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Female Rugby Union players were affected by contact breast injuries (CBI) and exercise-induced breast pain (EIBP). Hundred and eighty-two female Rugby players from 25 different countries reported incurring a CBI or EIBP which affected sport performance. A higher percentage of 7s players (7s: 64.3%, 15s: 51.9%) reported at least one CBI over a 12-month period. EIBP frequency, during the same period, was notably low for 7s and 15s. Sprinting, jumping and running were the most frequent activities precipitating the severest EIBP. Being tackled or tackling most frequently caused a CBI. Respondents affected by either CBI (57.3%) or EIPB (51.3%) reported always playing-on during matches despite their pain or injury. Between 19.4% and 32.1% of the respondents did not have a CBI or EIBP prevention strategy. A paucity of player knowledge on prevention strategies was noted, indicating a need for education addressing breast pain and injury among players. [ABSTRACT FROM AUTHOR]

Buildings represent habitats for microorganisms that can have direct or indirect effects on the quality of our living spaces, health, and well-being. Over the last ten years, new research has employed sophisticated tools, including DNA sequencing-based approaches, to study microbes found in buildings and the overall built environment. These investigations have catalyzed new insights into and questions about the microbes that surround us in our daily lives. The emergence of the “microbiology of the built environment” field has required bridging disciplines, including microbiology, ecology, building science, architecture, and engineering. Early insights have included a fuller characterization of sources of microbes within buildings, important processes that structure the distributions and abundances of microbes, and a greater appreciation of the role that occupants can have on indoor microbiology. This ongoing work has also demonstrated that traditional culture- and microscopy-based approaches for studying microbiology vastly underestimate the types and quantity of microbes present in environmental samples. We offer ten questions that highlight important lessons learned regarding the microbiology of buildings and suggest future areas of investigation.

The accuracy and appropriateness of 115 consecutive referrals by non-consultant physicians to a specialist Diabetic Retinopathy Clinic were assessed in a retrospective study. The source of the referrals was masked throughout the study. Referrals were classed as `appropriate' or `inappropriate' for patient management, and the referral diagnosis (where specified) was compared with the ophthalmologist's initial assessment. It was graded as `correct', `partly correct' and `incorrect'. Referrals from physicians who had received 40-50 hours of outpatient training in the Diabetic Retinopathy Clinic (group A, n=49)were compared with referrals from doctors without this special instruction (group B, n=66). Referral was deemed 'appropriate' in 32 (65%) of group A referrals, but in only 22 (33%) of group B (χ²=11.54, df=1, P<0.001). Referral diagnosis (when expressed) was graded as `correct' in 28 (67%) of group A referrals compared with only 12 (30%) of group B, being `incorrect' in 10 (25%) of group B referrals and just two (45%) of group A (χ²=12.9, df=2, P< 0.005). Regular fundoscopy with accurate assessment and appropriate action is vital to prevent loss of vision in diabetic patients. Short-term outpatient training in a Diabetic Eye Clinic leads junior physicians to more appropriate referral and more accurate referral diagnosis. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to an article about dye-assisted small incision cataract surgery by Titiyal and colleagues in the 2006 issue.

Abstract Introduction To the best of our knowledge, this is the first time triptorelin has been reported to cause benign intracranial hypertension. Case presentation A 43-year-old Caucasian woman who suffered from chronic menorrhagia was started on triptorelin, a gonadotrophin-releasing hormone analogue. Three days later, she developed gradually worsening headaches accompanied by bilateral visual disturbance. Examination revealed bilateral papilledema and enlarged blind spots on her visual fields. A diagnosis of benign intracranial hypertension was made and confirmed on magnetic resonance imaging. Conclusion We recommend that patients at high risk (women who are overweight and of reproductive age) who are using any gonadotrophin-releasing hormone analogue (for example, triptorelin) should be periodically monitored for the possible development of benign intracranial hypertension.

Abstract Background Biodiesel or ethanol derived from lipids or starch produced by microalgae may overcome many of the sustainability challenges previously ascribed to petroleum-based fuels and first generation plant-based biofuels. The paucity of microalgae genome sequences, however, limits gene-based biofuel feedstock optimization studies. Here we describe the sequencing and de novo transcriptome assembly for the non-model microalgae species, Dunaliella tertiolecta, and identify pathways and genes of importance related to biofuel production. Results Next generation DNA pyrosequencing technology applied to D. tertiolecta transcripts produced 1,363,336 high quality reads with an average length of 400 bases. Following quality and size trimming, ~ 45% of the high quality reads were assembled into 33,307 isotigs with a 31-fold coverage and 376,482 singletons. Assembled sequences and singletons were subjected to BLAST similarity searches and annotated with Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) orthology (KO) identifiers. These analyses identified the majority of lipid and starch biosynthesis and catabolism pathways in D. tertiolecta. Conclusions The construction of metabolic pathways involved in the biosynthesis and catabolism of fatty acids, triacylglycrols, and starch in D. tertiolecta as well as the assembled transcriptome provide a foundation for the molecular genetics and functional genomics required to direct metabolic engineering efforts that seek to enhance the quantity and character of microalgae-based biofuel feedstock.

