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Flow similarity model predicts allometric relationships among Acer platanoides L. branches

Using physical models to predict patterns of plant growth has been a long-standing goal for biologists. Most approaches invoke either thermodynamic, biomechanical or hydraulic principles and assume the mechanism of interest applies similarly throughout the plant branching architecture. A recent effort, the flow similarity model, predicts numerous aspects of branching physiology and morphology and argues that the physiological constraints experienced by plants change as a function of branch order and size, with more basal portions satisfying more biomechanical constraints, and more distal portions, hydraulic ones. Distal branches are expected to have a strong influence on allometric relationships within plants due to their numerical abundance. Here we evaluate the predictions of the flow similarity model and a well-known alternative fractal branching model, using data on the dimensions of 3,484 individual stem internodes across four individual Acer platanoides trees. Overall, we find strong agreement between model predictions and the allometric exponents describing tree branch allometry. Further the predicted curvature in allometric relationships is found in all 24 cases examined and the frequency distributions of branch lengths and diameters are consistent with model expectations in 6/8 cases. We also find the area ratios are consistent with the model assumption of area-preserving branching. Collectively, our data and analysis provide strong support for the flow similarity model, and identifies several areas in need of subsequent inquiry.

Activated human B cells produce phospholipase D4-containing extracellular vesicles

Phospholipase D4 (PLD4) is an intracellular exonuclease implicated in immune regulation via nucleic acid degradation. While public proteomic databases indicate the presence of PLD4 in human plasma, its mode of extracellular release remains unclear. This study demonstrates that activated B cells secrete PLD4-containing extracellular vesicles (EVs), providing a novel mechanism for its extracellular presence. EVs were purified from human plasma and confirmed to contain PLD4 through immunoelectron microscopy (IEM), Western blotting, and enzyme-linked immunosorbent assay. To further investigate the cellular origin, human B cells were stimulated in vitro with B cell receptor engagement and TLR9 agonist. Light and electron microscopy revealed significant cellular hypertrophy and accumulation of multivesicular bodies following stimulation. Nanoparticle tracking analysis (NTA) confirmed an increase in EV secretion, and IEM demonstrated a higher frequency of PLD4-positive EVs in stimulated B cells. Additionally, immunofluorescence and IEM revealed that PLD4 relocates from the Golgi apparatus to CD63-positive endosomes, where it is incorporated into intraluminal vesicles prior to EV release. These findings establish that activated B cells contribute to the extracellular distribution of PLD4 via EV secretion, highlighting a potential role in intercellular communication and immune regulation.

Spatial patterns and predictors of antenatal care interruption in war-torn Tigray, northern Ethiopia: Spatial modelling approach

Introduction Antenatal care (ANC) is vital for maternal health, yet its provision has been severely disrupted in conflict-affected Tigray, Ethiopia. This study employs a community-based approach to analyze the spatial patterns and predictors of ANC interruption in conflict-affected, Tigray region, northern Ethiopia. Methods and materials A cross-sectional design was used, to select 2,444 eligible women from 13,915 women of reproductive age across from six zones and 57 clusters. Multistage cluster sampling was employed to approach the study participants. Data were collected using structured questionnaires, and geographic coordinates were obtained for spatial geo-points. A spatial logistic regression model was used to assess the effects of geographic and socio-demographic factors on ANC interruptions, accounting for spatial dependencies. Results The prevalence of ANC interruption was24.8% (n = 605, 95% CI: 23.1%, 26.5%). Each additional minute of travel increased the log-odds of interruption by 0.000353 (SE = 0.0001, p < 0.001. Geographic zone significantly influenced ANC interruptions, with women in the southeast and eastern zones experiencing lower log-odds compared to the northwest zone. Moreover, having more under- five children raised the log-odds of ANC interruption by 0.083 (SE = 0.01, p < 0.001). Households without a radio had a 0.089 lower log-odds of ANC interruption (SE = 0.033425, p = 0.007), highlighting the importance of access to information. The war’s impact was significant, with 96.5% (2,358, 95% CI: [95.4%, 97.6%]) reporting a family member was disabled; of these, 72.7% (1,778, 95% CI: [71.0%, 74.4%]) did not postpone their ANC visit, while 23.7% (580, 95% CI: [22.2%, 25.2%]) did. Conclusions The findings revealed a significant ANC interruption in Tigray, influenced by geographic disparities, household dynamics, and information access. Improving infrastructure and security, implementing targeted interventions, enhancing mass media health information dissemination, and further research on geographic disparities are essential.

