Comorbidities can potentially impact the presentation or outcome of patients with pilonidal disease (PD) due to poor wound healing or increased inflammatory response. We hypothesized that certain comorbidities could lead to worse pain or higher recurrence rate. A retrospective study was performed on all PD patients treated with standardized minimally invasive protocol at our clinic 2019–2022. Patients’ demographics, comorbidities, initial/follow-up pain score, pain duration, and recurrence were recorded. Data were analyzed by t test and Chi-square test. Of 207 total PD patients (108 male, 99 female), 61 had comorbidities. Mean age was 18.2 years. The recurrence rate was 7

Background: Pilonidal disease begins in puberty when males and females have different sex hormone expression. We hypothesize that sex differences can lead to clinical differences in pilonidal disease. Methods: Patient demographics, Fitzpatrick skin type, hair characteristic, presentation, pain score, recurrence were recorded 2019–2022. All patients underwent regular epilation+/-pit excision. Excised pits were stained for estrogen receptor, progesterone receptor, and androgen receptor. Results: 237 patients (110F, 127 M) were followed 351±327days. Females present younger than males (17.5 ± 3.9 vs.18.4 ± 3.6years). While no sex-related differences noted in recurrence rate (4.5% vs.7.9 %) or skin type, there were significant sex-related differences in hair amount, thickness, density, and color. More males had granuloma than females (34% vs.12 %): 63 % granuloma were located left of midline, 30 % right, 7 % center. More males than females presented with drainage (67% vs.35 %). Significant differences were noted in patient-reported pain: Females’ mean initial pain score was higher than that of males’ (5.6 ± 2.5 vs.4.7 ± 2.2). 35 % females had menstruation-related gluteal cleft pain (MRGCP), not associated with recurrence or pads/tampons use. Females on contraceptives (15.5 %females) had lower pain score than those who were not (3.9 ± 2.7 vs.5.8 ± 2.4) and none of these females reported MRGCP. Patients with drainage had lower pain score than those without (4.5 ± 2.4 vs.5.8 ± 2.2). Excised pits from females with MRGCP had higher proportion of fibroblasts stain positive for estrogen receptor and androgen receptor compared to those without MRGCP (28.4 %±9.0 %vs.14.4 %±6.5 %, 18.0 %±11.7 %vs.6.9 %±9.0 %, respectively). Conclusions: Male and female pilonidal patients differ in pain intensity, drainage, and granuloma formation. More fibroblasts with estrogen receptor and androgen receptor expression is a potential mechanism for MRGCP that is ameliorated by contraceptive use.

Background: Pilonidal disease may present as acute abscesses or chronic draining sinuses. There is no standardized treatment and recurrence rates can be as high as 30%. Within our five-hospital network we have established a standardized treatment protocol including minimally invasive surgical trephina-tion and aggressive epilation. We hypothesize that such a treatment protocol can be established across different hospital settings and lead to low overall recurrence. Methods: Patients with pilonidal disease were enrolled in the study on presentation to our hospital net-work. Those that underwent initial surgery outside our hospital system or were noncompliant with our treatment protocol were excluded. Patients were grouped based on surgeon and treating facility. Fre-quency of recurrence per surgeon and per hospital was calculated and compared. Results: Out of 132 patients, 80 patients were included (45 female, 35 male) while 52 were excluded because of initial surgery at a non-network hospital or for protocol noncompliance. Median age was 17 (16-19) years and median length of follow-up was 352 (261-496) days. There were 6 patients who ex-perienced at least one recurrence. There was an overall 8% recurrence rate with no significant difference noted between surgeons or hospitals (p = 0.15, p = 0.64, respectively). Conclusions: We have successfully implemented a standardized treatment protocol for pilonidal disease across different hospital settings and by different surgeons, with an overall low recurrence rate. Our find-ings suggest that adoption of a standardized protocol for treatment of pilonidal disease can lead to low recurrence. Level of evidence: Level IV. (c) 2022 Elsevier Inc. All rights reserved.

Background: Hair at the gluteal cleft plays a key role in the development and recurrence of pilonidal disease (PD). We hypothesized that more hair reduction achieved using laser could correlate with lower chance of PD recurrence.Methods: PD patients who underwent laser epilation (LE) were categorized by Fitzpatrick skin type, hair color, and hair thickness. Photos taken at LE sessions were compared to determine hair reduction amount. LE sessions completed prior to the recurrences were recorded. Groups were compared using multivariate T-test.Results: 198 PD patients had mean age 18.1 & PLUSMN; 3.6 years. 21,156, and 21 patients had skin types 1/2, 3/4, and 5/6, respectively. 47 patients had light-and 151 had dark-colored hair. 29 patients had fine hair, 129 medium, and 40 thick. Median follow-up was 217 days. 95%, 70%, 40%, and 19% of patients reached 20%, 50%, 75%, and 90% hair reduction after mean LE sessions of 2.6, 4.3, 6.6, 7.8 sessions, respectively. To reach 75% hair reduction, patients require a mean of 4.8-6.8 LE sessions, depending on different skin/hair characteristics. PD recurrence rate was 6%. Probability of recurrence after 20%, 50%, 75% hair reduction was decreased by 50%, 78%, 100%, respectively. Dark hair and skin type 5/6 were associated with higher recurrence rates.Conclusion: Patients with dark-color and thick hair require more LE sessions to achieve certain degree of hair reduction. Patients with dark hair and skin type 5/6 were more likely to recur; more hair reduction correlated with lower chance of recurrence. Level of Evidence: Level IV.& COPY; 2023 Elsevier Inc. All rights reserved.

