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Objectives: To assess potential risk factors influencing diet outcomes after reconstruction of subtotal hypopharyngeal defects using free patch‐ or tube‐shaped anterolateral thigh (ALT) fasciocutaneous flaps. Study Design: Retrospective cohort study. Setting: First‐level referral hospital. Methods: Between January 2011 and December 2020, we studied hypopharyngeal cancer patients who underwent the reconstruction of hypopharyngeal defects using free patch‐ or tube‐shaped ALT fasciocutaneous flaps. The choice between patch‐ or tube‐shaped ALT flaps depended on the defect's nature, favoring patch‐shaped for subtotal defects and tube‐shaped for circumferential defects. A restricted diet was characterized by a history of enterostomy or endoscopic esophageal dilation treatment postreconstruction. We analyzed patients with restricted diets at 1‐ and 3‐year follow‐up visits. Results: Ninety‐eight patients were enrolled; 39 patch‐shaped flaps, and 59 tube‐shaped flaps. No significances were noted in demographics, postoperative radiotherapy (RT) or chemotherapy, rates of free flap reoperation/salvage, or complications. However, a significant difference emerged in diet outcomes at the 1‐year follow‐up (P =.005). The rate of a restricted diet was 6.08 times higher in patients with tube‐shaped flaps compared to patch‐shaped flaps (95% confidence interval [CI]: 1.95‐18.94). Stratifying based on postoperative RT revealed a 5.47 times higher rate of a restricted diet in tube‐shaped flap recipients compared to patch‐shaped flap recipients (95% CI: 1.44‐20.48). No significances were observed in 5‐year survival rates. Conclusion: Concerning postoperative RT, patch‐shaped flaps exhibited a lower incidence of a restricted diet compared to tube‐shaped flaps. Preservation of the posterior mucosa may play a crucial role in preventing RT‐induced esophageal stricture. [ABSTRACT FROM AUTHOR]

Lung cancer remains a major health problem despite the considerable research into prevention and treatment methods. Through a deeper understanding of tumors, patient‐specific ex vivo spheroid models with high specificity can be used to accurately investigate the cause, metastasis, and treatment strategies for lung cancer. Biofabricate lung tumors are presented, consisting of patient‐derived tumor spheroids, endothelial cells, and lung decellularized extracellular matrix, which maintain a radial oxygen gradient, as well as biophysicochemical behaviors of the native tumors for precision medicine. It is also demonstrated that the developed lung‐cancer spheroid model reproduces patient responses to chemotherapeutics and targeted therapy in a co‐clinical trial, with 85% accuracy, 86.7% sensitivity, and 80% specificity. RNA sequencing analysis validates that the gene expression in the spheroids replicates that in the patient's primary tumor. This model can be used as an ex vivo predictive model for personalized cancer therapy and to improve the quality of clinical care. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate the effect of varying bias parameters (−50 V, −100 V, and −150 V) on the properties of TiN/CrN multilayer films deposited on Ti-6Al-4V alloy using the cathodic arc deposition (CAD) technique. The deposited films were characterized for their composition, structure, morphology, thickness, adhesion, and hardness. Wear and polarization tests were also conducted to determine the optimal bias condition for wear and corrosion resistance. The results showed that the TiN/CrN films possessed a nano-multilayered structure comprising TiN and CrN phases. The hard coating significantly increased the surface hardness of Ti-6Al-4V alloy up to three–five times. The coated specimens demonstrated superior wear resistance compared to the uncoated, with the −150 V specimen exhibiting the least wear rate. Furthermore, the −150 V specimen had the highest polarization impedance value, indicating the best corrosion resistance compared to the other bias conditions. In short, the use of CAD-coated TiN/CrN multilayer film enhanced the surface properties of Ti-6Al-4V alloy, with the best wear and corrosion resistance achieved at −150 V bias. These novel findings have significant implications for improving the performance and durability of Ti-6Al-4V alloy components in various industrial applications. [ABSTRACT FROM AUTHOR]