Repurposing haemoproteins for asymmetric metal-catalysed H atom transfer

RPIPLM: Prediction of ncRNA-protein interaction by post-training a dual-tower pretrained biological model with supervised contrastive learning

The field of biological research has been profoundly impacted by the emergence of biological pre-trained models, which have resulted in remarkable advancements in life sciences and medicine. However, the current landscape of biological pre-trained language models suffers from a shortcoming, i.e., their inability to grasp the intricacies of molecular interactions, such as ncRNA-protein interactions. It is in this context that our paper introduces a two-tower computational framework, termed RPIPLM, which brings forth a new paradigm for the prediction of ncRNA-protein interactions. The core of RPIPLM lies in its harnessing of the pre-trained RNA language model and protein language model to process ncRNA and protein sequences, thereby enabling the transfer of the general knowledge gained from self-supervised learning of vast data to ncRNA-protein interaction tasks. Additionally, to learn the intricate interaction patterns between RNA and protein embeddings across diverse scales, we employ a fusion of scaled dot-product self-attention mechanism and Multi-scale convolution operations on the output of the dual-tower architecture, effectively capturing both global and local information. Furthermore, we introduce supervised contrastive learning into the training of RPIPLM, enabling the model to effectively capture discriminative information by distinguishing between interacting and non-interacting samples in the learned representations. Through extensive experiments and an interpretability study, we demonstrate the effectiveness of RPIPLM and its superiority over other methods, establishing new state-of-the-art performance. RPIPLM is a powerful and scalable computational framework that holds the potential to unlock enormous insights from vast biological data, thereby accelerating the discovery of molecular interactions.

The current status and determinants of perceived ageism among community-dwelling older adults: A cross-sectional, multifactorial analysis

Objective To investigate the prevalence of perceived ageism among community-dwelling older adults and systematically analyze its determinants, thereby providing a reference for the management of mental health in this population. Methods A cross-sectional survey was conducted from April 15–30, 2025, in 45 communities in Zigong City, Sichuan Province, China. A total of 500 questionnaires were distributed, and 484 valid responses were collected. The survey included a general information questionnaire and the Perceived Ageism Questionnaire (PAQ). LASSO (Least Absolute Shrinkage and Selection Operator) regression and multiple linear regression analyses were used to identify risk factors associated with perceived ageism. Results The mean score on the Perceived Ageism Questionnaire was 16.68 ± 3.70. Multiple linear regression analysis revealed that educational level, vision status, and hearing function were significantly associated with perceived ageism among community-dwelling older adults. Conclusion Perceived ageism among community-dwelling older adults is at a moderate level. Healthcare providers should develop targeted interventions based on these determinants to enhance mental health and well-being in this population.

Superoxide dismutase VPA1514 in Vibrio parahaemolyticus protects against environmental stresses

Vibrio parahaemolyticus is a foodborne enteropathogen that has become a global concern since the emergence of the pandemic O3:K6 strain in 1996. Three putative superoxide dismutases (SODs), namely FeSOD (VP2118), MnSOD (VP2860) and CuZnSOD (VPA1514), are found in V. parahaemolyticus . In this study, the VPA1514 mutant and gene complementary strains of V. parahaemolyticus were constructed to investigate the function of VPA1514 against environmental stresses. The growth of the VPA1514 mutant strain in broth medium under sublethal stress of H 2 O 2 was significantly slowed relative to that of the wild-type strain. The survival rate of this VPA1514 mutant strain, when challenged by lethal acetic acid for two hours, was significantly lower than that of the wild-type strain. Moreover, the presence of the complementary VPA1514 gene significantly ameliorated the survival of this V. parahaemolyticus mutant strain. VPA1514 also showed the effect on the survival of a SOD mutant strain of Escherichia coli against acetic acid. In summary, this study demonstrated that VPA1514 protects against exogenous H 2 O 2 and the lethal concentrations of acetic acid in V. parahaemolyticus .

