"I Feel Like I Have Lost Part Of My Identity" - A Qualitative Study Exploring The Impact Of Chronic Ankle Instability.

Introduction: Lateral ankle sprain is the most common ankle injury and up to 40% of those who sustain a lateral ankle sprain will develop chronic ankle instability (CAI). The aim of this study was to explore the thoughts and expectations of CAI-patients concerning their condition and expectations of care in an orthopedic setting. . Study Design: Qualitative study. Methods: Nine semi-structured one-to-one interviews were conducted with CAI-patients who were referred to an orthopedic setting. Interviews were recorded, transcribed, and analyzed using systematic text condensation with an inductive goal free approach. . Results: Seven themes emerged. The themes were Injury history and symptoms (Lateral ankle sprain during sport, pain and instability), Information from health professional (conflicting information about management and prognosis), Management (mental and physical challenges), Expectation and hope (explanation of symptoms, prognosis and imaging to provide clarification of condition), Activity and participation (restriction in sport and daily life and feelings of uncertainty), Support (support from family/friends) and Identity (low ability to participate in sport and social life result in loss of identity). . Conclusion: The impact of CAI exceeds an experience of pain and instability. Patients experienced loss of identity, having to manage uncertainty regarding their diagnosis and prognosis and had hopes of being able to explain their condition. . Level of Evidence: Not applicable.

Comparative flooding tolerance of Typha latifolia and Phalaris arundinacea in wetland restoration: Insights from photosynthetic CO2 response curves, photobiology and biomass allocation.

Tall helophytes such as Typha latifolia and Phalaris arundinacea often rapidly colonise after rewetting of former agricultural soil and are therefore often the first plants to contribute to the soil carbon pool. In this study we carried out a mesocosm experiment where these two species grew at three different water levels relative to the soil surface (-15 cm, 0 cm, +15 cm). After eight weeks' growth, measurements of photosynthetic CO2-response curves, stomatal conductance and chlorophyll fluorescence of photosystem II were carried out to detect flooding stress. After 10 weeks' growth, the plants were harvested and biomass production, biomass allocation and specific leaf area were determined. T. latifolia had a higher and more stable photosynthetic performance across all water level treatments, which resulted in an overall higher aboveground and belowground production than P. arundinacea. In contrast, Vcmax and Jmax decreased by 41 % and 42 %, respectively from drained to flooded conditions with signs of flooding stress as impairment of the photosynthetic apparatus. Moreover, increasing water level resulted in maintenance of aboveground organs for P. arundinacea but a decrease in allocation to belowground organs. P. arundinacea did not invest in a higher specific leaf area to counter the decreased photosynthesis under flooding. From -15 cm to 0 cm water levels, P. arundinacea showed a 68 % reduction in belowground biomass, which has negative implication for carbon retention immediately after rewetting. In contrast, recolonization of T. latifolia is likely to be a suitable contributor to the soil carbon pool due to its stable physiology and high above- and belowground biomass production at all water depths, and also likely under natural water level fluctuations. We showed that even though both species are generally considered wetland plants, they are likely to support considerably different photosynthetic carbon assimilation and soil carbon sequestration rates.

Comparison of visual assessments of anisocytosis in canine blood smears and analyzer-calculated red blood cell distribution width.

Red blood cell distribution width (RDW) and visual assessments of anisocytosis assess variability in erythrocyte size. Veterinary studies on the correlation between the two methods and on observer agreement are scarce. The objectives were to assess the correlation of the grading of anisocytosis by means of conventional microscopy of canine blood smears to RDW, and to assess intra- and inter-observer variation in assessing the degree of anisocytosis. The study included 100 canine blood samples on which blood smear examination and RDW measurement were performed. RDW was measured on the Advia 2120i analyzer. The degree of anisocytosis was based on a human grading scheme assessing the ratio between the size of the representative largest red blood cell and that of the representative smallest red blood cell (1+ if <2x, 2+ if 2-3x, 3+ if 3-4x, and 4+ if >4x). Three observers participated and assessed the blood smears by conventional microscopy twice, 3 weeks apart by each observer. The correlation was assessed for each observer on each occasion using Kendahl-tau-b analysis. Intra-observer agreement was assessed using quadratically weighted kappa. Inter-observer agreement was assessed using free-marginal multi-rater kappa. Anisocytosis graded on blood smears correlated significantly with RDW values as assessed by Kendahl-tau-b ranging between 0.37 and 0.51 (p < 0.0001). Intra-observer agreement ranged from weak to moderate with resulting kappa-coefficients being 0.58, 0.68, and 0.75, respectively. Inter-observer agreement was weak (Kappa-values 0.44). The weak to moderate observer agreement in the visual assessment of anisocytosis indicates that the more precise and more repeatable RDW measurement should be used for clinical decision-making.