Background: The risk of peripheral artery occlusive disease (PAOD) in patients with lower leg fracture who underwent fixation procedures is not yet completely understood. Therefore, the current study aimed to examine the risk of subsequent PAOD in patients with lower leg fracture who received fixation and non-fixation treatments. Methods: We included 6538 patients with lower leg fracture who received non-fixation treatment and a matched cohort comprising 26152 patients who received fixation treatment from the National Health Insurance Database. Patients were frequency matched according to age, sex, and index year. The incidence and risk of PAOD in patients with lower leg fracture who received fixation and non-fixation treatments were evaluated via the stratification of different characteristics and comorbidities. Results: Non-fixation treatment, male sex, older age (≥ 50 years old), diabetes mellitus, and gout were associated with a significantly higher risk of lower extremity PAOD compare to each comparison group, respectively. Moreover, there was a significant correlation between fixation treatment and a lower risk of lower extremity PAOD in women (adjusted hazard ratio [aHR] = 0.58, 95% confidence interval [CI] = 0.38–0.90), women aged > 50 years (aHR = 0.61, 95% CI = 0.38–0.96), and patients with coronary artery disease (aHR = 0.43, 95% CI = (0.23–0.81). Further, patients with fixation treatment had a significantly lower risk of lower extremity PAOD within 2 years after trauma (aHR = 0.57, 95% CI = 0.34–0.97). The Kaplan–Meier analysis showed that the cumulative incidence of PAOD was significantly higher in the non-fixation treatment group than in the fixation treatment group at the end of the 10-year follow-up period (log-rank test: P = 0.022). Conclusion: Patients with lower leg fracture who received non-fixation treatment had a significantly higher risk of PAOD than those who received fixation treatment. Moreover, the risk of PAOD was higher in women aged > 50 years, as well as in coronary artery disease patients who received non-fixation treatment than in those who received fixation treatment. Therefore, regular assessment of vessel patency are recommended for these patients. Nevertheless, further studies must be conducted to validate the results of our study. [ABSTRACT FROM AUTHOR]

Background: The role of adjuvant concurrent chemoradiotherapy (ACCRT) is unclear for patients with esophageal squamous cell carcinoma (ESCC) who receive esophagectomy with clean margins. We compared the survival of the ACCRT versus observation groups for these patients staged with positron emission tomography (PET) via a population‐based approach. Methods: Eligible patients with locally advanced ESCC diagnosed between 2011 and 2017 were identified via the Taiwan Cancer Registry. We used propensity score (PS) weighting to balance observable potential confounders between groups. The hazard ratios (HR) of death and incidence of esophageal cancer mortality (IECM) were compared between the ACCRT and observation groups. We also evaluated overall survival (OS) in subgroups of either with or without lymph node metastases. Results: Our primary analysis consisted of 105 patients in whom the covariates were well balanced after PS weighting. The HR for death when ACCRT was compared with observation was 0.58 (95% confidence interval 0.28–1.21, p = 0.15). The results were also not significantly different for IECM or in the subgroup analyses. Conclusion: We found that for patients with PET‐staged ESCC who received esophagectomy with clean margins, the survival was not statistically different between ACCRT and observation. Further studies (randomized or larger sample size) are needed to clarify this issue. [ABSTRACT FROM AUTHOR]

HR strategic integration is a key factor reflecting the strategic use of human resources for competitive advantage. It has been argued that the changing business environmental factors such as industry conditions, institutional factors and organizational characteristics drive the emergence of HR strategic integration. However, empirical evidence about the environment factors and HR strategic integration relationship in China is inconsistent, which might be attributed to methodological and theoretical considerations. To address these issues, we draw on strategic tripod theory and employ a multi-source (combining HR managers' subjective evaluations and Statistical Yearbook objective data), time-lagged (across three years), and multi-level research design to examine the environmental factors and the HR–strategic integration relationship. We explore the main and interactive effects of three key environmental variables (industry dynamism, firm size, and firm ownership) on HR strategic integration. We find that three-way interactions of environmental variables are more effective in explaining the relationship between context and HR strategic integration than are two-way interactions and main effects. Our study contributes to the HRM and strategy management literature. [ABSTRACT FROM AUTHOR]

Two new mixed-ligand coordination polymers with the chemical formulae of [Co(3mad)(dpa)]n (1, 3mad = 3-methyladipate, dpa = 4,4′-dipyridylamine) and [Co(33dmg)(dpa)]n (2, 33dmg = 3,3-dimethylglutarate) have been successfully synthesized by the hydrothermal reaction of the Co(NO3)2·6H2O, methyl-substituted aliphatic dicarboxylic acid, and the hydrogen-bonding capable 4,4′-dipyridylamine (dpa) ligand. Furthermore, the treatment activity of compounds 1 and 2 against low transit constipation (STC) was evaluated in vivo. Firstly, the ELISA detection was conducted for the neurotransmitter measurement, such as acetylcholine and serotonin. Then, the intestinal transmission function was tested to reflect the treatment effect of compounds 1 and 2in vivo. [ABSTRACT FROM AUTHOR]

