The automated procedure used in this study, including the use of the control-experimental protocol and response thresholds used for each of the five objective indices, can be used for difficult-to-test patients and may prove to be useful as an assessment and diagnostic method in both clinical and basic research efforts.

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Nontuberculous mycobacterial otomastoiditis is rare and can be easily confused with various different forms of otitis media. We describe the case of a 50-year-old woman who presented with left-sided chronic otitis media that had persisted for more than 1 year. It was not eradicated by standard antimicrobial therapy and surgical debridement. After appropriate antibiotic therapy for nontuberculous mycobacteria was added to the therapeutic regimen, the patient improved significantly and the lesion had healed by 6 months. Based on our experience with this case, we conclude that early bacterial culture and staining for acid-fast bacilli in ear drainage material or granulation tissue should be performed when standard antimicrobial therapy fails to eradicate chronic otitis media of an undetermined origin that is accompanied by granulation tissue over the external auditory canal or middle ear. Polymerase chain reaction testing is also effective for rapid diagnosis. Surgical debridement and removal of the foreign body can successfully treat nontuberculous mycobacterial otomastoiditis only when effective antimicrobial therapy is also administered.

This study uses National Taiwan University Hospital (NTUH) as the experimental field to explore the existing sign system design through the wayfinding behavior in the virtual environment. The experiment simulated scenes that allowed the participants to move freely from a first-person perspective and provided wayfinding tasks. The results showed that participants were more likely to use signs suspended from the ceiling to find directions. When they don't see the target information on the signs, they wander around or go to a similar section to look for it. If the target is not on the first floor, indicators should provide clear information about the floor. The existing sign system makes users ignore information in layout, and the way of arrow direction indication also needs to be standardized. The results of this research help to understand the wayfinding behavior of users in the hospital, to serve as a reference for design improvements.