Incidence and risk factors of postoperative pulmonary complications after oral cancer surgery with free flap reconstruction: A single center study.

BACKGROUND: Postoperative pulmonary complications (PPCs) increase the risk of morbidity and mortality in patients who underwent oral cancer surgery with free flap reconstruction. The association between PPC and preoperative risk factors has been investigated; however, reports on intraoperative factors are limited. Therefore, we investigated PPC incidence and its associated preoperative and intraoperative risk factors in these patients. METHODS: We retrospectively analyzed medical records of patients who underwent free flap reconstruction between 2009 and 2019. PPC was defined as presence of atelectasis, pneumonia, and respiratory failure based on radiological confirmation and clinical symptoms during hospitalization. Mortality, hospital stay, preoperative factors (including age and tumor stages), American Society of Anesthesiologists (ASA) classification, and intraoperative factors (including intraoperative fluids and medications) were recorded. RESULTS: PPC incidence among the 993 patients included in this study was 25.8% (256 patients). Six patients with PPCs died; death was not observed among patients without PPCs (p < 0.001). Patients with PPCs had longer hospitalization than those without PPCs (30.3 vs 23.3 days; p < 0.001). Tumor stage (stage I: reference; stage II [OR]: 3.3, p = 0.019; stage III: 4.4, p = 0.002; stage IV: 4.8, p = 0.002), age (OR: 1.0; p < 0.001), and ASA grade >2 (OR: 1.4; p = 0.020) were independent risk factors of PPC; using labetalol was a borderline significant factor (OR: 1.4; p = 0.050). CONCLUSION: The PPC incidence was 25.8% in patients undergoing oral cancer surgery with free flap reconstruction. Tumor stage, age, and ASA >2 were risk factors of developing PPC.

Visual and Real-Time Monitoring of Cd2+ in Water, Rice, and Rice Soil with Test Paper Based on [2 + 2] Lanthanide Clusters.

Cadmium ions (Cd2+) are highly toxic to animal and human health, especially through the drinking of Cd2+-contaminated water and eating Cd2+-contaminated rice. Therefore, accurate detection of Cd2+ in water, rice, and rice soil is urgent. In this work, two [2 + 2] lanthanide clusters of Tb2Tb2 and Eu2Eu2 were synthesized and characterized in detail. Interestingly, Tb2Tb2 is a rapid sensor for Cd2+ through luminescence "turn-off". Further studies show that Tb2Tb2 is a highly sensitive and selective sensor toward Cd2+ in water, rice supernatants, and rice soil supernatants, with a very short response time of 20 s. The limit of detection (LOD) in the above three real samples is as low as 0.0112, 1.1240, and 0.1124 ppb, respectively, which is lower than the national standards for food safety in China (GB 2762-2022). More interestingly, a portable sensing device of test paper based on Tb2Tb2 is developed with a facile method, which shows visible, highly sensitive, and selective sensing toward Cd2+ in real samples of water, rice supernatants, and rice soil supernatants. Tb2Tb2 and its sensing device of test paper are an on-site analysis sensor for potentially non-expert users, especially for people in remote rural areas.

Detection of heavy metal ion in real samples with fiber based paper based on new rare earth cluster.

Chromium (Cr) is an important material, but also one of the most toxic heavy metal pollutants, showing great threat to human health and ecological environment, thus, accurate and rapid detection of Cr3+ has far-reaching significance. In this work, based on the ligand of 2,3,4,5,6-pentafluorobenzoic acid (HPFBA) that does not contains oscillation effect group such as "CH, OH, and NH bond", three rare earth dinuclear cluster of Ln2(PFBA)6(phen)2(H2O)2 (Ln = Tb3+1-Tb, Eu3+1-Eu, Gd3+1-Gd, phen = 1,10-phenanthroline) were obtained. 1-Tb shows excellent stability and luminescence properties. In depth investigation reveals that 1-Tb shows quick detection towards Cr3+ in water through luminescence "turn-off", with extremely short response time of 1.0 min, very low limit of detection (LOD) of 5.2 ppb and no interference from other ions. The LOD value is much lower than the total content of chromium for water in China (15 ppm, GB9078-1996). In the actual environment such as tap water, lake water, human, and serum, 1-Tb shows excellent detection and recovery rate for Cr3+. More interestingly, a fiber based paper of test paper that based on 1-Tb and ordinary filter paper was fabricated, which can probe Cr3+ by visible color changes to the naked eye under UV light.

