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Virtual Reality (VR) has gained popularity in educational fields enabling new learning possibilities. In the implementation process, VR could improve learning by increasing positive affective and cognitive processing, whereas VR also could hurt learning by increasing distraction and leading to poorer learning outcomes. Thus, understanding the cognitive processes that occur during the learning process using VR can provide sufficient information to unlock the learning potential. This research aims to determine cognitive processes through brain waves when participants perform VR learning and reading activity. Cognitive processing during VR learning was compared to the reading process because reading was a fundamental activity of the learning process and one of the most common ways of accessing knowledge. Brain Wave data on attention and meditation were collected using the Mindset EEG headset developed by Neurosky Inc., in which participants read the material and experienced VR simulation regarding the weightlessness concept. The results show that reading activity has a higher attention level than VR learning due to the many learning modalities in VR learning causing cognitive overload. Regarding the level of meditation, the brain activities indicate that the reading activity and VR learning activities have the same level of meditation. One of the most plausible explanations is the absence of cybersickness in VR learning. Moreover, according to the trend analysis of the brain wave activity, VR learning can possibly enhance the learning process in specific scenarios, such as when participants complete their mission in the VR simulation and start free exploration and when participants see something that they thought was extraordinarily embodied in VR. Besides that, VR learning can also distort the learning process, such as when participants are confused during instruction about which path to take and what the next step is, then cause distraction in learning.

During the worldwide pandemic of coronavirus disease 2019 (COVID-19 pandemic), online learning is increasingly vital for students to learn at home, and online learning platforms provide learning opportunities to students. The Junyi Academy online platform is an online learning platform that both helps lower-achieving students review lessons and helps teachers in Taiwan do differentiated instruction. Several studies have shown the relationships between students' attention and their academic achievements for students' self-learning, but how to best use these platforms to help students learn by themselves is unclear. Therefore, this study investigates the relationships between students' attention and their academic achievements with two online learning environments. A total of 38 upper secondary students in Taiwan to participate in this study, and these students were divided between a Khan-style video lecture (VL) group and an online practice (OP) group. This study adopted an experimental design with data collected by an electroencephalogram (EEG). The results show that students' attention in the VL group was higher than in the OP group. Furthermore, their attention in three stages differed between the two groups. Student attention was similar in the two groups for the first stage, but the VL group had higher attention for the second and third stages was than did the OP group. In addition, there was no relationship between students' attention and their academic achievements in the VL and OP groups. Finally, this study raised some suggestions the future research.

Background Lower extremity trauma often necessitates reconstruction with flap transfer. One of the reconstructive goals is a thin soft tissue coverage with appropriate contour. Therefore, a secondary debulking of the flap is usually performed. Methods Debulking through conventional lipectomy is compared with liposuction followed by excision of the defatted flap excess. Demographic data, surgical details, and postoperative outcomes are compared and analyzed. The perfusion dynamics of the flaps undergoing liposuction debulking are studied by means of perioperative indocyanine green fluorescence angiography, as well as postoperative laser Doppler imaging. Results Patients undergoing lipectomy (n = 69; 57.5%) or liposuction (n = 51; 42.5%) debulking had a similar rate of postoperative complications. Partial necrosis was observed in 7.2% (lipectomy) versus 7.8% (liposuction) of flaps. Fluorescence angiography showed a substantial decrease in flap perfusion following the infiltration with an epinephrine-containing tumescent solution (74.3% ± 8.2% prior to infiltration versus 16.8% ± 7.1% after infiltration; p < 0.001), resulting in a dark flap appearance. Laser Doppler imaging confirmed the hypoperfusion on postoperative day 1. Conclusion Secondary debulking of a lower extremity flap can be safely and efficiently performed through liposuction combined with peripheral excision of the defatted flap in a single stage. Perfusion studies may show a misleading hypoperfusion of the defatted flap, which does not accurately predict subsequent necrosis or complications. [ABSTRACT FROM AUTHOR]