Purpose – Previous research on the relationship between cheif executive officer (CEO) and organizational performance focused primarily on behavior and demographic variables, but was seldom based on the CEO cognition perspective. To fill this gap, the purpose of this paper is to explore the relationship between CEO cognition and organizational performance. Design/methodology/approach – Taking CEO golden-mean thinking as an independent variable, organizational performance as dependent variable, ambidextrous orientation as a mediating variable, interdependence and connectedness as moderating variables, and using a multi-source data collection approach, data were collected from 193 Chinese firms to test the hypothesis by adopting hierarchical regression model. Findings – CEO golden-mean thinking is found to have significantly positive impacts on ambidextrous orientation and organizational performance. Ambidextrous orientation plays a partial mediating role between golden-mean thinking and organizational performance, while independence and connectedness play joint moderating roles between ambidextrous orientation and organizational performance. The three-way interaction among ambidextrous orientation, connectedness, and interdependence has a significantly positive effect on organizational performance. Research limitations/implications – CEOs should not only improve organizational performance through diversified, harmonious, and integrative thinking, but also enhance the ambidextrous ability by building ambidextrous orientation, connectedness, and interdependence mechanism in order to promote organizational performance. Originality/value – As one of the most salient thinking characteristics in Chinese traditional culture, golden-mean thinking increasingly has attracted scholars' attention. However, no previous scholar has applied this construct into leadership theory. [ABSTRACT FROM AUTHOR]

The hazard of subsequent arterial embolism and thrombosis (SAET) in patients with lower leg fractures is not yet well demonstrated. The purpose of this study is to determine the correlation between lower leg fracture and SAET in Taiwan. A total of 134,844 patients with lower leg fractures (ICD-9-CM: 823) and chronological diagnosis as SAET (ICD-9-CM: 444.22) was matched (1:1) to the non-fracture cohort according to their propensity score (data coming from the National Health Insurance database between January 2000 to December 2012). Patients were matched by age, gender, and comorbidities. The incidence of SAET and correlation between SAET development and lower leg fracture was statistically analyzed, and subgroup analysis categorized by characteristics and comorbidities was conducted as well. The cumulative incidence of SAET was calculated by Kaplan–Meier analysis. Kaplan–Meier analysis plot showed that, by the end of the ten-year follow-up period, the cumulative incidence of SAET was significantly higher for the lower leg fracture cohort than for the non-fracture cohort (log-rank test: p < 0.001). The lower leg fracture, male, elder age (45–64-year-old; ≥65-year-old), hypertension, diabetes mellitus, and gout were significantly associated with lower extremity SAET risk compared with the matched group. There was an inseparable correlation between the lower leg fracture group and the risks of SAET; subgroup analysis by gender (male, female), age (age < 40 years, age 40–64 years, and age > 65 years) and comorbidities (hypertension, diabetes mellitus, and gout) show compatible results as well. Patients with lower leg fracture have a significantly increased risk of SAET since then two years after the fracture. The hazard of SAET was significantly higher in patients with lower leg fracture than in the non-fracture cohort, and the high incidence was found since then two years after fracture. Further studies are warranted. [ABSTRACT FROM AUTHOR]

Mineral trioxide aggregate (MTA) is a common biomaterial used in endodontics regeneration due to its antibacterial properties, good biocompatibility and high bioactivity. Surface modification technology allows us to endow biomaterials with the necessary biological targets for activation of specific downstream functions such as promoting angiogenesis and osteogenesis. In this study, we used caffeic acid (CA)-coated MTA/polycaprolactone (PCL) composites and fabricated 3D scaffolds to evaluate the influence on the physicochemical and biological aspects of CA-coated MTA scaffolds. As seen from the results, modification of CA does not change the original structural characteristics of MTA, thus allowing us to retain the properties of MTA. CA-coated MTA scaffolds were shown to have 25% to 55% higher results than bare scaffold. In addition, CA-coated MTA scaffolds were able to significantly adsorb more vascular endothelial growth factors (p < 0.05) secreted from human dental pulp stem cells (hDPSCs). More importantly, CA-coated MTA scaffolds not only promoted the adhesion and proliferation behaviors of hDPSCs, but also enhanced angiogenesis and osteogenesis. Finally, CA-coated MTA scaffolds led to enhanced subsequent in vivo bone regeneration of the femur of rabbits, which was confirmed using micro-computed tomography and histological staining. Taken together, CA can be used as a potently functional bioactive coating for various scaffolds in bone tissue engineering and other biomedical applications in the future. [ABSTRACT FROM AUTHOR]

