UNASSIGNED: Chronic pain is a significant welfare concern in cats, and neuropathic pain, which arises from aberrant processing of sensory signals within the nervous system, is a subcategory of this type of pain. To comprehend this condition and how multimodal pharmacotherapy plays a central role in alleviating discomfort, it is crucial to delve into the anatomy of nociception and pain perception. In addition, there is an intricate interplay between emotional health and chronic pain in cats, and understanding and addressing the emotional factors that contribute to pain perception, and vice versa, is essential for comprehensive care.Clinical approach:Neuropathic pain is suspected if there is abnormal sensation in the area of the distribution of pain, together with a positive response to trial treatment with drugs effective for neuropathic pain. Ideally, this clinical suspicion would be supported by confirmation of a lesion at this neurolocalisation using diagnostic modalities such as MRI and neuroelectrophysiology. Alternatively, there may be a history of known trauma at that site. A variety of therapies, including analgesic, anti-inflammatory and adjuvant drugs, and neuromodulation (eg, TENS or acupuncture), can be employed to address different facets of pain pathways.Aim:This review article, aimed at primary care/ general practitioners, focuses on the identification and management of neuropathic pain in cats. Three case vignettes are included and a structured treatment algorithm is presented to guide veterinarians in tailoring interventions.Evidence base:The review draws on current literature, where available, along with the author\'s extensive experience and research.

BACKGROUND: Female genital mutilation/cutting (FGM/C) is tied to one of the most conservative cultures in the Mediterranean and Sub-Saharan Africa. More than 200 million girls and women in 30 African, Asian and the middle Eastern countries have undergone FGM/C. However, healthcare professionals are not adequately trained to prevent and manage FGM/C-related complications including sexual health problems. This study aimed to assess the need and acceptability of a curriculum to train nursing and medical students in the sexual healthcare of clients with FGM/C in Tanzania.
METHODS: We used a descriptive and cross sectional study design to collect and analyse information from 271 medical and 137 nursing students in Tanzania. A Qualtrics online survey was used to obtain quantitative data on training interest, previous training received, and the curriculum delivery method. Open-ended questions were used to explore their insights on significance to obtain the necessary competencies to treat and prevent FGM/C. Descriptive statistics were used to analyze quantitative data while qualitative data were analyzed using a thematic approach.
RESULTS: Almost half of the participants reported they had little to no training in sexual healthcare for women with FGM/C (47%). In all, 82.4% reported the training to be acceptable. Following thematic analysis of open-ended questions, participants expressed a desire to improve their competencies to meet the current and future sexual and psychological health needs of women and girls who have undergone FGM/C.
CONCLUSIONS: It is a necessary and acceptable to develop a curriculum to train healthcare students to diagnose, treat and prevent sexual health complications related to FGM/C. In our study, designing a culturally sensitive curriculum and its delivery method, that includes practical sessions with simulated patients, was considered the most beneficial and favorable.

DNA damage is a discrepancy in its chemical structure precipitated by a multitude of factors. Most DNA damages can be repaired efficiently through diverse restorative mechanisms subjective to the type of damage. DNA-damaging agents elicit a medley of cellular retorts like cell cycle arrest, followed by DNA repair mechanisms or apoptosis. An unrepaired DNA damage in a nonreplicating cell does not generally engender mutations but a similar scenario in replicating cell routes to permanent modification of genetic material shrugging to carcinogenesis. DNA mutilation can be allied to disarray in bases, debasement of backbone, or crosslinks. Base damages or backbone damages like single-strand and double-strand DNA breaks are usually produced by reactive oxygen species and ionizing radiation. This substantial DNA damage has broadly been considered to be caused by various exogenous and endogenous agents with variable rates of causality and decrees of risk, sourcing toward cancer or other diseases, necessitating furtherance in diagnostics at sequential points. The purpose of this article is to review in detail the various types of DNA damages, their contributory factors, and recent developments in their identification.