Between April and July 2021, a buzzword and the associated trendy lifestyle surfaced in mainland China amidst the ruling Party's month-long extravagant celebration of its 100th anniversary. This buzzword and the associated lifestyle quickly became a 'doctrine-ism' that was particularly phenomenal amidst the overwhelming official discourse of patriotism and national rejuvenation. This buzzword is 'lie Flat' (tangping), and the associated doctrine-ism is 'lying flat-ism'. Drawing on social media posts and focus group discussion, this article considers 'lying flat-ism' a youth subculture in contemporary China. It seeks to explore this subcultural phenomenon and traces the social, educational, and economic reasons behind the emergence of this subculture. Agreeing with the claim that this youth culture, along with 'diaosi' and 'sang' subcultures, reflects the 'collective frustration' of Chinese youth, the article further argues that 'lying flat-ism' is Chinese youth's non-violent uncooperative rebellion, modern cynicism and negotiation with official doctrines. It is a spontaneous resistance to social inequality, and a collective and desperate yearning for social change.

Patients with mild pilonidal disease often experience symptom resolution without excision. We hypothesized that treating symptom-free/asymptomatic pilonidal patients with regular epilation alone had similar recurrence rate as patients who were also treated surgically. Patient data were prospectively collected 2/2019-11/2022 at our Pilonidal Clinic. All patients received regular epilation; all patients presented before 12/2020 also underwent pit excision using trephines. Starting 1/2021, only symptomatic patients underwent pit excision; symptom-free patients at presentation received only regular epilation. Recurrence rates were statistically analyzed. 255 patients (male:54.4

Objective: To assess the outcomes of office-based circumcision performed using Plastibell devices in infants, utilizing the MyChart interactive electronic health record (iEHR) system to monitor the progress and identify potential complications. Methods: This is a prospective cohort study conducted between March 2021 to April 2022 on all infants undergoing office based Plastibell circumcision. Parents were encouraged to submit concerns via MyChart and to submit photos if the ring has not fallen by post-procedure day 7. Telehealth or in-person clinic visits were then made accordingly. Postoperative complications were collected and compared with existing literature. Results: Of the 234 consecutive infants, the average age was 33 days (9-126 days) and the average weight was 4.35 kg (2.5-7.25 kg). A total of 170 parents (73%) responded to MyChart messages. Fourteen (6%) complications necessitating local intervention were identified: excessive fussiness (1), bleeding (2), ring retention (11) including 2 incomplete skin division requiring repeat dorsal block and surgical completion, fibrinous adhesion (3), and proximal ring migration (6). The photo and messages submitted through iEHR facilitated early patient return for intervention. Additionally, 17 parents submitted photos which were expected postprocedural findings and were reassured through iEHR, thus omitting unnec-essary return visits. The 2 patients with incomplete skin division occurred early in the series using the included cotton ties. Subsequent procedures were performed with double 0-Silk ties (n 1/4 218) without similar finding. Conclusion: The interactive utilization of iEHR communication in the post-circumcision period identified proximal bell migration and bell trapping, allowed earlier intervention and reduced complications. Level of Evidence: Level 1. (c) 2023 Elsevier Inc. All rights reserved.

Pilonidal Disease (PD) affects adolescents in different aspects. We hypothesized that patients with different gender, ethnicity, and age have different quality of life (QOL) measurements which could improve with minimally invasive treatment (MIT). 131 PD patients underwent MIT (laser epilation ± trephination) from 2019 to 2021. Patients’ demographics were recorded. Before and after MIT, patients received QOL questionnaire consisting of four categories: daily activities, sports participation, school/work attendance, and socializing. Data were analyzed using Student and multivariate t test. P < 0.05 was considered statistically significant. 101 (51 male, 50 female) patients were included. 30 patients with incomplete data were excluded. 54% of patients were < 18 years old. 47.5% were Hispanic. Median symptom duration prior to presentation was 5.4 (1.3–15) months. Prior to MIT, patients’ ability to perform daily activities, participate in sports, attend school/work, and socialize was moderately or severely impacted in 66%, 57%, 45%, and 23% of respondents, respectively; after MIT, only 7%, 8%, 2%, and 4% were affected (p < 0.01). Recurrence rate was 6%. Pre-MIT, older patients and non-Hispanics reported worse impact on their QOL. Symptom duration or PD recurrence did not correlate with patient’s pre- or post-MIT QOL. Patients’ ethnicity and age impacted QOL in PD. All patients’ QOL significantly improved with MIT. Considering the importance of socializing, playing sports, and school/work attendance in adolescents, our study highlights importance of early treatment of PD.

