Measurement error regression is widely used in statistical modeling. When the regression function is discontinuous, the estimation and inference have become challenging. In this paper, we develop a jump detection framework for a single index model with measurement error. First, for the single index model with measurement error, the consistent estimator of the index coefficient is obtained by using both the SIMEX (simulation extrapolation) and estimation equation methods. Then, the one-sided kernel local linear method is used to construct the estimator of the nonparametric function and the estimator of the jump point. Under some regularity assumptions, the asymptotic properties of the resultant estimators are established. The finite sample performance of our methodologies is evaluated by numerical simulation, and finally they are used to analyze the effect of serum cholesterol level and age on male blood.

OBJECTIVES:A type IIB constricted ear is a common congenital auricular deformity. Traditional methods often require multistage surgeries or contralateral tissue transplantation. We hypothesized that helical cartilage inversion grafting combined with a V-Y advancement flap could achieve effective single-stage correction with comparable morphologic improvements to traditional methods, while significantly eliminating donor-site morbidity. This study aims to evaluate the clinical efficacy and safety of this technique. METHODS:This retrospective analysis included 20 patients (23 ears) with type IIB constricted ear. Through a retroauricular approach, the excessively folded helical cartilage was transected to create a free cartilage graft, then inverted and reconnected. A retroauricular V-Y advancement flap provided soft tissue coverage. Surgical outcomes were assessed using auricular measurements, the Aesthetic Outcomes Scale (AOS), and the Visual Analog Scale (VAS). RESULTS:The mean patient age was 5.2±1.8 years with a 12-month follow-up. Postoperative ear vertical height increased from 40.3±3.5 to 50.5±3.8 mm (25.3% increase, P<0.001). AOS scores improved from 1.8±0.6 to 3.2±0.7 (P<0.001). VAS satisfaction scores increased from 2.1±1.2 to 8.3±1.4 (P<0.001). A total of 90% of patients achieved satisfaction scores ≥7, with 13.0% complication rate. CONCLUSION:Helical cartilage inversion grafting combined with V-Y advancement flap is a safe and effective single-stage correction method for type IIB constricted ear, characterized by minimal trauma, adequate soft tissue coverage, and low complication rates, providing a valuable clinical treatment option.

BACKGROUND:Inferior displacement of tissue expanders during first-stage auricular reconstruction remains a persistent clinical challenge. We evaluated a modified dual-plane "bio-hammock" technique, in which the inferior pole of the expander (approximately 1.5-2.0 cm) is embedded within an intramuscular pocket fashioned within the sternocleidomastoid muscle (SCM) belly, because of its efficacy in preventing inferior displacement and reducing complications. METHODS:A retrospective cohort study was conducted on 198 patients with unilateral microtia who underwent first-stage expander implantation between January 2022 and December 2025. The modified dual-plane cohort (n=99) was treated using the modified dual-plane technique and conventional single-plane cohort (n=99) was treated using the conventional single-plane technique. All expanders (80 ml) were over-inflated to approximately 110 ml (137.5% of nominal volume). The primary outcome was inferior displacement distance prior to the second-stage procedure and secondary outcomes included complication rates, VAS pain scores, and patient satisfaction. RESULTS:Inferior displacement was significantly reduced in the modified dual-plane cohort compared with the conventional single-plane cohort [median 0.30 (IQR: 0.22-0.38) cm vs. 1.40 (IQR: 1.15-1.70) cm; P<0.001], representing a 78.6% reduction. The overall complication rate was 2.0% vs. 7.1% (P=0.170), with zero expander exposure in the modified dual-plane cohort vs. 4.0% in the conventional single-plane cohort (P=0.121). Early postoperative VAS scores were marginally higher in the modified dual-plane cohort; however, they normalized by postoperative day 7. CONCLUSION:The "bio-hammock" technique provides superior mechanical stability against gravitational inferior displacement under extreme over-inflation conditions, with a favorable safety profile including zero expander exposure. This technique represents a safe and effective refinement for first-stage auricular reconstruction.

