Pure Isolated Internuclear Ophthalmoplegia as Presentation of Midbrain Ischemic Stroke: A Case Report.

Internuclear ophthalmoplegia (INO) is a condition characterized by impaired ocular movement, leading to an inability to perform coordinated lateral gaze, resulting in ophthalmoplegia. This impairment results from damage to the medial longitudinal fasciculus (MLF), which can occur because of various types of lesions localized in the pons or midbrain. In this case, we report on a 67-year-old man with multiple comorbidities who arrived at the emergency department with complaints of sudden dizziness and an unsteady gait. During the examination, he exhibited left INO, which was characterized by limited left eye adduction and multidirectional nystagmus of the right eye when performing right lateral gaze.

Acute Pancreatitis Secondary to Intragastric Balloon: A Case Report and Literature Review.

Intragastric balloon (IGB) is a common minimally invasive procedure used for obesity management and weight reduction. It can be used alone, sequentially, with concomitant therapies, or as a bridge to longer-term weight-loss interventions, such as bariatric surgery. Although the insertion procedure is easy and generally well tolerated by patients, a few complications can occur with varying degrees of severity ranging from mild to severe and life-threatening. Acute pancreatitis is a rare complication of IGB but has been reported in the literature. We present a case in which the patient had a history of IGB insertion complicated by acute pancreatitis. The diagnosis of acute pancreatitis due to the IGB insertion was made after excluding other possible causes of acute pancreatitis. The patient was hospitalized and managed conservatively.

The effect of local anaesthetic biopsy in head and neck cancer on cancer pathway waiting times.

INTRODUCTION: The 31-day target in urgent suspicion of cancer (USOC) referrals fast-tracks patients through the cancer pathway. Local anaesthetic (LA) biopsy can be performed during an outpatient clinic and may improve pathway times. The aim of this study was to compare LA biopsy in head and neck USOC referrals with the traditional general anaesthetic (GA) pathway. METHODS: This was a retrospective cohort study of USOC referrals to the NHS Greater Glasgow and Clyde head and neck multidisciplinary team between 1 June 2018 and 28 December 2020, and compared pathway times in LA and GA biopsies. RESULTS: The mean number of days from clinic to biopsy was 4.4 in the LA group and 28.0 in the GA group. This was significantly faster in the LA biopsy group (p < 0.05). The overall pathway time in the LA and GA biopsy groups was 35.7 and 61.5 days, respectively, and was significantly faster in LA biopsy group (p < 0.05). CONCLUSIONS: The LA cohort had significantly faster pathway times compared with GA biopsy. LA biopsy requires careful patient selection, but is an effective alternative to GA biopsy in the appropriate patient group.

Barriers to Undergoing Body-Contouring Surgery Following Bariatric Surgery in Saudi Arabia.

Introduction The prevalence of obesity has experienced a significant global increase in recent years, emerging as a prominent worry affecting numerous individuals throughout various countries, including Saudi Arabia. Bariatric surgery, a common treatment, often leads to excess skin. Despite its benefits, few patients choose body contouring surgery. A cross-sectional study aims to identify barriers, including socioeconomic and psychological factors. Methodology This is a cross-sectional study conducted in Saudi Arabia. Participants included those who underwent bariatric surgery. Data were collected through questionnaires and analyzed by Statistical Product and Service Solutions (SPSS, version 29) (IBM SPSS Statistics for Windows, Armonk, NY). Results Our study involved 662 Saudi participants with post-bariatric surgery, primarily females (386, 58.3%), aged 19-29 (44.3%). Most had undergone bariatric surgery (558, 84.3%), mainly gastric sleeve (485, 73.3%). Excess skin was a common issue (311, 47.0%). Difficulties included rashes and emotional distress (e.g., depression). About 8.3% had body-contouring surgery, including body lifts (13, 23.6%) and liposuction (19, 34.5%). Factors influencing surgery decisions included self-confidence (123, 18.6%) and cost (9.9%). Barriers for 32.2% considering surgery included cost (80.2%) and fear of a second surgery (45.6%). Females (67.1%), Saudis (85.4%), and employed individuals (49.3%) were more likely to consider surgery (p < 0.05). Conclusion Our study highlights the complexity of body-contouring decisions after bariatric surgery in Saudi Arabia. Cost and fear were barriers; females, Saudis, and employed individuals were more likely to consider surgery. A patient-centered approach, addressing barriers, and offering support are crucial for informed choices and improved well-being.