Immune cells play a critical role in cytokine- and endotoxin-mediated endothelial permeability

Vascular leakage (VL) is a severe pathology occurring in a broad range of scenarios, e.g., during sepsis, cytokine storms, or as side effect of immunotherapies. Its severity is underlined by the high lethality rate of 20−30% for the systemic capillary leakage syndrome. While many compounds are reported to affect endothelial cell (EC)-activation, exact mechanisms behind VL remain unclear. We analyzed activation, viability, cytokine secretion, and relative permeability of human umbilical vein endothelial cells (HUVECs) upon treatment with 16 different stimuli. Relative HUVEC-permeability was assessed in a trans-well-based leakage assay in presence or absence of human peripheral blood mononuclear cells (PBMCs). HUVEC-activation is characterized by correlating upregulation of intercellular adhesion molecule (ICAM)-1, vascular cell adhesion molecule (VCAM)-1, and E-selectin, as well as production of interleukin (IL)-8, monocyte chemoattractant protein (MCP)-1, and IL-6. Strong HUVEC-activation and reduced viability was observed upon treatment with IL-1β, tumor necrosis factor (TNF)-α, a TGN1412-induced cytokine cocktail (SNTGN1412), thrombin, and lipopolysaccharide (LPS). Only thrombin, SNTGN1412, and vascular endothelial growth factor (VEGF) led to increased relative permeability, while other compounds associated with vascular leakage, including TNF-α, IL-1β, or LPS, had no direct effect on relative HUVEC-permeability. Interestingly, co-cultures with PBMCs mediated IL-1β- and LPS- but not TNF-α-induced relative HUVEC-permeability. In our study, we show that HUVEC activation upon direct stimulation does not necessarily result in increased relative permeability or massive cytokine production. Interestingly, we could demonstrate that activated HUVECs respond with a conserved pattern of markers, independent from the stimulus used. Moreover, we observed that the interplay with immune cells is critical to enhance relative HUVEC-permeability, which however depended on the stimulus applied suggesting different mechanisms of immune-mediated VL. A better understanding of VL will uncover potential treatment-targets for patients suffering from VL and help to improve safety-assessment of leakage-associated immunotherapies.

Silent voices: Uncovering women’s absence in veterinary surgery publications

Objective To determine the factors associated with an author being female in Veterinary Surgery journal publications from 2002 to 2023. Study design Retrospective observational study. Sample population A total of 2881 Veterinary Surgery papers published between 2002 and 2023. Methods Author gender was inferred using the Gender API and verified manually where necessary; only binary categories (male/female) were assigned. Statistical models (frequentist and Bayesian logistic regressions) were used to predict author gender based on publication year, author order (first, second, last), and surgical emphasis. Results Overall, 36% of the authors were female, with 43% of first authors, 37% of second authors, and 28% of last authors being women. The proportion of female first authors increased from 29% in 2010 to 60% in 2022, while female last authors ranged from 10% in 2002 to 36% in 2023. The likelihood of an author being female was influenced by the publication year, being the last author, and the subject of orthopaedics. Conclusion Compared with the demographics of the profession, women remain underrepresented in Veterinary Surgery authorships, particularly in senior author positions and orthopaedic papers. Disciplinary significance The underrepresentation of female authors highlights persistent gender disparities in veterinary surgery research. Further research is required to understand the factors that influence female authorship, so that institutions and journals can implement targeted initiatives to promote gender equity.