In a 1959 article, John C. Ford, SJ (1902-1989), proposed the existence of a new virtue to regulate recreational drug use which he names \"pharmacosophrosyne.\" This article analyzes the soundness of Ford\'s proposal and extends it by providing a mereological analysis of how pharmacosophrosyne relates to the virtues of temperance and sobriety. It then shows how understanding both pharmacosophrosyne and sobriety can inform a moral evaluation of recreational drug use.

We report the case of a woman in her thirties who suffered an esophageal rupture while participating in extreme sadomasochistic practices. After herself seeking help in a hospital for complaints alleged to be from a fall, she was initially diagnosed with several broken ribs and a pneumothorax. The cause of the pneumothorax was later discovered to be an esophageal rupture. When confronted with this atypical injury for a fall, the woman admitted to have accidentally swallowed an inflatable gag, which her partner had afterwards inflated. In addition to the esophageal rupture, the patient also had numerous other externally visible injuries of various ages, reportedly also from sadomasochistic acts. Although an in-depth police investigation was conducted and a \"slave contract\" was found, the woman\'s consent to the extreme sexual practices performed by her life partner could not be substantiated conclusively. The man was convicted for intentional infliction of serious as well as dangerous bodily injury and sentenced to a long term in prison.

We report on a case of criminal dismemberment and attempted scalping of a homicide victim with a \"Mohawk\" haircut. Case findings are presented. A review of the literature was performed for scalping in its historical and cultural context and particularly in criminal dismemberment and mutilation: Historically, scalping was prevalent in many ancient cultures around the world, where scalps were taken as trophies or \"proof of kill\", much like shrunken heads, trophy skulls, and other artefacts. Scalping was particularly widespread in Northern America in the context of tribal warfare, both before and after colonization. The iconic \"Mohawk\" haircut is closely linked with scalping, as it was meant to taunt the enemy. In the modern forensic context, scalping constitutes a form of criminal mutilation. However, cases of criminal dismemberment and mutilation are rare in forensic casework. Our literature review revealed a low number of scalping in criminal dismemberment and mutilation cases. The documentation was overall poor. Positioning scalping within the classification of criminal mutilation and dismemberment was difficult. In literature, even though case numbers were small, the majority of \"textbook scalping\" cases were German. The presented case, to our best knowledge, is the first modern-day photo-documented case of (attempted) scalping, even more so of a person wearing a \"Mohawk\".

We identified 43 cases of mutilation homicides in a nationwide population-based study in Sweden during the period of 1991-2017. 70% of cases were classified as defensive mutilations where the main motive was disposal of the body, while 30% were classified as offensive, that is, due to an expression of strong aggression, necro-/sexual sadism, or psychiatric illness. In comparison with a previous study covering mutilation homicides in Sweden between 1961 and 1990, we noted an increase in incidence. The percentage of cases involving mutilation had increased from 0.5% of all homicides in the 1960s to 2.4% in the 2010s. The most common cause of death was sharp force, but in 28% of the cases, the cause of death could not be determined. The clearance rate in cases of mutilation homicide was 67%, and in a large majority of the cases, the offender was known to the victim. With regards to gender women made up 44% of the victims, whilst men constituted 56% of the victims and a total of 95% of the offenders. Half of the offenders had a personality disorder, however, only 13% were sentenced to forensic psychiatric care.