Myxomatous Liposarcoma of the Mediastinum: A Review of the Literature.

Myxomatous liposarcoma is an extremely rare type of mediastinal tumour that manifests in a manner comparable to other lung pathologies. Chest pain, shortness of breath, and dysphagia are the common presenting complaints. Radiological examinations or postoperative histological examinations provide the majority of the diagnostic evidence. The cornerstone of therapy consists of surgery and sometimes chemotherapy. Those who are afflicted have a better chance of experiencing favourable outcomes if they receive a diagnosis and treatment quickly.

Disruption of the tagF Orthologue in the epa Locus Variable Region of Enterococcus faecalis Causes Cell Surface Changes and Suppresses an eep-Dependent Lysozyme Resistance Phenotype.

The disease-producing capacity of the opportunistic pathogen Enterococcus faecalis is enhanced by the ability of the bacterium to evade killing by antimicrobial agents. Survival of E. faecalis in the presence of the human antimicrobial enzyme lysozyme is mediated in part by the site 2 metalloprotease Eep; however, a complete model of enterococcal lysozyme resistance has not been elucidated. To better understand the molecular basis for lysozyme resistance in E. faecalis, we analyzed Δeep suppressor mutants that acquire resistance to lysozyme through mutation of the gene OG1RF_11713, a predicted teichoic acid biosynthesis-encoding gene located within the variable region of the enterococcal polysaccharide antigen (epa) locus. Sequence comparisons revealed that OG1RF_11713 is most similar to the cytidine-5'-diphosphate (CDP)-glycerol:poly-(glycerolphosphate)glycerophosphotransferase TagF from Staphylococcus epidermidis. Inactivation of OG1RF_11713 in both the wild-type and Δeep genetic backgrounds was sufficient to increase the resistance of E. faecalis OG1RF to lysozyme. Minimal amounts of N-acetylgalactosamine were detectable in cell wall carbohydrate extracts of OG1RF_11713 deletion mutants, and this was associated with a reduction in negative cell surface charge. Targeted disruption of OG1RF_11713 was also associated with increased susceptibility to the antibiotic polymyxin B and membrane-targeting detergents and decreased susceptibility to the lantibiotic nisin. This work implicates OG1RF_11713 as a major determinant of cell envelope integrity and provides further validation that lysozyme resistance is intrinsically linked to the modification of enterococcal cell wall polysaccharides. IMPORTANCE Enterococcus faecalis is a leading cause of health-care-associated infections for which there are limited treatment options. E. faecalis is resistant to several antibiotics and to high concentrations of the human antimicrobial enzyme lysozyme. The molecular mechanisms that mediate lysozyme resistance in E. faecalis are complex and remain incompletely characterized. This work demonstrates that a gene located within the variable region of the enterococcal polysaccharide antigen locus of E. faecalis strain OG1RF (OG1RF_11713), which is predicted to encode a component of the teichoic acid biosynthesis machinery, is part of the lysozyme resistance circuitry and is important for enterococcal cell wall integrity. These findings suggest that OG1RF_11713 is a potential target for new therapeutic strategies to combat enterococcal infections.

The effect of extended refrigerated storage on the physicochemical, structural, and microbial quality of sous vide cooked biceps femoris treated with ginger powder (zingibain).