Management of acute appendicitis in pregnancy (MAMA): Protocol for a multicentre observational study

Introduction Acute appendicitis is the most common emergency general surgical condition in pregnancy, affecting around 1 in 1000 pregnancies. Reaching a diagnosis is more challenging in this group because of altered clinical presentations and the limitations of diagnostic tools in pregnancy. There is limited guidance from national bodies in the UK on the management of this condition. This study aims to describe current diagnostic and treatment practices for acute appendicitis in pregnancy in the UK, and associated outcomes, to identify variations in practice and areas for improvement. Methods and analysis This is a UK-wide observational study. Hospitals providing an emergency general surgical service will be eligible to participate. The study consists of two components: (1) a site resource-profile questionnaire to assess the setup of services to care for the pregnant patient requiring emergency non-obstetric abdominal surgery to be completed by a senior collaborator at each participating site, and (2) a retrospective study of patients diagnosed with appendicitis or who had an appendicectomy for suspected appendicitis during a ten-year study period (2013–2023). Data will be collected on diagnostics, radiological findings, management approach and surgical and obstetric outcomes. The main measure of interest is the management approaches (operative versus non-operative; laparoscopic versus open surgery) and their association with selected outcomes. Multivariable logistic regression analyses will be conducted to identify factors which might predict the management strategy and outcomes. Ethics and dissemination The protocol for this service evaluation study has been reviewed by the University of Sheffield Research Ethics Committee. The study findings will be discussed in a multistakeholder workshop consisting of general surgeons, obstetricians and gynaecologists, radiologists, anaesthetists and patient representatives with a view to making recommendations for quality improvement work and further research. Key findings and recommendations will be disseminated through specialist societies.

Thematic morning report in clinical training for critical care medicine resident physicians: Preliminary exploration in a tertiary hospital of China

Morning report (MR) is one of the most important forms of resident standardized training. However, at present, it has not been carried out in most residential training bases in China. The specific content and implementation plan of MR lack standardized process. We introduced thematic MR in the training of residents who underwent standardized training in critical care medicine. A total of 37 residents (major in critical care medicine) were divided into two groups: the MR group (n = 22) and the traditional training group (n = 15). After receiving a 24-week training in the ICU of the Department of Critical Care Medicine, a comprehensive ability of critical care medicine was evaluated in the residents. The performance was assessed by Objective Structured Examination (OSCE) stations and theory examinations, including clinical decision-making ability, emergency treatment ability, clinical practice skills, communication and cooperation skills and medical theoretical knowledge. The results showed that, although there was no significant difference between the two groups in terms of communication and teamwork skills ( P  = 0.524), the MR group outperformed the traditional training group in terms of clinical decision-making ability, emergency treatment ability, clinical practice skills, medical theoretical knowledge ( P  < 0.05). Additionally, a questionnaire survey on the training mode of thematic MR in critical care medicine was conducted. The results showed that up to 90.9% (20/22) of residential physicians believed that thematic MR is necessary in the training of critical care medicine, and 86.4% (19/22) of them believed that the implementation of thematic MR could improve their mastery of knowledge in critical care medicine. In conclusion, this preliminary exploration demonstrated that thematic MR has the potential to enhance the training effect of residential physicians in critical care medicine. It is a favorite way among residents owing to its ease of implementation, flexibility, and hierarchical structure in the training of critical care medicine, offering a valuable complement to conventional training.

Effect and validation of plate thickness dimensional effects on grouting compactness in bridge ducts based on ultrasonic testing

Based on the theory of ultrasonic non-destructive testing, this study investigates the dimensional effect of plate thickness on the detection of grouting compactness in prestressed bridge ducts. By combining finite element simulation with engineering case validation, a high-precision time-domain analysis model is proposed to qualitatively and quantitatively evaluate the grouting compactness of prestressed bridge pipeline with varying plate thicknesses. This study employs ABAQUS finite element software to simulate and analyze the excitation, propagation, and reception characteristics of ultrasonic waves in concrete structural components. A time-domain analytical theoretical model is established to evaluate the detection results of pipelines with various defects. By comparing the simulation results of the theoretical model with actual engineering detection cases, the time-domain analytical theoretical model demonstrates high feasibility and reliability. The results indicate that the time-domain analysis method achieves high accuracy when utilizing the correlation between plate thickness and the first wave acoustic time. This approach enables both qualitative and quantitative analysis of pipeline density using ultrasonic non-destructive testing, thereby improving the accuracy and efficiency of damage assessment for prestressed pipe grouting compactness.