Background: Elective tracheotomy is commonly performed in resected oral squamous cell carcinoma (OCSCC) to maintain airway patency. However, the indications for this procedure vary among surgeons. This nationwide study evaluated the impact of tracheotomy on both the duration of in‐hospital stay and long‐term survival outcomes in patients with OCSCC. Methods: A total of 18,416 patients with OCSCC were included in the analysis, comprising 7981 patients who underwent elective tracheotomy and 10,435 who did not. The primary outcomes assessed were 5‐year disease‐specific survival (DSS) and overall survival (OS). To minimize potential confounding factors, a propensity score (PS)‐matched analysis was performed on 4301 patients from each group. The duration of hospital stay was not included as a variable in the PS‐matched analysis. Results: Prior to PS matching, patients with tracheotomy had significantly lower 5‐year DSS and OS rates compared to those without (71% vs. 82%, p < 0.0001; 62% vs. 75%, p < 0.0001, respectively). Multivariable analysis identified tracheotomy as an independent adverse prognostic factor for 5‐year DSS (hazard ratio = 1.10 [1.03–1.18], p = 0.0063) and OS (hazard ratio = 1.10 [1.04–1.17], p = 0.0015). In the PS‐matched cohort, the 5‐year DSS was 75% for patients with tracheotomy and 76% for those without (p = 0.1488). Five‐year OS rates were 66% and 67%, respectively (p = 0.0808). Prior to PS matching, patients with tracheotomy had a significantly longer mean hospital stay compared to those without (23.37 ± 10.56 days vs. 14.19 ± 8.34 days; p < 0.0001). Following PS matching, the difference in hospital stay duration between the two groups remained significant (22.34 ± 10.25 days vs. 17.59 ± 9.54 days; p < 0.0001). Conclusions: While elective tracheotomy in resected OCSCC patients may not significantly affect survival, it could be associated with prolonged hospital stays. [ABSTRACT FROM AUTHOR]

Background: Advanced non-small-cell lung cancer (NSCLC) can be treated with novel targeted therapies that are tailored to the genetic characteristics of malignancy. While tissue-based genomic testing is considered the gold standard for the detection of oncogenic driver mutations, several challenges like inadequate tissue availability, the invasiveness of procuring tumors, and prolonged turnaround time of analysis are encountered. Considering these limitations, guidelines have recognized liquid biopsies using circulating cell-free DNA (cfDNA) as a useful tool to complement conventional tissue testing. Even though cfDNA next-generation sequencing (NGS) can have high sensitivity and specificity, optimal patient benefit requires the interpretation of the molecular profiling results in the context of clinical and diagnostic features to achieve the best outcomes. Case Descriptions: In this case series, we present six patients with advanced NSCLC whose plasma or tissue biopsy samples were analyzed with commercially available comprehensive NGS assays that elucidate the role of testing at various time points in the treatment journey. In all six cases, comprehensive genomic profiling (CGP) provided clinically useful information to guide treatment decisions. Conclusion: Adding to the existing real-world evidence, this case series reinforces that CGP-driven treatment strategies in advanced NSCLC, coupled with other available clinical information, can optimize treatment decisions. [ABSTRACT FROM AUTHOR]

Esophageal cancer ranks among the ten most common cancers worldwide. Despite the adoption of neoadjuvant concurrent chemoradiotherapy (nCCRT) followed by surgery as the standard treatment approach in recent years, the local recurrence rate remains high. In this study, we employed RNA-seq to investigate distinctive gene expression profiles in esophageal squamous cell carcinoma (ESCC) with or without recurrence following a standard treatment course. Our findings indicate that recurrent ESCC exhibits heightened keratinizing and epidermis development activity compared to non-recurrent ESCC. We identified TP63 as a potential candidate for distinguishing clinical outcomes. Furthermore, immunohistochemistry confirmed the trend of TP63 overexpression in ESCC recurrence. Patients with elevated TP63 expression had poorer overall survival and lower 3-year recurrence-free survival. This study underscores the potential of TP63 as a biomarker for detecting cancer recurrence and suggests its role in guiding future treatment options. [ABSTRACT FROM AUTHOR]