Dirofilaria repens in a dog imported to Denmark: A potential for emerging zoonotic disease.

Dirofilarosis is spreading among dogs and humans in Europe with infections being established in many countries. Here, we describe the first molecular biologically confirmed case of D. repens infection in an imported dog in Denmark and highlight the potential zoonotic aspects from this emerging zoonotic parasite in central and northern Europe as at least one to two generations of Dirofilaria spp. can occur per year in Denmark.

Environmental Impacts of Large-Scale Spirulina (Arthrospira platensis) Production in Hellisheidi Geothermal Park Iceland: Life Cycle Assessment.

Spirulina algae (Spirulina platensis) cultivated in geothermally powered photobioreactors is here proposed as a potentially resource efficient, zero-carbon, and nutritious alternative to conventional beef meat. Employing a standard life cycle assessment, environmental impacts of large-scale Spirulina production in this facility are calculated. The production facility is sited in Orka náttúrunnar (ON Power) Geothermal Park, Iceland, and benefits from resource streams accessible through Hellisheiði (Hellisheidi) power station, including renewable electricity for illumination and power usage, hot and cold water streams for thermal management, freshwater for cultivation, and CO2 for biofixation. During cultivation, GHG-intensive ammonia-based fertilizers are replaced with macronutrients sourced from natural open mines. LCA results show that production of 1 kg of wet edible biomass in this facility requires 0.0378 m2 non-arable land, 8.36 m3 fresh water and is carbon neutral with - 0.008 CO2-eq GHG emissions (net zero). Compared with conventionally produced meat from beef cattle, Spirulina algae cultured in the ON Power Geothermal Park, referred to in this study as GeoSpirulina, requires less than 1% land and water and emits less than 1% GHGs. Considering food and nutritional security concerns, cultivation in a controlled environment agriculture system assures consistent nutritional profile year-round. Moreover, GeoSpirulina biomass assessed in this study contains all essential amino acids as well as essential vitamins and minerals. While keeping a balanced nutrition, for every kg beef meat replaced with one kg GeoSpirulina, the average consumer can save ~ 100 kg CO2-eq GHGs. It is concluded that environmental impacts of GeoSpirulina production in the Hellisheidi facility are considerably lower than those of conventionally produced ruminants.

What do we actually know about a common cause of plantar heel pain? A scoping review of heel fat pad syndrome.

BACKGROUND: The heel fat pad is an important structure of the foot as it functions as a cushion to absorb shock and distribute plantar force during ambulation. Clinical practice guidelines or decision support platforms emphasize that heel fat pad syndrome (HFPS) is a distinct pathology contributing to plantar heel pain. We aimed to identify and synthesize the prevalence, etiology and diagnostic criteria, and conservative management of HFPS. METHODS: A comprehensive search was conducted in May 2021 and updated in April 2022, using MEDLINE, Scopus, Cinahl, EMBASE, Cochrane Library, SPORTDiscus, and PEDro and ClinicalTrials.gov and the World Health Organization's International Clinical Trials Registry Platform (ICTRP) for pertinent registrations. We included all study types and designs describing the prevalence; etiology and diagnostic criteria; and non-pharmacological, non-surgical interventions for HFPS. RESULTS: We found a small body of original research for HFPS (n = 7). Many excluded full-text articles were expert-opinion articles or studies of heel fat pad in participants with plantar fasciitis/fasciopathy or unspecified heel pain. HFPS may be the second leading cause of plantar heel pain, based on two studies. A number of differentiating pain characteristics and behaviors may aid in diagnosing HFPS vs. plantar fasciopathy. Thinning heel fat pad confirmed by ultrasonography may provide imaging corroboration. Randomized controlled trials assessing the efficacy of viscoelastic heel cups or arch taping for managing HFPS do not exist. CONCLUSIONS: The research literature for HFPS is sparse and sometimes lacking scientific rigor. We have identified a substantial knowledge gap for this condition, frequent inattention to distinguishing HFPS from plantar fasciopathy when describing plantar heel pain, and an absence of robust clinical trials to support the commonly recommended conservative management of HFPS.