National health insurance membership in Indonesia: Do socio-economic elements matter?

The Indonesian government released a National Health Insurance (NHI) policy to realize universal health coverage (UHC) in Indonesia, yet disparities in membership persist. The study examined the influence of various socio-economic factors, including education, employment, and wealth status, on National Health Insurance (NHI) membership in Indonesia. Using a cross-sectional design, this study examined 1,223,377 individuals. The level of education was utilized as the exposure variable, while NHI membership served as the outcome variable. The analysis included residence, age, gender, marital status, and occupation as covariates. In the final stage, logistic multinomial regression was implemented. Based on the findings of this study, Indonesia’s coverage for NHI membership in 2023 was 72.5%. Higher education levels are associated with increased likelihood of NHI participation, supporting the notion that education promotes greater access to Universal Health Coverage (UHC). Wealth status and demographic factors such as age and marital status also significantly associated with NHI membership. According to the results, the study concluded that education level and wealth status significantly influence NHI membership in Indonesia. Demographic factors also play essential roles. Tailored interventions addressing these factors are necessary to improve NHI enrollment and achieve universal health coverage.

Decoding budget awareness: A multivariate analysis of generation Z undergraduates

Understanding public finance and budget processes has become increasingly important for the younger generation in recent years. This knowledge enables Generation Z to participate more effectively in democratic life as informed citizens. However, there is limited research on Generation Z’s awareness of public budgets in the existing literature. Therefore, the study addressed a significant gap in the public finance literature. We aimed to examine the determinants influencing the state budget awareness of Generation Z undergraduates by using the survey: “Citizens’ Budget Awareness and Effective Factors”. Data was collected from 3,972 undergraduates across all disciplines enrolled in four Turkish state universities between December 2023 and April 2024. We conducted a multiple linear regression analysis to examine the data. The main results showed that being informed about allocated public revenues for which public services, the constitutional power of the purse, budgeting processes and budget-related transactions were the determinants that most influenced the budget awareness of the students. On the contrary, being informed about the connection between taxes and public services, the Public Financial Management and Control Law No. 5018, and the amounts of public revenues within the state budget were determined as the lowest determinants influencing their awareness. Based on our results, we mainly suggested that (i) comprehensive education programmes and interactive learning should be organised in universities by using digital tools, (ii) the link between public revenues and expenditures should be explained through awareness campaigns, and (iii) budget processes should be made more transparent and accessible.

Predicting achievement of clinical goals using machine learning in myasthenia gravis

Background Myasthenia Gravis (MG) is an autoimmune disease characterized by the production of autoantibodies against neuromuscular junctions, leading to varying degrees of severity and outcomes among patients. This variability makes clinical evaluation crucial for determining appropriate treatment targets. However, accurately assessing Minimal Manifestation (MM) status is challenging, requiring expertise in MG management. Therefore, this study aims to develop a diagnostic model for MM in MG patients by leveraging their clinical scores and machine learning approaches. Methods This study included 1,603 MG patients enrolled from the Japan MG Registry in the 2021 survey. We employed non-negative matrix factorization to decompose three MG clinical scores (MG composite score, MGADL scale, and MG quality of life (QOL) 15r) into four distinct modules: Diplopia, Ptosis, Systemic symptoms, and QOL. We developed a machine learning model with the four modules to predict MM or better status in MG patients. Using 414 registrants from the Japan MG Registry in the 2015 survey, we validated the model’s performance using various metrics, including area under the receiver operating characteristic curve (AUROC), sensitivity, specificity, accuracy, F1 score, and Matthews Correlation Coefficient (MCC). Results The ensemble model achieved an AUROC of 0.94 (95% CI: 0.94–0.94), accuracy of 0.87 (95% CI: 0.86–0.88), sensitivity of 0.85 (95% CI: 0.85–0.86), specificity of 0.89 (95% CI: 0.88–0.91), precision of 0.93 (95% CI: 0.92–0.94), F1 score of 0.89 (95% CI: 0.88–0.89), and MCC of 0.74 (95% CI: 0.72–0.75) on the validation dataset. Conclusions The developed MM diagnostic model can effectively predict MM or better status in MG patients, potentially guiding clinicians in determining treatment objectives and evaluating treatment outcomes.

