Radiofrequency ablation (RFA) is a minimally invasive management strategy that has been widely applied for benign and recurrent malignant thyroid lesions as an alternative to surgery in Taiwan. Members of academic societies for specialists in interventional radiology, endocrinology, and endocrine surgery collaborated to develop the first consensus regarding thyroid RFA in Taiwan. The modified Delphi method was used to reach a consensus. Based on a comprehensive review of recent and valuable literature and expert opinions, the recommendations included indications, pre-procedural evaluations, procedural techniques, post-procedural monitoring, efficacy, and safety, providing a comprehensive review of the application of RFA. The consensus effectively consolidates advice regarding thyroid RFA in clinical practice for local experts.

Thyroid radiofrequency ablation and microwave ablation are widely adopted minimally invasive treatments for diverse thyroid conditions worldwide. Fundamental skills such as the trans-isthmic approach and the moving shot technique are crucial for performing thyroid ablation, and advanced techniques, including hydrodissection and vascular ablation, improve safety and efficacy and reduce complications. Given the learning curve associated with ultrasound-guided therapeutic procedures, operators need training and experience. While training models exist, limited attention has been given to ultrasound maneuvers in ablation needle manipulation. This article introduces two essential maneuvers, the zigzag moving technique and the alienate maneuver, while also reviewing the latest ultrasound techniques in thyroid ablation, contributing valuable insights into this evolving field.

Background: Either sodium-glucose cotransporter-2 (SGLT-2) inhibitors or pioglitazone (Pio) has doubtful issues of bladder cancer, especially for the combination therapy with these two drugs. Our study aimed to investigate the risk of bladder cancer under combination therapy of SGLT-2 inhibitors and Pio. Materials and Methods: We included 97,024 patients with type 2 diabetes mellitus (T2DM) in the Chang Gung Research Database in Taiwan from 1 January 2016 to 31 December 2019. The primary outcome was newly diagnosed bladder cancer after combination therapy with SGLT-2 inhibitors and Pio. Group 1 received both study drugs, group 2 received SGLT-2 inhibitors, group 3 received Pio, and group 4 received non-study drugs (the reference group). The secondary outcome in each group was all-cause mortality. Results: In group 1, no newly diagnosed bladder cancer was detected after a mean 2.8-year follow-up and all-cause mortality decreased significantly (adjusted hazard ratio (AHR), 0.70; 95% confidence interval (CI), 0.54–0.92) in comparison to the reference group (group 4). In group 2 and group 3, no trend of increased bladder cancer was observed (group 2: AHR 0.49, 95% CI 0.05–4.94; group 3: AHR 0.48, 95% CI 0.15–1.58) and it still reduced all-cause mortality (group 2: AHR 0.83, 95% CI 0.70–0.99; group 3: AHR 0.90, 95% CI 0.83–0.99). Conclusions: In T2DM patients without previous or active bladder cancer, the combination therapy of SGLT-2 inhibitors and Pio was not associated with newly diagnosed bladder cancer and had lower all-cause mortality.

Background: To evaluate the outcomes in differentiated thyroid cancer (DTC) patients who achieved excellent response to initial treatment and developed distant metastasis during follow-up. Methods: Thyroid cancer patients registered in Chang Gung Memorial Hospital thyroid cancer database between January 1979 and December 2019 were assessed. Results: Among 1053 DTC patients with excellent response to initial therapy, 14 (1.3%) patients developed metastatic disease during follow-up, including 6 males and 8 females with median age of 50.2 years [interquartile range (IQR), 39.9-53.7]. Nine (64.3%) patients had papillary cancer, four (28.6%) had follicular cancer, and one (7.1%) had Hürthle cell cancer. Most patients (92.9%) had stage I disease at diagnosis. The sites of metastasis were lung (71.4%), bone (7.1%), mediastinum (7.1%) and multiple sites (14.3%). With a median follow-up of 18.3 years (IQR, 14.8-23.8), 2 patients had disease-specific mortality. The 5- and 10-year disease-specific survival after the diagnosis of distant metastasis was 92% and 74%, respectively. Multiple sites of metastasis was associated with increased risk of mortality (P = 0.022). Conclusions: A small proportion of DTC patients with an excellence response to initial therapy developed distant metastasis during follow-up. Multiple organ distant metastases conferred a worse disease-specific survival.

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Background: Socially assistive robots (SARs) have the potential to support pediatric care; yet, routine clinical adoption remains limited. Because SARs interact directly with children, health care professionals (HCPs) may consider not only clinical utility and usability but also child-robot interaction, trust, and implementation concerns that may not be fully represented by conventional technology acceptance frameworks. Objective: This study aimed to examine factors associated with pediatric HCPs’ behavioral intention (BI) to adopt SARs and explored how clinical perspectives contextualized conventional technology acceptance constructs. Methods: A convergent parallel mixed methods study was conducted at a tertiary medical center in Taiwan between June and December 2025. In the quantitative strand, 125 pediatric HCPs viewed a standardized video of a SAR interacting with a child and completed a Unified Theory of Acceptance and Use of Technology (UTAUT2)-based questionnaire incorporating trust. Multiple linear regression examined associations with BI. In the qualitative strand, 17 HCPs with direct clinical SAR exposure, recruited primarily from 2 pilot units, participated in semistructured interviews. The strands involved partially overlapping but nonequivalent samples with different levels of SAR exposure. Qualitative data were analyzed thematically, and findings were integrated using a joint display. Results: The quantitative model accounted for 72.7% of the variance in BI. Social influence (SI: β=0.348; P <.001), hedonic motivation (HM: β =0.307; P <.001), and performance expectancy (PE: β=0.238; P =.001) had the largest standardized coefficients; the association for trust was small and sensitive to model specification, whereas effort expectancy (EE) and facilitating conditions (FC) were not significantly associated with BI. Limited discriminant validity and potential common method variance warranted caution in construct-specific interpretation. Qualitative analysis generated 6 themes concerning children’s emotional and stress-related challenges, SAR functions and clinical positioning, HCP attitudes, child-centered design, and implementation and institutional considerations. Integration showed convergence for clinical usefulness and complementarity for trust-related concerns. Children’s engagement and relational interaction were conceptually distinct from UTAUT2-defined HM, reflecting HCPs’ own enjoyment. SI was prominent quantitatively but was not articulated as a salient consideration in participants’ accounts, whereas operational concerns were elaborated in detail in participants’ accounts despite the nonsignificant association for EE. Conclusions: Pediatric HCPs’ intentions to adopt SARs were associated with SI, HM, and PE, but measurement limitations and the predominantly video-based evaluation context preclude interpreting these associations as distinct determinants or predictors of actual use. Qualitative findings highlighted child-centered relational value and context-specific implementation concerns. Child-centered relational value was conceptually distinct from HCP-centered HM, suggesting that evaluations of patient-facing socially interactive technologies may involve considerations not fully represented by conventional user-centered acceptance constructs. Multisite longitudinal studies using validated measures and real-world SAR exposure are needed to examine actual uptake and sustained use.