The Potential Role of Iceland in Northern Europe's Protein Self-Sufficiency: Feasibility Study of Large-Scale Production of Spirulina in a Novel Energy-Food System.

Europe is dependent on protein-rich crop imports to meet domestic food demand. This has moved the topic of sustainable protein self-sufficiency up the policy agenda. The current study assesses the feasibility of protein self-sufficiency in Iceland, and its capacity to meet Northern Europe's demand, based on industrial-scale cultivation of Spirulina in novel production units. Production units currently operating in Iceland, and laboratory-derived nutritional profile for the Spirulina cultivated, provide the basis for a theoretical protein self-sufficiency model. Integrating installed and potentially installed energy generation data, the model elaborates six production scale-up scenarios. Annual biomass produced is compared with recommended dietary allowance figures for protein and essential amino acids to determine whether Northern Europe's population demands can be met in 2030. Results show that Iceland could be protein self-sufficient under the most conservative scenario, with 20,925 tonnes of Spirulina produced using 15% of currently installed capacity. In a greater allocation of energy capacity used by heavy industry, Iceland could additionally meet the needs of Lithuania, or Latvia, Estonia, Jersey, Isle of Man, Guernsey, and Faroe Islands. Under the most ambitious scenario utilizing planned energy projects, Iceland could support itself plus Denmark, or Finland, or Norway, or Ireland with up to 242,366 tonnes of biomass. On a protein-per-protein basis, each kilogram of Spirulina consumed instead of beef could save 0.315 tonnes CO2-eq. Under the most ambitious scenario, this yields annual savings of 75.1 million tonnes CO2-eq or 7.3% of quarterly European greenhouse gas emissions. Finally, practicalities of production scale-up are discussed.

Distributed backscattering in production O-band Si nanophotonic waveguides.

Backscattering in integrated photonic waveguides can significantly impact the performance of optical systems. However, it has not been extensively studied in the literature and measurements on waveguides fabricated in production foundry processes are particularly lacking in view of their importance to technology. Here we experimentally measure and analyze distributed backscattering in various production O-band silicon photonic waveguides. We find the measured backscattering to scale from -18 to -36 dB/mm. Measured trends across waveguide geometry and polarization are consistent with stochastic defects on waveguide sidewalls being the dominant source of distributed backscattering in production Si waveguides. For production SiNx waveguides, both sidewall and cladding defects need to be considered to fit measured trends.

Recommendations for designing and conducting veterinary clinical pathology biologic variation studies.

The recent creation of a veterinary clinical pathology biologic variation website has highlighted the need to provide recommendations for future studies of biologic variation in animals in order to help standardize and improve the quality of published information and to facilitate review and selection of publications as standard references. The following recommendations are provided in the format and order commonly found in veterinary publications. A checklist is provided to aid in planning, implementing, and evaluating veterinary studies on biologic variation (Appendix S1). These recommendations provide a valuable resource for clinicians, laboratorians, and researchers interested in conducting studies of biologic variation and in determining the quality of studies of biologic variation in veterinary laboratory testing.

The effect of host age and inoculation dose on infection dynamics of Angiostrongylus vasorum in red foxes (Vulpes vulpes).

