METHODS: From January to November 2024, 3 patients with broad nasal bridges following HA filler injections were identified. All underwent clinical evaluation and portable ultrasound imaging (Sonon 500L, Healcerion) to confirm residual HA. Ultrasound-guided hyaluronidase injections were performed to dissolve the filler. Follow-up assessments included ultrasound imaging and clinical photography to evaluate outcomes.
RESULTS: Patients presented with delayed broadening of the nasal bridge years after a single HA injection. Ultrasound confirmed residual HA and guided hyaluronidase injections significantly improved nasal contour, reducing the bone-to-skin thickness and resolving the broadened appearance. The procedure was well-tolerated, with minimal downtime and no adverse effects.
CONCLUSIONS: "Avatar Nose" underscores the importance of recognizing long-term HA filler complications. Ultrasound is critical for diagnosis and precise treatment. Ultrasound-guided hyaluronidase injection is an effective and minimally invasive solution, emphasizing the need for informed patient consent and further research into delayed filler effects.
METHODS: Following PRISMA guidelines, we searched PubMed, EMBASE, Science Direct, Web of Science, Google Scholar, and Scopus for cross-sectional studies on adolescent hypertension/elevated BP in Asia published from January 2019 to June 2024, after which we narratively synthesised their findings.
RESULTS: Of the 2634 retrieved studies, 39 met the inclusion criteria, covering over 200 000 adolescents in Asia. The prevalence of hypertension ranges from 0.7% in urban Bangladesh to 24.5% in urban Malaysia, with urban areas generally showing higher rates than rural areas (e.g. India: 8.4% urban vs. 5.7% rural). By region, East Asia has the highest overall prevalence (14.25%), followed by West Asia (14.14%), South Asia (13.77%), Southeast Asia (13.16%), and Central Asia (12.37%). Males had higher prevalence rates (for example, 22.3% in Chinese males vs. 20% in females).
CONCLUSIONS: The increasing prevalence of adolescent hypertension in urban Asia is a significant public health concern. Although extensive research has been conducted in East and South Asia, there is a dearth of studies in Western, Southeast, and Central Asia, emphasising a need for future research. Standardised diagnostic criteria and targeted interventions are crucial for addressing regional disparities and reducing long-term cardiovascular risks.
OBJECTIVE: This study explored the relationship between school bullying and suicidal ideation (SI) among vocational school students in China, and it constructs a moderated mediation model to examine the mediating effects of physical anhedonia (PA) and social anhedonia (SA), as well as the moderating effects of cognitive reappraisal (CR) and expressive suppression (ES).
PARTICIPANTS AND SETTING: Convenience sampling was conducted. The sample included 13,675 vocational school students (57.7 % female) with an average age of 15.88 years (ranging from 13 to 21) from 13 vocational schools in Hainan Province, China.
METHODS: Participants completed questionnaires on demographics, school bullying, PA, SA, CR, ES, and SI.
RESULTS: The results showed that the prevalence rates of PA, SA, and SI among bullied students were significantly higher (40.7 %, 37.8 %, and 34.0 %, respectively). Mediation analysis revealed that school bullying had a significant indirect effect on SI through PA and SA (accounting for 42.4 % of the total effect), with SA being the key mediator. Moderated mediation analysis confirmed that CR moderated the mediating effects of school bullying via PA/SA on SI, and ES moderated the mediating effects of school bullying via SA on SI. ES did not moderate the relationship between school bullying and SA in the female group.
CONCLUSION: School bullying induces SI by impacting PA and SA, and CR and ES moderate this process. This provides theoretical support for developing effective intervention measures to alleviate the negative impact of bullying on mental health.
METHODS: Asthma and atopic dermatitis prevalence, incidence, DALYs, and mortality, with corresponding 95% uncertainty intervals (UIs), were estimated for 204 countries and territories from 1990 to 2021. A systematic review identified data from 389 sources for asthma and 316 for atopic dermatitis, which were further pooled using the Bayesian meta-regression tool. We also described the age-standardised DALY rates of asthma attributable to four modifiable risk factors: high BMI, occupational asthmagens, smoking, and nitrogen dioxide pollution. Furthermore, as a secondary analysis, prevalence was forecasted to 2050 using the Socio-demographic Index (SDI), air pollution, and smoking as predictors for asthma and atopic dermatitis. To assess trends in the burden of asthma and atopic dermatitis before (2010-19) and during (2019-21) the COVID-19 pandemic, we compared their average annual percentage changes (AAPCs).
