengths in complex psychiatric problems and ethical understanding, yet it presented limitations in up-to-date legal updates and specialized psychiatry knowledge, such as recent amendments to the Mental Health Act, psychopharmacology, and advanced neuroimaging. Conclusions: Chatbot technology could be a valuable tool for medical education and clinical decision support in psychiatry, and as technology continues to advance, these models are likely to play an increasingly integral role in psychiatric practice. [ABSTRACT FROM AUTHOR]

Listeria monocytogenes causes listeriosis, a serious foodborne illness with a high mortality rate, especially in vulnerable populations. It accounts for 19% of foodborne deaths, with invasive cases having a mortality rate of up to 44%, leading to conditions like meningitis, bacteremia, and meningoencephalitis. However, the prognostic factors remain unclear. This study examines the hospital outcomes of invasive listeriosis and identifies risk factors for in-hospital and one-year mortality. We analyzed the electronic medical records of 118 hospitalized patients with non-perinatal, culture-proven invasive listeriosis collected over a 21-year period. The in-hospital mortality rate was 36.4%, with only 33.1% surviving one year and 22.0% surviving two years. The key findings indicate that a quick Sequential Organ Failure Assessment (qSOFA) score of ≥2 (OR 106.59, p < 0.001), respiratory failure (OR 7.58, p = 0.031), and shorter ampicillin duration (OR 0.53, p = 0.012) independently predicted poorer in-hospital outcomes. Additionally, a qSOFA score of ≥2 (OR 8.46, p < 0.001) and shorter ampicillin duration (OR 0.65, p < 0.001) were linked to higher one-year mortality. This study is the first to identify a qSOFA score of ≥2 as a significant marker for high-risk invasive listeriosis patients, with poorer outcomes linked to a qSOFA score of ≥2, respiratory failure, and shorter ampicillin use. [ABSTRACT FROM AUTHOR]

Background/Objectives: The complex association between attention-deficit/hyperactivity disorder (ADHD) and methylphenidate (MPH) with precocious puberty (PP) is still unclear. This study aims to investigate the association between ADHD, MPH, and PP. Methods: This is a nationwide cohort study including a total of 3,342,077 individuals, 186,681 with ADHD and 3,155,396 without. First, we compared the risk of PP between ADHD cases and non-ADHD cases. Second, we compared the risk of PP between MPH users and non-MPH users in patients with ADHD. Results: Patients with ADHD were at a greater risk of PP (adjusted hazard ratio [aHR], 2.01 [95% CI, 1.91–2.11]). In our moderation analyses, the female gender was a positive additive effect modifier of the association between ADHD and PP, whereas tics and intellectual disability were negative effect modifiers. In patients with ADHD, MPH users had a significantly lower risk of PP (aHR, 0.63 [95% CI 0.57–0.70]), and females had a negative effect modification on the association between MPH and PP. Conclusions: Our study found that children with ADHD were at a greater risk of PP. Girls with ADHD were a group particularly vulnerable to PP. Comorbid tics or intellectual disability was associated with a lower risk of PP. Among patients with ADHD, MPH was protective against PP, especially in girls. However, these preliminary results need further validation due to the nature of them being from an electronic database study. Unmeasured confounding factors might affect the association between MPH and PP. [ABSTRACT FROM AUTHOR]