The aim of the study was to investigate quality and shelf life of beef meat cooked under sous vide conditions then extended refrigerated storage for 10 weeks. Biceps femoris (n = 6) from six to seven year old cows were treated with 2 g/L ginger powder (GP) containing zingibain or control (no injection) and were then cooked in sous vide conditions at 65 °C for 1 h or 8 h. Cooked samples were evaluated for physicochemical (pH, total water content, cooking loss, Warner-Bratzler shear force (WBSF), texture profile analysis (TPA), L*, a*, b* properties and thiobarbituric acid reactive substance (TBARS)), microstructure (scanning electron microscopy) and microbiological (Brochothrix thermospacta, Clostridium perfringens, Lactic acid bacteria, Listeria monocytogenes, Salmonella spp, and yeasts and moulds) quality after vacuum packing, cooking, then refrigerated storage at 4 °C for 0, 2, 4, 8 or 10 weeks. Physicochemical parameters were improved by GP treatment (P < 0.05) while there was no effect of storage time on WBSF, TPA or microstructure. The microbial quality of sous vide cooked meat in refrigerated storage appeared to be four weeks and oxidation shelf life of the cooked meat was found to be two weeks under refrigerated storage.

Sensory and Physical Characteristics of M. biceps femoris from Older Cows Using Ginger Powder (Zingibain) and Sous Vide Cooking.

This study aimed to evaluate the sensory and physical characteristics of zingibain-injected meat combined with sous vide cooking. M. biceps femoris (BF; n = 12) acquired from 6-7 year old Angus cows were cooked using the sous vide method at 65 °C, for 8 h or 12 h, either with ginger powder (GP) injected in a 2 g/L solution in water (treatment) or un-injected (control). The sensory attributes included flavour, juiciness, tenderness, and physicochemical characteristics were Warner-Bratzler shear (WBSF), hardness, total water content (TWC), cooking loss (CL) and collagen content. A significant improvement in tenderness with injection treatment and cooking time was observed, as evaluated through trained sensory panellists, and reduced WBSF and hardness (p < 0.05 for all). The flavour of the meat was not affected by injection treatment or cooking time (p > 0.05), but juiciness and TWC were reduced with longer cooking times (p < 0.01 for both). Soluble collagen increased with injection treatment and cooking time (both p < 0.05). Moderate to high correlations were found between sensory and physical measurements for tenderness and juiciness. The longer cooking time (12 h) with GP injection treatment caused over tenderization of the meat. The soft texture associated with over-tenderization may be suitable for some specialised consumer markets, for instance, the elderly population with chewing difficulties. Improving the eating quality of low-quality meat from old animals through sous vide cooking and the use of ginger proteases may increase the acceptability of lower value beef, potentially enhancing the commercial value of carcasses typically produced in the beef industry.

Improving tenderness and quality of M. biceps femoris from older cows through concentrate feeding, zingibain protease and sous vide cooking.

The study investigated the effect of zingibain protease and sous vide cooking on tenderness and water-holding capacity of M. biceps femoris (BF) from 30 older Angus cows (6-7 years) fed concentrates for 0, 28, 42 or 56 days. BF were cooked for 1, 8, and 18 h at 65 °C and 75 °C, without any pre-treatment, after they have been injected with water only or after they have been injected with either 1 g/L or 2 g/L ginger powder solution (containing zingibain). Samples were tested for cooking loss, total water content, Warner-Bratzler shear force (WBSF), collagen content, and myofibrillar fragmentation index (MFI). Results revealed the significant interactions between concentrate feeding, ginger powder injection, cooking temperature, and time on quality traits. WBSF was reduced (P < 0.001) by increasing zingibain concentration at 65 °C but a gradual decrease was noted at 75 °C. Collagen solubility and MFI increased (P < 0.05) with increasing zingibain concentration. Injecting zingibain along with sous vide cooking demonstrated the weakening of myofibrillar and connective tissue proteins contributing to enhanced collagen solubility and tenderness in BF.

USP22 promotes HER2-driven mammary carcinoma aggressiveness by suppressing the unfolded protein response.