A more efficient estimation procedure on a panel data partially linear time-varying coefficient model (PDPLTVCM) with both fixed effects and spatial autoregressive errors is discussed in this paper. Without taking the first-order difference, we develop a new procedure for estimating the autoregressive parameter by taking a dummy variate-based semiparametric least-squares estimation (SLSE) approach and a new generalized method of moments (GMM) method. Asymptotic properties of the resultant estimators are established under some mild assumptions. Further, we derive the weighted semiparametric estimators for both the parameters and coefficient functions, and the main results show that they have the optimal convergence rate and are more efficient than the unweighted versions. Some Monte Carlo experiments are conducted to evaluate the finite sample performance of the proposed methods, and an authentic data example is investigated for illustration.

OBJECTIVES:The aims of the study were to evaluate the clinical efficacy of the ear remnant incision expander method for ear reconstruction in conchal-type (Grade II in Marx classification) microtia and analyze its advantages, limitations, and optimization strategies. METHODS:This retrospective study included 159 patients with conchal-type microtia treated between 2013 and 2023. The surgical procedure involved a standardized tissue expansion protocol followed by a 3-step reconstruction process: (1) incision design along the longitudinal axis of the remnant ear and expander removal, (2) selective excision of cartilage tissue from the upper wall of the conchal region of the remnant ear, and (3) carving and implantation of a 3-dimensional ear framework using rib cartilage (6th-8th), with the inferior crus of the antihelix positioned at the site of remnant cartilage removal. Outcomes were evaluated by 2 independent physicians using a validated anatomical scoring system and patient satisfaction assessment, with follow-up ranging from 6 months to 10 years. RESULTS:Among the 159 patients, 147 (92.5%) reported satisfactory results. Physician evaluation showed excellent outcomes in 127 patients (79.9%), good in 29 patients (18.2%), and poor in 3 patients (1.9%). The highest scores were observed for helix and lowest for triangular fossa. Complications included pigmentation (2.5%) in the conchal cavity and scar hyperplasia (3.8%) on the reconstructed ear. Age subgroup analysis revealed better outcomes in pediatric patients (5-12 years) compared to adults ( P < 0.05). CONCLUSIONS:The ear remnant incision expander method is effective for conchal-type microtia, providing good aesthetic outcomes with high patient satisfaction. This approach is particularly beneficial for pediatric patients, with complications effectively managed through conservative measures. The technique offers a valuable option for auricular reconstruction in selected patients with conchal-type microtia.

This study focuses on blepharoptosis, a common condition in oculoplastic surgery characterized by drooping of the upper eyelid. The efficacy and safety of using the combined fascial sheath (CFS) to correct blepharoptosis are still unclear. A systematic search encompassing four databases (PubMed, Embase, Web of Science, and Cochrane Library) up to December 15, 2023, was conducted. The meta-analysis was performed using Stata 14. A total of 10 studies involving 683 patients were included. The meta-analysis indicated a significant improvement in mean marginal reflex distance 1 (MRD1) in the CFS group compared to the control group (WMD: 2.33; 95 www.springer.com/00266

Autoimmune diseases have been linked to keloids in observational studies. Yet, the causality underlying this association remains ambiguous. To investigate the causal effects of selected autoimmune diseases, including rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), type 1 diabetes (T1D), inflammatory bowel disease (IBD), Crohn's disease (CD), and ulcerative colitis (UC), on keloids. We conducted a bidirectional two-sample Mendelian randomization (MR) analysis utilizing publicly released genome-wide association studies summary statistics. The inverse-variance weighted (IVW) method served as the primary analysis tool, supplemented by other methods such as weighted median, weighted mode, and MR Egger regression. Outliers, heterogeneity, and pleiotropy were assessed using the MR-PRESSO outlier test, Cochran's Q test, and MR-Egger regression, respectively. The IVW analysis revealed that genetically determined autoimmune diseases do not causally effect keloids (RA: OR=0.95, 95% CI: 0.89-1.00, p=0.07; SLE: OR=0.98, 95% CI: 0.93-1.02, p=0.34; IBD: OR=1.01, 95% CI: 0.90-1.03, p=0.27; CD: OR=1.02, 95% CI: 0.96-1.09, p=0.56; UC: OR=0.97, 95% CI: 0.90-1.04, p=0.34; T1D: OR=0.98, 95% CI: 0.95-1.01, p=0.27). Reverse IVW MR analysis showed no significant causal effect of keloids on autoimmune diseases. The results from MR-Egger regression, weighted median, and weighted mode methods were consistent with those obtained from the IVW method, and sensitivity analysis suggested that horizontal pleiotropy was unlikely to distort the causal estimates. Our MR analysis does not provide strong evidence supporting causal associations between autoimmune diseases and keloids in the European population.