BACKGROUND: Infections and clinical cases of Angiostrongylus vasorum in dogs are found increasingly across Europe, thus rendering knowledge on its infection biology more important. We used red foxes as a carnivore model to examine the effect of host age and infection dose on the establishment of adult A. vasorum in single experimental infections. METHODS: Fourteen juvenile and fourteen adult red foxes, free of metastrongyloid infections, were given a low (50) or high (200) dose of third-stage larvae (L3) of A. vasorum. Two groups of three foxes of each age group served as uninfected controls. Larval excretion by Baermann and blood parameters were followed for ten weeks. Worm counts were performed at necropsy by sequential perfusion, dissection and Baermann method. RESULTS: The establishment rate (i.e. recovery in percentage of inoculation dose) of A. vasorum primary infections in red foxes was associated with host age and inoculation dose. In the low dose juveniles, 61% (range 52-72%) of the infection dose was recovered as worms in the pulmonary arteries and heart at necropsy while only 35% (21-50%) were recovered in the high dose. Corresponding establishment rates for adults were 39% (18-98%) and 8% (1-21%). In juveniles, a higher dose resulted in significantly higher adult worm counts, higher larval excretion and more pronounced pathophysiological changes, particularly in coagulation parameters. Earlier onset of patency was also found in the juveniles. In contrast, the larval excretion in high dose adults was very low and two infected animals never reached patency. However, a few adults showed only limited resistance as judged by excretion of larvae. The increase to very high larval excretion levels (> 4,000 larvae per g of faeces) after several months in a single animal, indicated that any potential acquired immunity does not affect worm fecundity. CONCLUSIONS: Resistance to a primary A. vasorum infection was generally higher in older animals, and this age resistance was reflected in lower worm counts and reduced excretion of larvae. The juvenile red foxes were fully susceptible, as reflected in high establishment rates. Although severe clinical disease was never observed in the foxes, A. vasorum infections in red foxes appear to be chronic and moreover, to resemble infections in dogs. The results underline the red fox as a suitable model as well as natural reservoir for the parasite.

Active and Passive Immunization Against Staphylococcus aureus Periprosthetic Osteomyelitis in Rats.

BACKGROUND/AIM: Staphylococcus aureus infection associated with orthopedic implants cannot always be controlled. We used a knee prosthesis model with implant-related osteomyelitis in rats to explore induction of an effective immune response with active and passive immunization. MATERIALS AND METHODS: Fifty-two Sprague-Dawley rats were divided into active (N=28) and passive immunization groups (N=24). A bacterial inoculum of 103 S. aureus MN8 was injected into the tibia and the femur marrow before insertion of a non-constrained knee prosthesis in each rat. The active-immunization group received a synthetic oligosaccharide of polysaccharide poly-N-acetylglucosamine (PNAG), 9G1cNH2 and the passive-immunization group received immunization with immunoglobulin from rabbits infected with S. aureus. RESULTS/CONCLUSION: Active immunization against PNAG significantly reduced the consequences of osteomyelitis infection from PNAG-producing intercellular adhesion (ica+) but not ica- S. aureus. Passive immunization resulted in better clinical assessments in animals challenged with either ica+ or ica- S. aureus, suggesting a lack of specificity in this antiserum.

Prevalence of feline haemoplasma in cats in Denmark.

BACKGROUND: Infections with the three feline haemotropic mycoplasmas Mycoplasma haemofelis, Candidatus Mycoplasma haemominutum and Candidatus Mycoplasma turicensis cause feline infectious anemia. The purpose of this study was to investigate the prevalence of carriage of feline haemoplasma in Danish cats in different age groups. The presence was detected by a conventional polymerase chain reaction (PCR) assay on blood samples as well as by real-time PCR (RT-PCR). RESULTS: The study revealed a prevalence of 14.9% Candidatus Mycoplasma haemominutum positive cats and 1.5% Mycoplasma haemofelis positive cats. No cats were found positive for Candidatus Mycoplasma turicensis. The results showed a statistically significant higher prevalence in older (>8 years) cats compared to younger cats and a higher prevalence among domestic cats compared to purebred cats. As part of this study, we developed a cloning strategy to obtain Danish positive controls of haemoplasma 16S rRNA. CONCLUSION: From convenience-sampled cats in Denmark, we found that 16.4% were carriers of feline haemotropic mycoplasmas. Haemoplasma was mostly found in older and domestic cats. The prevalence found in Denmark is similar to that found in several other European countries.

Canine serum C-reactive protein as a quantitative marker of the inflammatory stimulus of aseptic elective soft tissue surgery.