FINDINGS: In 2021, there were an estimated 260 million (95% UI 227-298) individuals with asthma and 129 million (124-134) individuals with atopic dermatitis worldwide. Asthma cases declined from 287 million (250-331) in 1990 to 238 million (209-272) in 2005 but increased to 260 million in 2021. Atopic dermatitis cases consistently rose from 107 million (103-112) in 1990 to 129 million (124-134) in 2021. However, age-standardised prevalence rates decreased-by 40·0% (from 5568·3 per 100 000 to 3340·1 per 100 000) for asthma and 8·3% (from 1885·4 per 100 000 to 1728·5 per 100 000) for atopic dermatitis. In 2021, there were substantial variations in the burden of asthma and atopic dermatitis across different SDI groups, with the highest age-standardised DALY rate found in south Asia for asthma (465·0 [357·2-648·9] per 100 000) and the high-income super-region for atopic dermatitis (3552·5 [3407·2-3706·1] per 100 000). During the COVID-19 pandemic, the decline in asthma prevalence had stagnated (AAPC pre-pandemic -1·39% [-2·07 to -0·71] and during the pandemic 0·47% [-1·86 to 2·79]; p=0·020); however, there was no significant difference in atopic dermatitis prevalence in the same period (pre-pandemic -0·28% [-0·33 to -0·22] and during the pandemic -0·35% [-0·78 to 0·08]; p=0·20). Modifiable risk factors were responsible for 29·9% of the global asthma DALY burden; among them, high BMI was the greatest contributor (39·4 [19·6-60·2] per 100 000), followed by occupational asthmagens (20·8 [16·7-26·5] per 100 000) across all regions. The age-standardised DALY rate of asthma attributable to high BMI was highest in high-SDI settings, whereas the contribution of occupational asthmagens was highest in low-SDI settings. According to our forecasting models, we expect 275 million (224-330) asthma cases and 148 million (140-158) atopic dermatitis cases in 2050, with population growth driving this increase. However, age-standardised prevalence rates are expected to remain stable (-23·2% [-44·4 to 5·3] for asthma and -1·4% [-9·1 to 7·0] for atopic dermatitis) from 2021 to 2050.
INTERPRETATION: Although the increases in the total number of asthma and atopic dermatitis cases will probably continue until 2050, age-standardised prevalence rates are expected to remain stable. A considerable portion of the global burden could be managed through efforts to address modifiable risk factors. Additionally, the contribution of risk factors to the burden substantially varied by SDI, which suggests the need for tailored initiatives for specific SDI settings. The growing number of individuals expected to be affected by asthma and atopic dermatitis in the future suggests that it is essential to improve our understanding of risk factors for asthma and atopic dermatitis and collect disease prevalence data that are globally generalisable.
FUNDING: Gates Foundation.
METHODS: A total of 167 participants were recruited (male/female = 46/121; aged 22.0 ± 5.2). Chronotype was assessed via reduced Morningness-Eveningness Questionnaire (rMEQ). Participants tracked their sleep behaviors using an activity wristband (Xiaomi® Mi Smart Band 5), and recorded their smartphone screen time usage. Psychometric measures - WHO-5 Well-being Index, Cognitive Distortion Questionnaire (CDQUEST), Three-Factor Eating Questionnaire-R18, Brief Self-Control Scale (BSCS), and Power of Food Scale. Blood pressures (BP), anthropometrics, and body composition like high waist circumference (WC), waist-hip ratio (WHR), waist-to-height ratio (WHtR), body mass index (BMI) and visceral fat level (VFL) were also measured.