BACKGROUND: Although the tearing of tissues during castration is forbidden in the EU, it is still routinely applied in many countries. The goal of this study was to evaluate vocalizations and movements of male piglets undergoing castration by applying different techniques and pain treatments based on scores under practical conditions (Trial 1, n = 50) and to investigate anatomical features after castration of dead piglets with different techniques (Trial 2, n = 28).
RESULTS: In Trial 1, treatment groups did not significantly influence the duration of castration. Both the duration of vocalization and the scores for vocalizations and movements were lower in piglets castrated under general anesthesia (P < 0.05). Behavior scores in conscious piglets did not differ. The incision and extraction caused lower vocalizations and movements than the pulling and severing of spermatic cords (P < 0.01). Movements were more intense during tearing of the spermatic cords than during cutting at the first and second severing (P < 0.01). In both trials, the remains of spermatic cords protruded tendentially more often from castration wounds after severing by tearing (P < 0.09). In Trial 2, the minimum, mean and maximum lengths of the testicles and spermatic cords were extended when severing was realized by tearing (P < 0.01). The mean relative testicle weight of 1.05‰ in dead piglets castrated by tearing was larger than that in dead piglets castrated by cutting (0.91‰) (P < 0.05).
CONCLUSIONS: The trials uncovered significant differences between behavior expressed by piglets castrated by tearing or cutting, indicating a higher pain level in the tearing group. It was found that the castration technique tearing increased the amount of removed tissues and might cause intraabdominal damage to the remaining tissues and vessels in a yet unknown dimension. These findings should be considered for implementation and stricter enforcement of the ban on tearing for castration.

Adolescent sexual and reproductive health is an essential aspect that may be forgotten in the COVID-19 pandemic. Valuable insights gained from previous humanitarian crises indicate undesirable short and long-term adolescent maternal consequences in low resource settings. Young girls are at a higher risk of dropping out of school and being forced into early child marriages and high-risk jobs that predispose them to sexual exploitation and sexual and gender-based violence. Economic recessions, supply chain disruptions and reallocation of resources may limit access and utilisation of services and commodities. The COVID-19 pandemic thus indirectly exposes adolescent girls to multiplied risks of unintended pregnancies, sexually transmitted infections including HIV and Human Papilloma Virus. Sexual and gender-based violence, including female genital mutilation cases may increase as intervention programmes to avert these are disrupted, and the resultant psychosocial and socioeconomic consequences may be devastating. Thus, a pro-active approach is required to come up with frameworks to ensure the minimum initial service package for reproductive health. A multi-sectoral collaborative intersection of relevant stakeholders in adolescent sexual and reproductive health is therefore urgently desired.

UNASSIGNED: Female genital mutilation (FGM) is a harmful practice that causes health-related problems in the life of the affected women and girls. Though FGM is declared as a human right violation, studies revealed it is being practiced throughout Ethiopia. Therefore, this study was conducted to assess the prevalence, trends, and predictors of FGM among reproductive-aged (1549 years) women in Ethiopia.
UNASSIGNED: Trends of FGM among reproductive-age women were estimated using the three Ethiopian Demographic and Health Survey (EDHS): 2000 (n=15,367), 2005 (n=14,070) and 2016 (n=7248) data. Multilevel logistic regression analysis was conducted to identify both individual- and community-level factors of FGM using the latest (2016) EDHS. To adjust potential confounders, the analysis was conducted considering sample weighting, clustering, and stratifications using STATA-14 software.
UNASSIGNED: The prevalence of FGM among women of reproductive age in Ethiopia decreased from 79.91% in 2000 to 70.37% in 2016. Similarly, FGM among daughters of circumcised mothers decreased from 56.16% in 2000 to 16.76% in 2016. Being Muslim (adjusted odds ratio [AOR] 5.48; 95% confidence interval [CI]: 4.23, 7.09), attending higher education (AOR 0.40; 95% CI: 0.29, 0.54), 45-49 years old (AOR 5.06; 95% CI: 3.38, 7.57), marriage at ≥ 18 years (AOR 0.80; 95% CI: 0.66, 0.96), not working (AOR 1.20; 95% CI: 1.02, 1.41), married (AOR 1.41; 95% CI: 1.12, 1.77) and residing in peripheral region (AOR 3.0.4; 95% CI: 1.96, 4.70) were determinants of FGM.
UNASSIGNED: Though the reduction of FGM among women of reproductive age in Ethiopia was minimal, it was encouraging among daughters of circumcised women over the last 16 years. Education, religion, age, age at marriage, occupation, marital status, and geographical regions were determinants of FGM. Combined and integrated interventions based on the identified factors are recommended to abandon FGM in Ethiopia.