BACKGROUND: C-reactive protein (CRP) is an established serum marker for the presence of systemic inflammation in dogs. Results from previous experimental and clinical studies suggest that CRP concentrations also quantitatively reflect the degree and progress of an inflammatory process, suggesting its use for inflammation monitoring. OBJECTIVES: The objective was to investigate whether the canine CRP response in serum correlates with the amount of trauma and the consequent inflammatory response after 3 standard aseptic soft-tissue surgical procedures in 3 groups of dogs. METHODS: A total of 24 client-owned intact female dogs of various breeds were enrolled in a clinical study with random allocation into 2 surgical groups, for either conventional, open-approach ovariohysterectomy (OVH; n = 14) or laparoscopic assisted OVH (n = 10). In addition, a group of 8 male Beagles from a laboratory animal facility underwent vasectomy, serving as the third and mildest surgical trauma group. Serum CRP was measured pre- and at 4, 8, 12, 23, and 27 hours postsurgery. Cumulative concentration over time and point concentrations of CRP were correlated with the surgical trauma impact level. RESULTS: There was a significant surgery trauma-related difference in cumulative CRP concentrations among the 3 groups, and also in the 12 hours postsurgery concentration. CONCLUSION: The CRP response varied according to the degree of surgical trauma on 3 standardized levels, thus supporting the use of canine serum concentrations of CRP as an inflammatory activity indicator and monitoring marker.

A novel knee prosthesis model of implant-related osteomyelitis in rats.

BACKGROUND AND PURPOSE: There have been numerous reports of animal models of osteomyelitis. Very few of these have been prosthesis models that imitate human conditions. We have developed a new rat model of implant-related osteomyelitis that mimics human osteomyelitis, to investigate the pathology of infection after orthopedic implant surgery. METHODS: 2 wild-type strains of Staphylococcus aureus, MN8 and UAMS-1, and their corresponding mutants that are unable to produce poly-N-acetyl glucosamine (PNAG) (ica::tet) were injected into the medullary canals of the femur and tibia at 3 different doses: 10(2), 10(3), and > 10(4) CFU/rat. We measured clinical signs, inflammatory markers, radiographic signs, histopathology, and bacteriology in the infected animals. RESULTS: An inoculum of at least 10(4) cfu of either wild-type bacterial strain resulted in histological, bacteriological, and radiographic signs of osteomyelitis with loosening of the prosthesis. An inoculum of 10(3) CFU gave signs of osteomyelitis but the prosthesis remained in situ. Bacterial inocula of 10(2) cfu gave no signs of osteolysis. INTERPRETATION: We have established a new knee prosthesis model that is suitable for reliable induction of experimental implant-associated osteomyelitis with the prosthesis in situ, using a small inoculum of S. aureus. At a dose of 10(3) CFU/rat, bacteria unable to produce PNAG (ica::tet) had only minor defects in their virulence.

Emotions in veterinary surgical students: a qualitative study.

A surgical educational environment is potentially stressful and can negatively affect students' learning. The aim of the present study was to investigate the emotions experienced by veterinary students in relation to their first encounter with live-animal surgery and to identify possible sources of positive and negative emotions, respectively. During a Basic Surgical Skills course, 155 veterinary fourth-year students completed a survey. Of these, 26 students additionally participated in individual semi-structured interviews. The results of the study show that students often experienced a combination of emotions; 63% of students experienced negative emotions, while 58% experienced positive ones. In addition, 61% of students reported feeling excited or tense. Students' statements reveal that anxiety is perceived as counterproductive to learning, while excitement seems to enhance students' focus and engagement. Our study identified the most common sources of positive and negative emotions to be "being able to prepare well" and "lack of self-confidence," respectively. Our findings suggest that there are factors that we can influence in the surgical learning environment to minimize negative emotions and enhance positive emotions and engagement, thereby improving students' learning.

Anxiety in veterinary surgical students: a quantitative study.