The Ubiquitin-Specific Protease 22 (USP22) is a deubiquitinating subunit of the mammalian SAGA transcriptional co-activating complex. USP22 was identified as a member of the so-called "death-from-cancer" signature predicting therapy failure in cancer patients. However, the importance and functional role of USP22 in different types and subtypes of cancer remain largely unknown. In the present study, we leveraged human cell lines and genetic mouse models to investigate the role of USP22 in HER2-driven breast cancer (HER2+-BC) and demonstrate for the first time that USP22 is required for the tumorigenic properties in murine and human HER2+-BC models. To get insight into the underlying mechanisms, we performed transcriptome-wide gene expression analyses and identified the Unfolded Protein Response (UPR) as a pathway deregulated upon USP22 loss. The UPR is normally induced upon extrinsic or intrinsic stresses that can promote cell survival and recovery if shortly activated or programmed cell death if activated for an extended period. Strikingly, we found that USP22 actively suppresses UPR induction in HER2+-BC cells by stabilizing the major endoplasmic reticulum (ER) chaperone HSPA5. Consistently, loss of USP22 renders tumor cells more sensitive to apoptosis and significantly increases the efficiency of therapies targeting the ER folding capacity. Together, our data suggest that therapeutic strategies targeting USP22 activity may sensitize tumor cells to UPR induction and could provide a novel, effective approach to treat HER2+-BC.

Effect of sous vide cooking and ageing on tenderness and water-holding capacity of low-value beef muscles from young and older animals.

This study investigated the effect of the age of the animal, sous vide cooking and ageing on tenderness and water-holding capacity of bovine biceps femoris (BF) and semitendinosus (ST). Samples of each muscle from young (<18 months) and older (30-42 months) animals, at 0 and 13 days ageing, were cooked at 55 °C, 65 °C, and 75 °C for 1 h, 8 h and 18 h and tested for Warner-Bratzler shear force (WBSF), cooking loss, total water content and collagen solubility. WBSF reduced with ageing (P < 0.05) and sous vide cooking (P < 0.001) in both muscles. Our results demonstrated that meat from older animals required a higher temperature (75 °C) and prolonged cooking (18 h) to achieve equal tenderness in both BF and ST relative to young animals. Cooking time, temperature and their interaction altered cooking loss (P < 0.001) for both muscles. The higher cooking temperature increased collagen solubility (P < 0.001) in both muscles and solubilisation of collagen may have contributed to improved tenderness of BF and ST in sous vide cooking.

Challenges in delivery and performance of a cervical cancer prevention program in the Kurdistan Region of the Iraq health system.

OBJECTIVE: To investigate health-system challenges responsible for the poor performance of a cervical cancer prevention program in the Kurdistan Region of Iraq. METHOD: A qualitative study was conducted among a purposive sample of healthcare providers and female volunteers in Erbil, Kurdistan Region of Iraq, between December 10, 2014, and July 23, 2016. Data were collected from participants using in-depth semi-structured interviews. The interviews were then transcribed and analyzed with an inductive content analysis approach. RESULTS: In total, 23 individuals completed the interviews. The participants included 8 (35%) female volunteers; 5 (22%) nurses; 4 (17%) managers; 3 (13%) doctors; and 3 (13%) gynecologists. The health-system challenges were classified into three main categories: existence of an official reminder system, public information delivery programs, and infrastructures of facilities, which included three subcategories-cervical cancer screening center, material resources, and human resources. CONCLUSIONS: The Kurdistan Region of Iraq health system faced several challenges in delivering a cervical cancer prevention program. These challenges must be addressed to improve the coverage of cervical cancer screening, diagnosis, and treatment.

De Novo Design of Iron-Sulfur Proteins.

Iron-sulfur proteins are one of the most abundant and functionally pliable redox proteins found in all living organisms. Because of their crucial role in mediating electron transfer processes, minimalist model systems have been developed as a proxy to study natural Fe-S redox proteins and to dissect rules to enable tuning of their redox and electron transfer activities. This goal has been pursued through computational design, mutagenesis in the first and second coordination sphere, metal substitution, cofactor replacement, and the use of unnatural amino acids to stabilize a given cluster. In this chapter, we discuss the most recent design strategies to introduce various Fe-S clusters into natural and artificial protein scaffolds. Practical approaches for the cluster reconstitution, hydrogen production, and electrochemical characterization are mentioned.

Contraception Use among Iranian Women With HIV: A Qualitative Study.