BACKGROUND:Congenital earlobe clefts, particularly the defective type with severe tissue deficiency, present unique reconstructive challenges requiring specialized techniques. OBJECTIVE:To evaluate the efficacy and safety of a preformed, inverted, and anastomosed subauricular tongue-shaped flap technique for treating defective-type congenital earlobe clefts. MATERIALS AND METHODS:Twenty patients (12 male and 8 female patients; aged 8-34 years) with unilateral defective-type congenital earlobe clefts underwent surgical correction using a tongue-shaped flap from the subauricular region. Outcomes were evaluated using a 15-point scoring system by 2 independent surgeons. RESULTS:The mean assessment score was 13.4 (range: 10-15), with substantial interrater reliability (κ = 0.85). Eighteen patients (90%) achieved good outcomes, whereas 2 (10%) had fair outcomes. Minor complications occurred in 2 patients (10%). Patient satisfaction was high, with 85% reporting being "very satisfied" with overall appearance. CONCLUSION:The preformed, inverted, and anastomosed subauricular tongue-shaped flap technique provides a reliable method for repairing defective-type congenital earlobe clefts, offering natural appearance and minimal scarring.

Alzheimer's disease (AD) is the major cause of dementia in the elderly, and investigations on the impact of risk factors on neurocognitive performance are crucial in preventative treatment. While existing statistical regression models, such as single-index models, have proven effective tools for uncovering the relationship between the neurocognitive scores and covariates of interest such as demographic information, clinical variables, and neuroimaging features, limited research has explored scenarios where jump discontinuities exist in the regression patterns and the covariates are unobservable but measured with errors, which are common in real applications. To address these challenges, we propose a single-index measurement error jump regression model (SMEJRM) that can handle both jump discontinuities and measurement errors in image covariates introduced by different image processing software. This development is motivated by data from 168 patients in the Alzheimer's Disease Neuroimaging Initiative. We establish both the estimation procedure and the corresponding asymptotic results. Simulation studies are conducted to evaluate the finite sample performance of our SMEJRM and the estimation procedure. The real application reveals that jump discontinuities do exist in the relationship between neurocognitive scores and some covariates of interest in this study.

Most studies on partially linear models (PLMs) focus on the properties of the linear component, typically assuming the nonparametric function is smooth. In this article, we consider a more practical approach where the nonparametric function may exhibit jump discontinuities within a high-dimensional PLM framework. We propose a post-detection penalized estimation procedure that integrates jump detection with a group version of the smoothly clipped absolute deviation (gSCAD) penalized estimation. Specifically, we first construct a chi-square statistic to identify potential jump discontinuities, followed by a post-detection gSCAD penalty to estimate both the unknown parameter vector and the nonparametric function. To address the computational challenges posed by high-dimensional matrix inversion, we employ a Gauss-Seidel iterative algorithm. Under mild conditions, we establish theoretical properties of the parametric estimators, including consistency and sparsity. Simulation studies are then conducted to assess the performance of the proposed method, which is further demonstrated through a real data application.

PURPOSE:Congenital microtia is a complex maxillofacial malformation with various risk factors. This study aimed to find potential pathogenic noncoding RNAs for congenital microtia patients. METHODS:We collected 3 pairs of residual ear cartilage samples and corresponding normal ear cartilage samples from nonsyndromic congenital microtia patients for microarray experiments. The differentially expressed RNAs were screened, and enrichment analysis and correlation expression analysis were performed to elucidate the function of the differentially expressed genes (DEGs). We further investigated the most significantly differentially expressed long noncoding RNA (lncRNA), AC016735.2, through follow-up analyses including RT-qPCR and Western blotting, to validate its differential expression in residual ear cartilage compared with normal ear cartilage. SiRNA was designed to study the regulatory role of AC016735.2, and cell proliferation experiments were conducted to explore its impact on residual ear chondrocytes. RESULTS:Analysis of the microarray data revealed a total of 1079 differentially expressed RNAs, including 305 mRNAs and x lncRNAs, using a threshold of FC>1.5 and P<0.05 for mRNA, and FC>1.0 and P<0.05 for lncRNA. Enrichment analysis indicated that these genes are mainly involved in extracellular matrix regulation and embryonic development. AC016735.2 showed the highest differential expression among the eRNAs, being upregulated in residual ear cartilage. It acts in cis to regulate the nearby coding gene ZFP36L2, indirectly affecting downstream genes such as BMP4, TWSG1, COL2A1, and COL9A2. CONCLUSION:Significant differences were observed in the expression of lncRNAs and mRNAs between residual ear cartilage and normal auricular cartilage tissues in the same genetic background of congenital microtia. These differentially expressed lncRNAs and mRNAs may play crucial roles in the occurrence and development of microtia through pathways associated with extracellular matrix regulation and gastrulation. Particularly, AC016735.2, an eRNA acting in cis, could serve as a potential pathogenic noncoding gene.