The surgical educational environment is potentially stressful and this can negatively affect students' learning. The aim of this study was to investigate whether veterinary students' level of anxiety is higher in a surgical course than in a non-surgical course and if pre-surgical training in a Surgical Skills Lab (SSL) has an anxiety reducing effect. Investigations were carried out as a comparative study and a parallel group study. Potential participants were fourth-year veterinary students who attended a surgical course (Basic Surgical Skills) and a non-surgical course (Clinical Examination Skills); both courses were offered in multiple classes (with a total of 171 students in 2009 and 156 students in 2010). All classes in 2009 participated in the SSL stage of the Basic Surgical Skills course before performing live-animal surgery, and one class (28 students) in 2010 did not. Two validated anxiety questionnaires (Spielberger's state-trait anxiety inventory and Cox and Kenardy's performance anxiety questionnaire) were used. Anxiety levels were measured before the non-surgical course (111 students from 2009) and before live-animal surgery during the surgical course (153 students from 2009 and 28 students from 2010). Our results show that anxiety levels in veterinary students are significantly higher in a surgical course than in a non-surgical course (p<.001), and that practicing in a SSL helps reduce anxiety before live-animal surgery (p<.005).

Blood plasma clinical-chemical parameters as biomarker endpoints for organohalogen contaminant exposure in Norwegian raptor nestlings.

Raptors are exposed to biomagnifying and toxic organohalogenated compounds (OHCs) such as organochlorines, brominated flame retardants and perfluorinated compounds. To investigate how OHC exposure may affect biochemical pathways we collected blood plasma from Norwegian northern goshawk (n=56), golden eagle (n=12) and white-tailed eagle (n=36) nestlings during three consecutive breeding seasons. We found that blood plasma concentrations of calcium, sodium, creatinine, cholesterol, albumin, total protein, urea, inorganic phosphate, protein:creatinine, urea:creatinine and uric acid:creatinine ratios and liver enzymes ALKP and ALAT were positively correlated to PCBs, chlordanes, p,p'-DDE, HCB, PFCs and/or PBDEs. Total bilirubin and glucose were negatively correlated to PCBs while magnesium and potassium were negatively correlated to HCB and p,p'-DDE. In addition, protein:creatinine and ALAT were also negatively correlated to PCBs and PFCs, respectively. The most significant relationships were found for the highly contaminated northern goshawks and white-tailed eagles. The statistical relationships between OHCs and BCCPs indicate that biochemical pathways could be influenced while it is uncertain if such changes have any health effects. The OHC concentrations were below concentrations causing reproductive toxicity in adults of other raptor species but similar to those of concern for endocrine disruption of thyroid hormones in e.g., bald eagles.

Development of a flow cytometric assay for detection of coated platelets in dogs and evaluation of binding of coated platelets to recombinant human coagulation factor VIIa.

OBJECTIVE: To develop an antibody-based flow cytometric assay to detect coated platelets in dogs and to characterize the interaction of recombinant human coagulation factor VIIa with activated platelets from dogs with hemophilia A. SAMPLE: Platelets from 4 dogs with hemophilia A, 4 dogs with hemophilia B, 4 dogs with von Willebrand disease, and 6 hemostatically normal dogs. PROCEDURES: Freshly isolated platelets were activated with thrombin, convulxin, or a thrombin-convulxin combination. Resulting platelet phenotypes were resolved on the basis of P-selectin and fibrinogen expression, and binding of recombinant human coagulation factor VIIa to these distinct platelet subpopulations was measured by use of a flow cytometric assay. RESULTS: Coated platelets were identified on the basis of expression of α-granule fibrinogen and were generated in response to stimulation with the thrombin-convulxin combination but not to stimulation with either agonist alone. Approximately 70% of the platelets from dogs with hemophilia A, hemophilia B, and von Willebrand disease and from the control dogs had the coated platelet phenotype. Recombinant human coagulation factor VIIa bound preferentially to coated platelets with a mean ± SD binding equilibrium constant of 2.6 ± 0.5µM. CONCLUSIONS AND CLINICAL RELEVANCE: Formation of coated platelets in dogs was similar to that in humans. Recombinant human coagulation factor VIIa bound preferentially to coated platelets from dogs. IMPACT FOR HUMAN MEDICINE: A similar mechanism of action for recombinant human coagulation factor VIIa may exist in dogs and humans. The potential for use of dogs in the study of bleeding disorders in humans was strengthened.