RESULTS: Men and women did not differ significantly in terms of chronotype and sleep behaviors, except Rapid Eye Movement (REM) sleep. Longer weekday total and deep sleeps significantly correlated with better WHO-5 well-being scores, while longer weekend time awake during sleep significantly correlated with greater cognitive distortion (higher CDQUEST scores). Longer average deep sleep significantly correlated with lower Cognitive Restraint (CR) but higher Food Available scores. Higher rMEQ scores (indicating morningness) significantly correlated with better WHO-5 well-being, BSCS Total and Restraint scores; and significantly correlated with decreased systolic and diastolic BP specifically among men. Evening-type participants had up to six-fold higher risk of becoming obese, and having high WC, WHR, and VFL; however, the significance was abolished after adjustment for socio-demographics. Indeed, WC, weight, WHtR, BMI, VFL, and resting metabolism were significantly higher among evening-types by analysis of covariance. BSCS Total and Impulsivity scores were significantly higher among neither-types. Lifestyle factors and smartphone screen time were not associated with chronotype or sleep behaviors.
CONCLUSIONS: Although chronotype and sleep behaviors did not differ between sexes, those with a morning chronotype had lower overall, central and visceral adiposity, better well-being and self-control. Those with good sleep behaviors also had better well-being, eating and appetitive behaviors. In conclusion, this study supports the continuous advocacy for a morning-chronotype and good sleep behaviors for better physical and mental health.
METHODS: A mixed-methods sequential explanatory design was used. This study was conducted at a primary care clinic in an academic hospital from April - November 2018. The insulin PDA was implemented using a tailored implementation intervention, which comprised of 11 strategies aiming to overcome 13 prioritised implementation barriers. Evaluation data were collected from: healthcare administrators such as the head of department, the clinic coordinator, and the nursing officer who oversees the clinic operations, doctors whose tasks were to deliver the insulin PDA to patients, nurses who were responsible for making sure the insulin PDAs were available, and patients with type 2 diabetes who were offered the insulin PDA. The study commenced with the quantitative approach to assess 'Reach', 'Adoption', 'Implementation' and 'Maintenance'of the insulin PDA. Subsequently, qualitative approach was employed and qualitative interviews were conducted with the relevant stakeholders to explain the quantitative outcomes. A total of six IDIs and six FGDs were conducted with healthcare providers (healthcare policymakers: 3, doctors: 35, and staff nurses: 5), and 62 IDIs were conducted with patients.
RESULTS: For 'Reach', 88.9% (n = 48/54) of doctors and 55% (n = 11/20) of nurses attended the insulin PDA training workshops. This was attributed to their self-motivation and the mandate from the Head of Department. The PDA reached 387 patients and was facilitated by the doctors who delivered the PDA to them and their own desire to know more about insulin. Doctors' 'Adoption' of the PDA was high (83.3%, n = 45/54) due to the positive personal experience with the usefulness of the PDA. Only 65.7% (n = 94/143) of patients who received the PDA read it. The degree of 'Implementation' of the PDA varied for different tasks (ranged from 19.2 to 84.9%) and was challenged by patient and system barriers. For 'Maintenance', 80% of the doctors were willing to continue using the PDA due to its benefits.
CONCLUSION: This study highlighted that the implementation of an insulin PDA in a primary care setting is promising. Addressing the issues of social hierarchy, and healthcare providers' roles and responsibilities can further improve implementation outcomes.
METHODS: The 2022 Adolescent Health Survey (AHS) 2022 was a nationwide study involving Malaysian students aged 13 to 17 years old. It used a multistage stratified cluster sampling method to ensure a representative sample. Data collection was performed via a validated self-administered questionnaire. Descriptive and multivariate logistic regression was used to determine the prevalence and factors associated with the consumption of carbonated soft drinks.
RESULTS: The prevalence of carbonated soft drink consumption at least once daily in the past 30 days was 32.4% (95% CI: 30.93, 33.87). The results revealed that the consumption of carbonated soft drinks was highest among males and young adolescents. Multivariate logistic regression analysis indicated that health-related behaviours associated with high soft drink consumption included consuming fast food at least three days per week, drinking alcohol, drinking fewer than six glasses of plain water, and being physically inactive. In addition, a greater intake of carbonated soft drinks was positively associated with depression and suicide attempts.
CONCLUSION: This study provides compelling evidence that the consumption of carbonated soft drinks was associated with health-related behaviours and poor mental health among Malaysian adolescents.