BACKGROUND:Traditional facelift surgery does not behave well in the correction of nasolabial folds, which is a common clinical problem and needed to be improved. OBJECTIVES:To investigate the effect of free dermal fat grafting during facelift surgery for the treatment of nasolabial folds. METHODS:This prospective cohort study involved 80 patients with moderate to severe nasolabial folds and facial skin dermatolysis. Fifty of them underwent facelift surgery combined with free dermal fat grafting, and 30 of them underwent traditional facelift surgery. These patients were followed up 2 months, 6 months, and 1 year after the surgery to evaluate the effect. RESULTS:The difference in Wrinkle Severity Rating Scale (WSRS) scores, assessed at each follow-up, between the patients who underwent and did not undergo free dermal fat grafting during facelift surgery, was statistically significant. For patients who underwent free dermal fat grafting during facelift surgery, the WSRS scores assessed at 2 months, 6 months, and 1 year after the surgery were significantly different from those before the surgery. The analytic results of FACE-Q indicated a high level of overall satisfaction rate. No major complications were recorded. CONCLUSIONS:Free dermal fat as a filler for nasolabial folds can achieve excellent therapeutic effect. The combination of facelift surgery with free dermal fat grafting for the treatment of nasolabial folds can provide very good long-term results and a high patient satisfaction rate for patients with symptoms of facial aging such as facial dermatolysis, obvious wrinkles, and deep nasolabial folds. LEVEL OF EVIDENCE: 4:

Diffusion models have been widely used to describe the stochastic dynamics of the underlying economic variables. Renò ( 2008 ) introduced a nonparametric estimator of the volatility function, which is based on the estimation of quadratic variation between observations by means of realized variance. However, they may be misleading when one uses intraday data to implement directly the estimator, because intraday data display microstructure effects that could seriously distort the estimation. To filter out the impact of microstructure noise on the estimation of the volatility function, in this paper we propose an improved estimator when there is microstructure noise in the observed price. Also, we show that the proposed estimator has the same asymptotic properties as the Renò estimator when the step of discretization inclines to zero. Some simulations and empirical applications on Shanghai Stock Exchange data from March 3, 2002 to December 31, 2008 are used to illustrate the finite sample performance of the proposed estimator.

瘢痕疙瘩的发生与不同部位的皮肤损伤和损伤的程度有关,包括手术、耳穿孔、撕裂伤、烧伤、疫苗接种或炎症过程.瘢痕疙瘩可以发生在全身各处,颌面颈部及耳部是瘢痕疙瘩常见的形成部位.耳部瘢痕疙瘩会影响耳部美观及患者的心理健康.目前,糖皮质激素(glucocorticoid,GC)是治疗耳垂瘢痕疙瘩的有效措施.现就近年来手术配合GC治疗耳部瘢痕疙瘩的研究进展作一综述.

This paper studies an Internet congestion control system with two time delays, which are accessed by a single resource and considers both discrete and distributed delays of the system. By designing a new hybrid controller containing negative feedback control and time delay feedback control to control the system, and taking discrete time delay variables as bifurcation parameters, the local stability and Hopf bifurcation of the system are studied. The results show that the Hopf bifurcation can be effectively delayed or avoided by adjusting the value of the feedback control parameter β . The global asymptotically stable dynamic characteristics of the system are ideal, which has important functional significance for optimizing network congestion control. Finally, a large number of simulation examples verify the correctness of the conclusions.