Alteration of BDNF and noradrenergic markers in locus coeruleus in a mouse model of cancer-induced bone pain

The locus coeruleus (LC) is the principal source of noradrenaline (NA) in the central nervous system. In neuropathic pain states, nociceptive stimuli activate LC. This study examined the expression and localization of BDNF and NE neuron-specific proteins in the LC of mice with cancer-induced bone pain (CIBP). Behavioral experiments demonstrated that CIBP mice exhibited persistent spontaneous pain, mechanical and thermal hyperalgesia, and deficits in locomotor activity and motor coordination. H&E and TRAP staining revealed trabecular bone destruction and increased in osteoclast activity. Immunostaining showed elevated expression of neuronal activity marker c-Fos in the LC. Additionally, upregulation of noradrenergic markers - tyrosine hydroxylase (TH) and dopamine β-hydroxylase (DBH) – as well as brain-derived neurotrophic factor (BDNF), was observed in the LC. In vitro studies indicated that inhibition of the BDNF/TrkB signalling pathway reduced the expression of noradrenergic markers. Anterograde tracing, achieved by Fluoro-ruby injection into the LC and subsequent detection of Fluoro-ruby colocalised with TH and DBH in spinal cord, confirmed LC-spinal cord projections. Immunofluorescence analysis demonstrated increased fluorescence intensities of TH, DBH, c-Fos, phosphorylated cAMP-response element- binding protein (pCREB), and α2A receptor in the spinal cord, alongside reduced intensities of enkephalin (ENK) and GABA A Receptor β2 (GABRB2). Western blotting further corroborated elevated expression levels of TH and c-Fos in spinal cord tissue. In summary, CIBP mice exhibited enhanced neuronal activity in the LC, upregulation of noradrenergic markers, and BDNF/TrkB-mediated modulation of noradrenergic neurons. Concurrently, inhibitory signalling was attenuated in the SDH.

Scientific bedlam at the world’s weirdest and wildest research conference

Peer play network in preschool classrooms: Features and variations by child characteristics and skills

Peers play a critical role in creating opportunities for learning. However, less is known about how children form peer play networks in preschool and how their level of connection in peer play varies based on individual characteristics and skills. This exploratory study used social network modeling to examine variations in peer play networks across preschool classrooms (N = 5), focusing on children’s play centrality and classroom network density. Data from all classroom children, including those with both active and passive parental consent, revealed similar peer play patterns at both mid-year (N = 81) and year-end (N = 79). Most children had one or more peers with whom they played frequently or always, but a small subset (3%) rarely or never engaged with playmates. Classroom network density fell within a moderate range, suggesting that children tended to select specific peers for play rather than interacting uniformly with all classmates. Analyses of play centrality among children with active consent (n = 26) revealed that dual language learners (DLLs), defined as children exposed to a language other than English at home, were less likely than their non-DLL peers to hold central positions in classroom play networks at the end of the preschool year. Additionally, the study identified a homophily effect related to problem behaviors, indicating that children were more likely to play with peers who displayed similar levels of problem behaviors. These findings highlight the importance of recognizing variations in peer play networks to foster inclusive and supportive peer play environments in early childhood education. This study underscores the need for further research into the factors that shape peer play networks in preschool settings, particularly the roles of language, culture, and behavior in influencing children’s interactions.