According to the Centers for Disease Control and Prevention, tooth caries is a common problem affecting 9 out of every 10 adults worldwide. Dentin regeneration has since become one of the pressing issues in dentistry with tissue engineering emerging as a potential solution for enhancing dentin regeneration. In this study, we fabricated cell blocks with human dental pulp stem cells (hDPSCs)-laden alginate/fish gelatin hydrogels (Alg/FGel) at the center of the cell block and human umbilical vascular endothelial cells (HUVEC)-laden Si ion-infused fish gelatin methacrylate (FGelMa) at the periphery of the cell block. 1H NMR and FTIR results showed the successful fabrication of Alg/FGel and FGelMa. In addition, Si ions in the FGelMa were noted to be bonded via covalent bonds and the increased number of covalent bonds led to an increase in mechanical properties and improved degradation of FGelMa. The Si-containing FGelMa was able to release Si ions, which subsequently significantly not only enhanced the expressions of angiogenic-related protein, but also secreted some cytokines to regulate odontogenesis. Further immunofluorescence results indicated that the cell blocks allowed interactions between the HUVEC and hDPSCs, and taken together, were able to enhance odontogenic-related markers' expression, such as alkaline phosphatase (ALP), dentin matrix phosphoprotein-1 (DMP-1), and osteocalcin (OC). Subsequent Alizarin Red S stain confirmed the benefits of our cell block and demonstrated that such a novel combination and modification of biomaterials can serve as a platform for future clinical applications and use in dentin regeneration. [ABSTRACT FROM AUTHOR]

In this study, polymer-assisted dispersants are used to stabilize the nanohybrids of platinum nanoparticles (PtNPs)/carbon nanotubes (CNTs) through non-covalent bond forces. These dispersants aim to replace the florine-doped tin oxide (FTO) glass in traditional dye-sensitized solar cells (DSSCs) as counter electrodes. The large specific surface area, high conductivity, and redox potential of PtNPs/CNT nanohybrids are used as the basis to utilize them as the counter electrode material to fabricate a dye-sensitized solar cell. The conductivity results indicate that the resistance of the PtNP/CNT nanohybrid film can be reduced to 7.25 Ω/sq. When carbon nanotubes are mixed with platinum nanoparticles at a weight ratio of 5/1, the photoelectric conversion efficiency of DSSCs can reach 6.28%. When using the FTO-containing substrate as the counter electrode, its conversion efficiency indicates that the micro-/nano-hybrid material formed by PtNPs/CNTs also exhibits an excellent photoelectric conversion efficiency (8.45%) on the traditional FTO substrate. Further, a large-area dye-sensitive cell is fabricated, showing that an 8 cm × 8 cm cell has a conversion efficiency of 7.95%. Therefore, the traditional Pt counter electrode can be replaced with a PtNP/CNT nanohybrid film, which both provides dye-sensitive cells with a high photoelectric conversion efficiency and reduces costs. [ABSTRACT FROM AUTHOR]

In this study, a thermal conductivity of 0.22 W·m−1·K−1 was obtained for pristine epoxy (EP), and the impact of a hybrid filler composed of two-dimensional (2D) flake-like boron nitride (BN) and zero-dimensional (0D) spherical micro-sized aluminum oxide (Al2O3) on the thermal conductivity of epoxy resin was investigated. With 80 wt.% hybrid Al2O3–BN filler contents, the thermal conductivity of the EP composite reached 1.72 W·m−1·K−1, increasing approximately 7.8-fold with respect to the pure epoxy matrix. Furthermore, different important properties for the application were analyzed, such as Fourier-transform infrared (FTIR) spectra, viscosity, morphology, coefficient of thermal expansion (CTE), glass transition temperature (Tg), decomposition temperature (Td), dielectric properties, and thermal infrared images. The obtained thermal performance is suitable for specific electronic applications such as flip-chip underfill packaging. [ABSTRACT FROM AUTHOR]

In this study, heat and polarization treatments were applied to poly(vinylidenefluoride-co-trifluoroethylene (PVDF-TrFE) films to improve their crystallinity and piezoelectric effect. Carbon-based nanomaterials (CBNs) of multiple dimensions (i.e., modified zero-dimensional (0D) carbon black (OCB), one-dimensional (1D) modified carbon nanotubes (CNT–COOH) and two-dimensional (2D) graphene oxide (GO)) were added to the copolymer to study the effects of different CBN dimensions on the crystallinity and piezoelectric effect of PVDF-TrFE films. Additionally, amphiphilic polymeric dispersants were added to improve the dispersibility of CBNs; the dispersant was synthesized by the amidation, and imidization reactions of styrene-maleic anhydride copolymer (SMAz) and polyoxyalkylene amine (M1000). Polymer solutions with different ratios of CBN to dispersant (z = 10:1, 5:1, 1:1, 1:5, 1:10) were prepared. The enhanced dispersibility enabled the fluorine atoms in the PVDF-TrFE molecular chain to more efficiently form hydrogen bonds with the –COOH group in the CBN, thereby increasing the content of the β crystal phase (the origin of the piezoelectric effect) of the film. Therefore, the resulting film exhibited a higher output voltage on the application side and better sensitivity on the sensing element. The addition of CNT–COOH and polymeric dispersants increased the β-phase content in PVDF-TrFE from 73.6% to 86.4%, which in turn raised the piezoelectric coefficient from 19.8 ± 1.0 to 26.4 ± 1.3 pC/N. The composite film-based pressure sensor also exhibited a high degree of sensitivity, which is expected to have commercial potential in the future. [ABSTRACT FROM AUTHOR]

