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We were therefore able to draw attention to the limitations of dichotomising emancipatory-empowerment discourses and argue for a theorisation of the patient-doctor relationship as a contextually bounded and relationally ambivalent humanity. © 2020 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL.BACKGROUND AND AIM Following abdominal surgery, patients usually experience a transient episode of impaired gastrointestinal motility. This study aimed to determine whether a single preoperative dose of dexamethasone can promote the recovery of gastrointestinal function in patients following elective gastrointestinal surgery. METHODS In this single-center, two-arm, parallel, randomized controlled trial, we studied 126 patients (aged 18-80 years) who underwent elective open or laparoscopic bowel surgery for malignant or benign pathology. At the induction of anesthesia, a treatment group (n = 64) received a single dose of 8-mg intravenous dexamethasone, and a control group (n = 62) received normal saline. RESULTS Intravenous administration of 8-mg dexamethasone significantly decreased the time to return of flatus by an average of approximately 8 h (P less then 0.05). Abdominal distension was significantly reduced on the third day after surgery in the dexamethasone group (P less then 0.05), and the time to tolerance of a liquid diet was shorter in the dexamethasone group (P less then 0.01). There were no significant differences in other secondary outcomes, including postoperative pain, complication rates, length of hospital stay, or time to first defecation, between the two groups. CONCLUSIONS A single intravenous dose of 8-mg dexamethasone at induction of anesthesia significantly decreases the time to return of flatus, improves abdominal distension at 72 h, and promotes tolerance of a liquid diet. Although further studies are required to confirm our results, we recommend that dexamethasone should be used more widely in gastrointestinal surgery. © 2020 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.Engaging in risky behaviors is a sexual signalling strategy that men use to procure mates. The present study investigates men's preferences for engaging in risky behaviors (along with women's preferences for their male partner's risky behavior) within dating couples. We investigated associations between relationship length, self-perceived attractiveness, sociosexuality orientation, and preference for risky behaviors in a sample of 256 couples. Results indicated that men had stronger preferences for risky behaviors than their partner's ideal preference. Furthermore, relationship length was associated with a decline in women's preference for their partner's risk-taking, but not men's preference for their own risk-taking. Self-perceived attractiveness was negatively associated with risk preference, and sociosexuality orientation was not directly related to risk preference. Female preferences for less intense male risky behaviors could reflect the need of paternal investment which is required for offspring care. Decreased male sexual signalling could account for lower preferences of risky behaviors in females who are involved in longer lasting romantic relationships. © 2020 Scandinavian Psychological Associations and John Wiley & Sons Ltd.Microfluidic system, or lab-on-a-chip, has grown explosively. This system has been used in research for the first time and then entered in the clinical section. selleck chemicals Due to economic reasons, this technique has been used for screening of laboratory and clinical indices. The microfluidic system solves some difficulties accompanied by clinical and biological applications. In this review, the interpretation and analysis of some recent developments in microfluidic systems in biomedical applications with more emphasis on tissue engineering and cancer will be discussed. Moreover, we try to discuss the features and functions of microfluidic systems. © 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.The regulation of hepatic very-low-density lipoprotein (VLDL) secretion is vital for lipid metabolism whose pathogenetic status is involved in fatty liver disease and dyslipidemia seen in hepatic steatosis. Accumulated evidence suggest that ApoE closely related to hepatic VLDL secretion. Here, we report that the expression of patatin-like phospholipase domain containing protein 7 (PNPLA7) is strongly induced by hepatic steatosis and positively correlates with plasma triacylglycerols (TAG) levels in the human subjects. With genetic manipulation in the mice, the deficiency of hepatic PNPLA7 expression resulted in reduced VLDL secretion accompanied by enhanced hepatic lipid accumulation and decreased hepatic ApoE expression. Furthermore, knockdown of PNPLA7 in the livers of the db/db mice also resulted in significant reduction in plasma TAG level but aggravated hepatic steatosis. Importantly, we observed that PNPLA7 interacted with ApoE and presumably at the site of ER. Mechanistically, we have shown that PNPLA7 could modulate polyubiquitination and proteasomal-mediated degradation of ApoE. Overexpressed ApoE restored the impaired VLDL-TAG metabolism in PNPLA7-knockdown primary hepatocytes. Conclusion PNPLA7 plays a critical role in regulating hepatic VLDL secretion by modulating ApoE stability through its interaction with ApoE. This article is protected by copyright. All rights reserved.KEY POINTS Alternaria aeroallergens induce the release of ATP from human bronchial epithelial (HBE) cells by activating a