Transition of milk fatty acid profile and vitamins A and E from colostrum to mature milk in Danish Holstein cows

Colostrum, the initial milk produced by mammals after giving birth, has evolved to serve as a primary rich source of essential nutrients for newborns. However, there are considerable changes in nutrient composition from colostrum to mature milk. Colostrum and transition milk have specific fat-soluble vitamin levels, fat level, and fatty acid (FA) composition compared to mature milk, and this unique fatty acid composition of colostrum may reflect the physiological needs of newborn calves. The aim of this study was to investigate changes in the FA profile and levels of vitamins A and E from colostrum to mature milk. Colostrum or milk samples from the 1st (colostrum), 2nd, 3rd, 4th, 5th, 6th, and 13th (as a sample of mature milk) milking were collected from 10 multiparous Danish Holstein cows. The level of vitamin A was significantly affected by milking time (p < 0.001), with the highest level in the colostrum (2.3) and the lowest in mature milk (0.5 µg/g). Vitamin E level was significantly affected by milking time (p < 0.001), with the highest level in the colostrum (14.8) and the lowest in mature milk (1.8 µg/g). The proportion of C16:0 FA decreased from colostrum to mature milk while the proportion of C18:0 FA increased from the colostrum to mature milk. The proportion of n-6 FA (C18:2n-6, C18:3n-6, C20:3n-6, C20:4n-6, and C22:5n-6) decreased from colostrum to mature milk (p < 0.001 for all FA). However, the proportion of C18:3n-3 FA increased from colostrum (3.0) to mature milk (5.9 g/kg of FA; p < 0.001), while proportions of C20:5n-3, C22:5n-3, and C22:6n-3 FA decreased from colostrum to mature milk (p < 0.001 for all FA). The proportion of trans 18:1n-10 (p = 0.005) and trans 18:1n-11 (p < 0.001) was affected by milking time and increased from colostrum to mature milk. In conclusion, there is a considerable higher vitamin A and E levels in colostrum compared to mature milk, and vitamin A and E levels were reduced from colostrum to mature milk. Additionally, there were significant changes in the FA profile from colostrum to mature milk, with an increase in C18:3n-3 FA and a decrease in C18:2n-6 FA.

Exploring the addictive processes in repetitive self-harm through a grounded theory approach: “It always felt like a choice until it didn’t”

Introduction There is limited empirical research to suggest repetitive self-harm can be understood or conceptualised as an addictive behaviour. However, few empirical studies have investigated this and yielded conflicting results. This study aims to explore to what extent can repetitive self-harm be conceptualized as an addictive behaviour. Methods The study employed the principles of Constructivist Grounded Theory to guide the collection and analysis of data from 15 adults with current or past experience of repetitive self-harm. Results Thirteen categories were identified within the data that depicted participants journeys with self-harm over time. ‘Starting’ to self-harm (category 1) and participants’ description of ‘needing to punish myself’ (category 2) led to self-harm ‘feeling addictive’ (category 3). Once self-harm had become repetitive, ‘having the urge to self-harm’ (category 4) and experiencing a ‘conflicting relationship with self-harm and self’ was ongoing for participants (category 5). Throughout each incidence of self-harm, participants described a “cycle of self-harm”, in which self-harm had different functions and consequences: ‘managing emotions’ (category 6), ‘allowing me to function’ (category 7), ‘caring for myself’ (category 8), ‘controlling’ (category 9) and ‘feeling guilt and shame after self-harm’ (category 10). All participants described ‘responding to other’s reactions’ to their self-harm (category 11), six discussed ‘breaking the self-harm cycle’ (category 12) and six participants described ‘relapsing’ (category 13) and returning to self-harm following a period of abstinence. Conclusion This study has provided a conceptual model of processes that maintain engagement in repetitive self-harm, discussed in relation to addiction literature. Clinical practice could consider working alongside the client to identify where they feel they are within the self-harm cycle in relation to changing their self-harm behaviours.