The COVID-19 pandemic has fundamentally transformed global media industries' practices and altered audiences' media consumption habits. The film industries have shortened theatrical windows and expanded streaming services to cope with this reality, which has accelerated the so-called digital distribution revolution. This study focuses on the transformation of China's film distribution and exhibition sector before and during the pandemic. Specifically, the study tracks the strategies of China's digital giants, iQIYI, Tencent-backed Maoyan, and Alibaba-backed Tao Piao Piao, for promoting and exhibiting films. By integrating digital media studies and industrial studies, the study seeks to tackle the issue of whether distributional platformization can serve as the infrastructure of the film industry and usher in a new era of the digital entertainment revolution. The findings indicate that digital corporations' strategies have accelerated the platformization of the distribution infrastructure of the film industry. However, current industrial practices nourish the prospect of coexistence in the foreseeable future.

Employing empirical focus group research and drawing on transnational audience studies, this article investigates the consumption and reception of American films by Chinese college students. The article argues that Hollywood films satisfy the Chinese audience's need for entertainment, visual pleasure, and escape from the restraints and hardships of daily life. In addition, Chinese audiences' reception of Hollywood films functions as a site of negotiation of different political and cultural values. Hollywood films evoke Chinese youth's global imagination, trigger their reflection on and debate over their own culture and society, and inspire a collective desire for alternative modernities and an alternative way of life. Chinese audiences engage in a process of civic participation by actively debating and contemplating a functional and ideal society and value system, bringing in agency that is crucial to audience studies.

Drawing on empirical focus group discussions and historical document analysis, this chapter intends to inquire about how young Chinese audiences' reception of Japanese pop culture enhances their cultural imagination in a rapidly globalized world. The chapter argues that the reception process functions as an effective way of self-expression and escapism from the hardship of real life. Through engaging in Japanese media culture, Chinese fans not only actuate a deep reflection on their own society, but also form an imaginary cultural identity that negotiates through the political and social constraints of the Chinese society. Accordingly, the reception process is a site of contestation, negotiation, and even resistance, in which transnationalism triumphs and a cross-border Asian modernity is in the making.

The honeymoon between the film industries of the USA and China appears to be ending. The American entertainment industry was shocked and shaken by the development, and the American media were full of laments such as "the China party is over" and "the romance has cooled". The chapter explores the relationship between globalization and nation-state policy, analyzes their interplay, and examines insights and implications for global communication. It discusses the China's integration into the global market and distribution system between 2014 and 2018, followed by a discussion of China's integration into the capital investment and film production system. A number of China experts in the West have analyzed the reasons for the crackdown on the Dalian Wanda Group. The most obvious reasons were the Chinese government's concerns about the slowdown in China's economic development, the accelerating outflow of capital, and the weakening of the yuan. Chinese and Hollywood business parties continue to show significant interest in expanding collaborative relationships.

This introduction presents an overview of the key concepts discussed in the subsequent chapters of this book. The book provides an ambitious attempt to engage film collaborations in the entire Asia-Pacific region, bridging those countries and regions whose socioeconomic statuses range from developed to developing. It presents a broad range of cross-border case studies, involving complicated geographic politics, industries, cultures, and markets. The book examines a twist in the US-China relationship and its influences on co-productions between the two countries. It explores the implications of co-production in the East Asian region, specifically in the Greater China region, where co-production has a history dating back to the 1950s. The book also examines China-Korea co-production as filmmakers from China and Korea have been actively collaborating with each other since the early 2000s. It discusses transnational co-production through interviews with director Gina Kim.

The unprecedented growth in U.S.-China film coproductions and Chinese companies' high-profile investment in Hollywood studios and U.S. cinemas signal a shift in global power relationships and a reshaping of the global media structure. Combining textual and document analysis with interviews of policy makers and film professionals in China and Hollywood, this article explores the implications of U.S.-China coproduction for global communication. The article proposes three ways of understanding coproductions: as a market-driven and profit-seeking partnership, as a policy and power negotiation, and as a brave experimental adventure. This article contends that the current state of U.S.-China coproduction manifests the contradiction between desire and reality. Although coproductions have the potential to create a space for a new global culture, to develop innovative communication models, and to achieve a China-U.S. consensus, the fulfillment of these potentials will require a steadfast effort and the commitment of more than one generation of filmmakers from both China and the U.S.A. Nevertheless, a global culture and a reshaping of the global media structure are in the making.