Background: Listeriosis is caused by the facultative anaerobic bacterium Listeria monocytogenes. Infection from Listeria-contaminated food or water is the main etiology. If Listeria travels outside the intestines, it can cause invasive listeriosis, such as sepsis, meningitis, and meningoencephalitis. Invasive illness is especially dangerous for pregnant women and their newborns, elderly people, and people with compromised immune systems or medical conditions such as end-stage kidney disease (ESKD) patients receiving long-term dialysis. Purpose: Describe the manifestations and hospital outcomes of invasive listeriosis and identify the risk factors for in-hospital and one-year mortality in ESKD patients receiving long-term dialysis. Patients and Methods: This retrospective observational study examined hospitalized patient records at a Taiwanese tertiary medical center from August 1, 2000, to August 31, 2021. ESKD patients on chronic dialysis were identified with invasive listeriosis by blood culture and discharge diagnosis. Over 21 years, we accurately recorded 26 cases. Results: ESKD patients on chronic dialysis with invasive listeriosis have a poor prognosis. Only 53.8% of chronic dialysis patients with invasive listeriosis survived their first hospital episode. 42.3% of hospitalized ESKD patients with invasive listeriosis survived one year later. In univariate analysis, shock, tachypnea (RR ≥ 22), respiratory failure, qSOFA score ≥ 2, and lower initial platelet count were linked to greater in-hospital mortality rates. Conclusion: ESKD patients with invasive listeriosis have a grave prognosis. Our research reveals that an early blood sample for a bacterial culture may identify invasive listeriosis in chronic dialysis patients with fever, nausea or vomiting, confusion, and respiratory distress. This study is the first to identify a lower platelet count and qSOFA score ≥ 2 as markers of high-risk invasive listeriosis in ESKD patients. [ABSTRACT FROM AUTHOR]

Limited knowledge is available about the association between autistic spectrum disorder (ASD) and precocious puberty. Our study examined the association between the two medical conditions and effect modification by sex and neuropsychiatric comorbidities in a nationwide population. To compare the risk of precocious puberty between ASD and non-ASD cases, we conducted a Cox regression analysis using ASD as the exposure and time to precocious puberty as the outcome. We adjusted for sex, attention-deficit/hyperactivity disorder (ADHD), tic disorder, obsessive–compulsive disorder (OCD), anxiety disorder, intellectual disability, and epilepsy. We performed a moderation analysis to examine the potential moderating effects of sex and comorbidities. Patients with ASD were prone to have precocious puberty, with an adjusted hazard ratio (aHR) of 1.80 (95% CI: 1.61–2.01). For effect modification, sex, specifically females, moderated the association between ASD and precocious puberty, with a relative excess risk due to interaction (RERI) of 7.35 (95% CI 4.90–9.80). No significant effect modification was found for any of the comorbidities within the scope of additive effect modification. We found that patients with ASD were prone to precocious puberty, regardless of sex or comorbid neuropsychiatric disorders. Girls with ASD are at a particularly higher risk of developing precocious puberty. [ABSTRACT FROM AUTHOR]

Background and objective: Local advanced rectal cancer (LARC) poses significant treatment challenges due to its location and high recurrence rates. Accurate early detection is vital for treatment planning. With magnetic resonance imaging (MRI) being resource-intensive, this study explores using artificial intelligence (AI) to interpret computed tomography (CT) scans as an alternative, providing a quicker, more accessible diagnostic tool for LARC. Methods: In this retrospective study, CT images of 1070 T3–4 rectal cancer patients from 2010 to 2022 were analyzed. AI models, trained on 739 cases, were validated using two test sets of 134 and 197 cases. By utilizing techniques such as nonlocal mean filtering, dynamic histogram equalization, and the EfficientNetB0 algorithm, we identified images featuring characteristics of a positive circumferential resection margin (CRM) for the diagnosis of locally advanced rectal cancer (LARC). Importantly, this study employs an innovative approach by using both hard and soft voting systems in the second stage to ascertain the LARC status of cases, thus emphasizing the novelty of the soft voting system for improved case identification accuracy. The local recurrence rates and overall survival of the cases predicted by our model were assessed to underscore its clinical value. Results: The AI model exhibited high accuracy in identifying CRM-positive images, achieving an area under the curve (AUC) of 0.89 in the first test set and 0.86 in the second. In a patient-based analysis, the model reached AUCs of 0.84 and 0.79 using a hard voting system. Employing a soft voting system, the model attained AUCs of 0.93 and 0.88, respectively. Notably, AI-identified LARC cases exhibited a significantly higher five-year local recurrence rate and displayed a trend towards increased mortality across various thresholds. Furthermore, the model's capability to predict adverse clinical outcomes was superior to those of traditional assessments. Conclusion: AI can precisely identify CRM-positive LARC cases from CT images, signaling an increased local recurrence and mortality rate. Our study presents a swifter and more reliable method for detecting LARC compared to traditional CT or MRI techniques. [ABSTRACT FROM AUTHOR]