CEO cultural background and overinvestment decisions: The north-south divide in China.

This study addresses an under-researched area in corporate behavior by examining the impact of a CEO's cultural background on corporate overinvestment decisions. We focus on the unique cultural dichotomy between northern and southern China as our context of study. Additionally, we scrutinize the interactions between a CEO's age and the type of company ownership in influencing overinvestment tendencies. Our aim is to enrich theoretical understanding of factors influencing corporate overinvestment, offering practical implications for businesses within and beyond China. By filling this gap in the literature, our study sheds light on the nuanced determinants of overinvestment decisions, aiding businesses in refining their investment strategies and governance mechanisms.

Applying High-Resolution Impedance Manometry for Detecting Swallowing Change in Anterior Cervical Spine Surgery Patients.

Background: Objectively detecting perioperative swallowing changes is essential for differentiating the reporting of subjective trouble sensations in patients undergoing anterior cervical spine surgery (ACSS). Swallowing indicates the transmission of fluid boluses from the pharynx (velopharynx, oropharynx, and hypopharynx) through the upper esophageal sphincter (UES). Abnormal swallowing can reveal fluid accumulation at the pharynx, which increased the aspiration risk. However, objective evidence is limited. High-resolution impedance manometry (HRIM) was applied for an objective swallowing evaluation for a more detailed analysis. We aimed to elucidate whether HRIM can be used to detect perioperative swallowing changes in patients undergoing ACSS. Methods: Fourteen patients undergoing elective ACSS underwent HRIM with the Dysphagia Short Questionnaire (DSQ, score: 0-18) preoperatively (PreOP), on postoperative at day 1 (POD1), and postoperative at day seven (POD7). We calculated hypopharyngeal and UES variables, including hypopharyngeal mean peak pressure (PeakP) and UES peak pressure, representing their contractility (normal range of PeakP, 69-280 mmHg; peak pressure, 149-548 mmHg). The velopharynx-to-tongue base contractile (VTI) was also calculated (normal range, 300-700 mmHg.s.cm), indicating contractility. The swallowing risk index (SRI) from HRIM combined with four hypopharyngeal parameters, including PeakP, represents the global swallowing function (normal range, 0-11). A higher SRI value indicated higher aspiration. Results: SRI was significantly higher on POD1 (10.88 ± 5.69) than PreOP (6.06 ± 3.71) and POD7 (8.99 ± 4.64). In all patients, PeakP was significantly lower on POD1 (61.8 ± 18.0 mmHg) than PreOP (84.9 ±34.7 mmHg) and on POD7 (75.3 ± 23.4 mmHg). The UES peak pressure was significantly lower on POD1 (80.4 ± 30.0 mmHg) than PreOP (112.9 ± 49.3 mmHg) and on POD7 (105.6 ± 59.1 mmHg). Other variables, including VTI, did not change significantly among the three time points. DSQ scores were 1.36, 3.43, and 2.36 at PreOP, POD1, and POD7 respectively. Conclusions: With similar trends in DSQ and SRI, swallowing was significantly decreased on POD1 because of decreased hypopharyngeal and UES contractility but recovered to the preoperative state on POD7 after ACSS. Applying HRIM is superior to DSQ in detecting mechanisms and monitoring the recovery from swallowing dysfunction. Clinical Trial Registration: The study was registered at ClinicalTrials.gov (NCT03891940).

A new method for skin aging evaluation of Chinese women.

BACKGROUND: With the development of cosmetic industry in China, an aging evaluation method of Chinese women is in great need. AIMS: The aim of this study is to establish a skin aging assessment method using convenient portable machine Antera 3D. METHODS: The quantitative approach was developed by capturing 11 areas of the face, and overall, 48 parameters were extracted for aging evaluation. Later, 297 subjects were recruited to take facial image and life style questionnaire. Evaluation of age was accomplished by establishing prediction method with detected skin traits. RESULTS: The age prediction model was built by using the evaluated facial traits, and a R square of 0.6 is achieved by comparing to the chronological age. The crow's feet, cheek skin pigmentation, forehead skin tone, and wrinkles around the month are critical factors in evaluating Chinese women skin aging. In addition, we also explored life styles associated with important skin aging traits. CONCLUSION: The method developed in this research provides reliable alternative in aging study of Chinese women.