BACKGROUND: The application of family planning methods to people with HIV not only prevents unwanted pregnancy, but also leads to a reduction in the possibility of transmission of the virus from the patient to the sexual partner and the fetus. In order to prevent the spread of HIV and enhance reproductive rights, it is necessary to inform women with HIV of the contraception methods. OBJECTIVE: The aim of this study was to explore experiences of HIV positive women about contraception use. METHOD: This qualitative study was conducted on 18 women with HIV who were at reproductive age and had referred the Center for clients with Risky Behavior in Imam Khomeini Hospital. Data were analyzed using the conventional content analysis method in MAXQDA 10. RESULTS: The following two themes were derived from descriptions of the use of contraception methods by women with HIV: 1) Contraception is the forgotten component of reproductive health services; 2) inconsistent condom use. Each theme also contained three sub-themes. CONCLUSION: Results of investigations showed that Risky Behavior consultation Centers mostly stress the use of condom for husband/sexual partners without HIV. In addition, since health care practitioners play an important role in provision of reproductive health services, their lack of knowledge and cooperation considerably contribute to the spread of the disease and violation of patient rights.

Sexual and reproductive health problems of female university students in Iran: a qualitative study.

OBJECTIVE: Youth is defined as the time of transition into adulthood and an important period in a person's life. During this period new behavior is learned easier than adulthood. Therefore, special attention has to be necessarily paid to this period in order to promote the health. Addressing adolescent reproductive health issues is also a critical factor METHODS: This research was a qualitative study conducted from January 2014 to July 2014. Data from focus group discussions and semi-structured interviews with 25 female students and 10 key members of the university (including university authorities, consultants, reproductive health professionals and university officials) was collected and all interviews were recorded, formulated and classified. RESULTS: The mean age of participants was 22.43 years. A total of 8 students majored in geology, 5 majored in chemistry, 3 in statistics, 3 in mathematics, and 6 in biology. 17 had a bachelor's degree, 3 master's degree and 5 doctorate degree. Majority of students (82.4%) were never married and 23 of them lived in dormitories. The following three main themes were extracted from the interviews: Reproduction thought as pregnancy; the taboo of sex; and inappropriate relation between parents and children. CONCLUSION: Most participants stressed the need to provide reproductive health services for young girls.

Prevalence and risk factors for domestic violence against infertile women in an Iranian setting.

OBJECTIVE: To determine the prevalence of and risk factors for domestic violence against women with female factor infertility in an Iranian setting. METHODS: In this cross-sectional survey conducted from August 1, 2009 to January 31, 2010, 400 women with primary infertility attending Valiasr Reproductive Health Research Center in Tehran, Iran, were interviewed using the Revised Conflict Tactics Scales questionnaire (CTS(2)). This instrument was developed to investigate the presence domestic violence. RESULTS: A total of 247 women (61.8%) reported having experienced domestic violence because of their infertility. The most common type of violence was psychological (n=135 [33.8%]), followed by physical (n=56 [14%]) and sexual (n=32 [8%]), with 24 women (6%) reporting injuries. All women reported their husbands to be the perpetrators. CONCLUSION: Domestic violence against infertile women is a considerable yet unreported problem. Clinicians should identify the abused women and provide them with medical care and supportive counseling.

Statistical media optimization for growth and PHB production from methanol by a methylotrophic bacterium.

Media components were optimized by statistical design for cell growth and PHB production of Methylobacterium extorquens DSMZ 1340. Four important components of growth media were optimized by central composite design. The growth increased from an OD=1.35 for Choi medium as control to an OD=2.15 for optimal medium. Then media components for PHB production were optimized. Optimization of five important factors was conducted by response surface method. The optimal composition of PHB production medium was found to be at 7.8 (g/L) Na2HPO4 x 12H2O, and surprisingly at zero concentration of (NH4)2SO4, KH2PO4, MgSO4 and MnSO4. The PHB production was found to be 2.95 (g/L) at this medium. RSM results indicated that a deficiency of nitrogen and magnesium is crucial for PHB accumulation in this microorganism. Also, PHB production was carried out in a 5 L fermentor at the optimum condition which resulted in 9.5 g/L PHB and 15.4 g/L cell dry weight with 62.3% polymer content.