conductive pathway involving VDAC-1 and by exocytosis of ATP localized within membrane vesicles. Inhibition of VDAC-1 blocked Alternaria-evoked Ca2+ uptake across the plasma membrane of HBE cells and IL-33 release into the extracellular media. Reducing cholesterol content with a cholesterol scavenger (b-methylcyclodextrin) or statin compound (simvastatin) blocked ATP and IL-33 release by lowering the expression of VDAC-1 in the plasma membrane. Pretreatment with simvastatin for 24 hours also inhibited the increase in tight junction macromolecule permeability that occurs following Alternaria exposure. These results establish a novel role for VDAC-1 as a mechanism underlying ATP release induced by fungal allergens and suggests a possible therapeutic use for cholesterol lowering compounds in reducing Alternaria-stimulated allergic inflammation. ABSTRACT Human bronchial epithelial (HBE) cells secretion by decreasing the level of VDAC-1 expression in the plasma membrane. In addition, simvastatin inhibited the increase in tight junction macromolecule permeability that was previously observed after Alternaria exposure. These results demonstrate a novel function for VDAC-1 as the conductive mechanism responsible for Alternaria-induced ATP release, an essential early step in the processing, mobilization and secretion of IL-33 by the airway epithelium. Furthermore, the simvastatin-evoked reduction of VDAC-1 expression in the plasma membrane, suggests the possibility that cholesterol lowering compounds may be beneficial in alleviating allergic airway inflammation induced by fungal allergens. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.BACKGROUND Near-infrared (NIR) fluorescence imaging has recently been introduced to the sentinel lymph node (SLN) mapping because of the benefits of the SLN biopsy, such as providing real-time and high-resolution optical guidance. Methylene blue is available and less expensive as an SLN mapping tracer. Our study aims to identify SLN through the NIR fluorescence imaging system mediated by blue dye. METHODS Early-stage breast cancer patients were prospectively enrolled. All participants received a subareolar or peritumoral injection of 1 mL methylene blue (MB) before surgery. The MB fluorescence system was set immediately after injection. SLNs were searched and removed under the guidance of fluorescence and blue dye. RESULTS We identified SLN adequately with the help of real-time lymphography and blue dye. Symbolic lymphatic drainage patterns were also observed. CONCLUSION NIR fluorescence imaging mediated by blue dye has benefits on the identification of lymph vessels, the location of SLN, and the patterns of breast lymphatic flow. © 2020 Wiley Periodicals, Inc.Patients with sickle cell disease (SCD) are at increased risk for neurocognitive impairments. While disease-modifying treatment, such as hydroxycarbamide (hydroxyurea), may decrease this risk, it has not been systematically investigated in children with SCD. We screened neurocognitive functioning in 103 adolescents with SCD (16-17 years, 50% female) and compared outcomes between patients with a history of exposure to hydroxycarbamide (n = 12 HbSC/HbSβ+ thalassaemia; n = 52 HbSS/HbSβ0 thalassaemia) and those never treated with hydroxycarbamide (n = 31 HbSC/HbSβ+ thalassaemia; n = 8 HbSS/HbSβ0 thalassaemia). Demographic distributions were similar between the groups. After adjusting for socioeconomic status, the hydroxycarbamide group had significantly higher scores on nonverbal IQ (HbSC/HbSβ thalassaemia P = 0·036, effect size [d] = 0·65), reaction speed (HbSS/HbSβ0 thalassaemia P = 0·002, d = 1·70), sustained attention (HbSS/HbSβ0 thalassaemia P = 0·014, d = 1·30), working memory (HbSC/HbSβ+ thalassaemia P = 0·034, d = 0·71) and verbal memory (HbSC/HbSβ+ thalassaemia P = 0·038, d = 0·84) when compared to those who did not receive hydroxycarbamide. In patients with HbSS/HbSβ0 thalassaemia, longer treatment duration with hydroxycarbamide was associated with better verbal memory (P = 0·009) and reading (P = 0·002). Markers of hydroxycarbamide effect, including higher fetal haemoglobin (HbF), higher mean corpuscular volume (MCV) and lower white blood cell count (WBC), were associated with better verbal fluency (HbF P = 0·014, MCV P = 0·006, WBC P = 0·047) and reading (MCV P = 0·021, WBC P = 0·037). Cognitive impairment may be mitigated by exposure to hydroxycarbamide in adolescents with SCD. © 2020 British Society for Haematology and John Wiley & Sons Ltd.BACKGROUND Although diabetes mellitus is reported to be related to tooth loss, there is limited population-based evidence for this relationship. We investigated the actual situation of tooth loss by performing a population-based survey using information obtained from the National Database of Health Insurance Claims and Specific Health Checkups (NDB) in Japan. METHODS Medical, dental and pharmacy claims data generated between 1 April 2015 and 31 March 2016 were obtained and analysed. Patients with medical and pharmacy claims of diabetes mellitus were allocated to the diabetes mellitus group. Patients with medical claims of acute upper respiratory inflammation, but without claims of diabetes mellitus, were allocated to the control group. The number of claims involving tooth loss, treatment of periodontal disease and visits to medical and dental institutions were obtained from the NDB. Descriptive statistics were used to compare the nature of tooth loss between patients with diabetes mellitus and the control groups.
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