Background: Peripheral arterial occlusive disease (PAOD) is a challenge in peripheral vascular disease. Clinical observations show reperfusion of occluded vessels may cause compartment syndrome or remote organ injury. Less well known is the role of vitamin D3 in tissue injury; therefore, we attempted to determine whether vitamin D3 could alleviate local and remote organ injury induced by reperfusion of occluded vessels in animal models. Methods: Twenty-four male Sprague-Dawley rats were randomized into four groups: saline + sham, saline + I/R, vitamin D3 + sham, and vitamin D3 + I/R group. After pretreatment for 5 d, the animals designed to I/R injury were subjected to 3 h of ischemia induced by bilateral femoral arteries clamp, followed by reperfusion of the vessels for 3 h on d 6. Left lung and left anterior tibial muscle tissue were harvested for wet/dry weight ratio and histopathologic analysis. Blood was collected for analysis of urea nitrogen (BUN), creatinine (Cr), aspartate aminotransferase (AST), alanine aminotransferase (ALT), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), ionized calcium levels, and heme oxygenase-1 (HO-1). Results: Compared with the saline + sham group, there was a significant increase in plasma IL-6 level in both saline + I/R and vitamin D3 + I/R groups and muscle, lung wet/dry weight ratio in the saline + I/R group (P < 0.05). Compared with the saline + I/R group, there was a significant decrease in plasma IL-6 level, muscle and lung wet/dry weight ratio in both vitamin D3 + sham and vitamin D3 + I/R groups, and leukocyte HO-1 expression in vitamin D3 + sham group (P < 0.05). Compared with the vitamin D3 + sham group, there was a significant increase in plasma IL-6 levels in the vitamin D3 + I/R group, and leukocyte HO-1 expression in vitamin D3 + sham group (P < 0.05). BUN, Cr, AST, ALT, TNF-α, ionized calcium levels did not differ significantly among the groups. Conclusions: Pretreatment of vitamin D3 ameliorates the systemic IL-6 levels, lung and muscle injury induced by ischemia followed by reperfusion of bilateral occluded vessels in a rat model. [Copyright &y& Elsevier]

Abstract: Background: Lung ischemia-reperfusion (I/R) injury plays an important role in lung transplantation. Less well known is the role of sildenafil in lung I/R injury; therefore, we attempted to determine whether sildenafil could alleviate lung apoptosis and tissue injury in a rat model. Methods: Forty male Sprague-Dawley rats were randomized into four groups: saline + sham, saline + I/R, sildenafil + sham, and sildenafil + I/R groups. Three hours before the operation, each rat received normal saline or sildenafil (10 mg/kg) by lavage. The animals designed to I/R injury were subjected to 2 h of ischemia induced by occlusion of left pulmonary artery, veins, and bronchus, followed by reperfusion for 2 h. The lung tissue was harvested for the analysis of the expression of Bax, Bcl-2, p53, caspase 3, tumor necrosis factor (TNF)-alpha, interleukin (IL)-6, and wet/dry (W/D) weight ratio. Results: Compared with the saline + sham group, the saline + I/R group had significant increases in Bax, p53, Bax/Bcl-2 ratio, caspase 3, IL-6, TNF-α, and W/D weight ratio but a decrease in Bcl-2 (P < 0.05). Compared with the saline + I/R group, sildenafil + I/R group had significant decreases in Bax, p53, Bax/Bcl-2 ratio, caspase 3, IL-6, TNF-α level, and W/D weight ratio but an increase in Bcl-2 expression (P < 0.05). Compared with the sildenafil + sham group, there were significant increases in p53 and TNF-α expression in the sildenafil + I/R group (P < 0.05). Conclusions: Pretreatment with sildenafil alleviates lung apoptosis and tissue injury in a rat model. [Copyright &y& Elsevier]