鼻唇沟是位于两侧鼻翼和面颊交界处的凹陷性区域,随着年龄增长而加深、加长.鼻唇沟皱纹的治疗方式包括注射填充、面部除皱术、面部埋线悬吊术、激光射频等.笔者总结近年来对于鼻唇沟皱纹治疗的主流方案及其创新技术,分析其优缺点,以期临床医师可根据不同的鼻唇沟类型选择合适的治疗方式.

耳郭畸形可以由先天畸形、外伤、烧伤或癌症等导致,该畸形可对患者造成较大的心理负担.外耳结构畸形患者的主要治疗方式为耳郭再造,目前耳郭再造的术式已趋于成熟,但术前患侧耳郭很难准确定位.对于合并半侧颜面短小畸形(hemifacial microsomia,HFM)的小耳畸形患者的术前准确定位尤为困难.笔者总结了主流及新兴的重建耳郭的定位方法,以期帮助临床医师在实践中根据具体的临床情况,选择最优的定位方法.

Objective:To introduce a suture anchor technique and its outcomes in the repair of lower eyelid malposition caused by previous blepharoplasty.Methods:Patients with lower eyelid malposition treated with this technique in Plastic Surgery Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College from September 2017 to January 2021 were enrolled. This series included patients with lower eyelid malposition caused by lower blepharoplasty, with or without revision surgery. The suture anchor technique was used to suspend the orbicularis oculi musculocutaneous flap under local infiltrative anesthesia with all patients.Results:A total of 47 patients (64 eyes) were enrolled in this study, including 11 lower eyelid retraction cases (12 eyes) and 36 ectropion cases (52 eyes). The age range was 27 to 61 years (average: 43 years). Thirty-seven patients had their revision surgery for the first time and 10 patients had their second operation more than once. Patients were followed up for 6-24 months. Forty-six patients (63 eyes, 98.4%) shown normal lower eyelid position with satisfied shape, without obvious ectopia, valgus deformity or eyelid exposure. One patient (1 eye, 1.6%) of postoperative anchored area infection was controlled after drainage and dressing changes. The surgical incisions were healed, and the lower eyelid malposition was improved with patient’s satisfactory.No recurrence was observed.Conclusions:The absorbable suture anchor technique is an effective, minimally invasive, and safe method for correcting post-blepharoplasty lower eyelid malposition.

This paper considers a nonparametric diffusion process whose drift and diffusion coefficients are nonparametric functions of the state variable.A two-step approach to estimate the drift function of a jump-diffusion model in noisy settings is proposed.The proposed estimator is shown to be consistent and asymptotically normal in the presence of finite activity jumps.Simulated experiments and a real data application are undertaken to assess the finite sample performance of the newly proposed method.

Background: Revision operation of the unsatisfactory microtia reconstruction is 1 of the most difficult revision operations in plastic surgery. This study discussed the cases about revision operation of the unsatisfactory or failed ear reconstruction using autologous costal cartilage and residual. Methods: A prospectively maintained database of all consecutive patients who underwent secondary total ear reconstruction from 2013 to 2020 was reviewed. Demographic data and outcomes were assessed. Results: Thirty-six patients with microtia met the inclusion criteria. The age of the patients who underwent secondary reconstruction ranged 6 to 56 years. The follow-up duration was from 1 to 8 years. Primary reconstruction using costal cartilage was performed in 34 cases, and Medpor (porous high-density polyethylene) were used in 2 cases. All 36 cases were treated with costal cartilage as the revision. One-stage revision was performed in 27 cases, including scaffold covered by superficial temporal fascia flap in 9 cases, retroauricular fascia flap in 12 cases and superficial temporal plus retroauricular fascia flap in 5 cases. Nine cases were renovated with expanders by stages, of which 8 cases were covered by retroauricular fascia and 1 case was covered by expanded skin flap. Complications occurred in 2 cases, and 1 patient was not satisfied with the partial scaffold repair. Conclusions: The effect of revision operation of ear reconstruction with costal cartilage is satisfactory, and different methods of ear reconstruction are indicated in different operation conditions, and the revision surgery requires adequate preoperative evaluation. Level of Evidence: Level IV, therapeutic study.