Wastewater-based surveillance has emerged as a powerful approach to monitoring infectious diseases within a community. Typically, wastewater samples are concentrated before viral analyses to improve sensitivity. Current concentration methods vary in time requirements, costs, and efficiency. Here, we evaluated the concentration efficiency and bias of a novel viral concentration approach, Nanotrap Microbiome Particles (NMP), in wastewater. NMP concentration efficiency was target-specific, with significantly lower concentrations of the bacterial indicator HF183 and viral indicator Carjivirus (formerly crAssphage) relative to direct extraction (1.2 × 10 5 vs. 3.4 × 10 5 GC/mL and 2.0 × 10 5 vs. 1.2 × 10 5 GC/mL, respectively), but significantly higher concentrations of the viral fecal indicator Pepper Mild Mottle Virus (PMMoV) relative to direct extraction (1.4 × 10 5 vs. 8.4 × 10 3 GC/mL). Targeted metagenomic sequencing showed that NMP resulted in significantly more unique species reads per sample than direct extractions (p < 0.001) by detecting species that went undetected by direct extractions. Key viral families identified with high abundances were Adenoviridae, Caliciviridae, Herpesviridae, Papillomaviridae, and Polyomaviridae. NMP showed differential ability for concentrating clinically relevant viral families, suggesting that the technology should be evaluated and optimized for specific viral targets before implementation., Competing Interests: Declarations. Competing Interests The authors declare no competing interests., (© 2025. The Author(s).)

Measles is a highly transmissible disease of increasing concern due to waning vaccination contributing to a significant rise in measles cases, with 283 reported cases and 16 outbreaks in the U.S. as of November 7, 2024. Early identification of measles cases is thus critical to disease containment and control. Wastewater-based epidemiology (WBE) represents a potential strategy for the efficient identification of measles outbreaks. We investigated the suitability of WBE for measles outbreak identification by using a model-based approach to elucidate the relationship between measles shedding, wastewater concentration, and detectability. The model reveals conditions for effective detection, specifying the optimal timing, location, and methodology needed to achieve a specific probability of detection, including accounting for geographic variability of wastewater generation and measles case rates. Measles RNA shedding, primarily from urine, contributes an average of 8.72 log10 genome copies (GC) daily per infection into sewage. At the average U.S. wastewater treatment plant (WWTP), achieving a 50 % probability of detection requires approximately 78 cases per 100,000 people with a process limit of detection (PLOD) of 3.0 log10 GC/L. At a PLOD of 3.0 log10 GC/L, over half of all WWTPs in the world can detect a single hypothetical measles case at a 10 % probability of detection. However, achieving a 50-90 % detection rate is challenging, especially with a higher PLOD, except in areas with the highest measles cases. Some locations require case levels consistent with a complete lack of vaccination for feasible measles detection in wastewater. Future work exploring measles shedding, variable shedding behavior, and local case rates can enhance model predictions. Overall, this analysis suggests that WBE detection of measles in most locations remains challenging without a significant increase in case rates or technical improvements decreasing the PLOD., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Microbial source tracking (MST) is a critical tool for identifying sources of human and animal fecal pollution in aquatic environments. To enhance human fecal pollution tracking, this study evaluated the performance characteristics of pBI143, a cryptic plasmid recently identified for potential MST applications. Nucleic acid samples from ten animal species were screened for pBI143, revealing its presence in a small number of pigs, cows, dogs, cats, and flying fox fecal samples. Despite minor cross-detection with non-human fecal samples, pBI143 exhibited a high specificity value (up to 0.93). In untreated urban wastewater, pBI143 was consistently detected in all samples, exhibiting higher concentrations than the well-established human Bacteroides HF183 marker gene. Following a wastewater discharge event, pBI143 concentrations were monitored in an urban river and correlated well with both HF183 and enterococci 23S rRNA marker genes. Using conditional probability analysis, the likelihood of human fecal pollution was estimated to be 89.3 % when pBI143 was detected in 50 % of the river water samples. This study demonstrates that pBI143 is a highly abundant and specific human fecal marker for tracking human fecal pollution in environmental waters. Monitoring of pBI143 could significantly improve the accuracy of human fecal source identification in environmental waters, offering valuable insights for public health risk management and pollution mitigation strategies., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

World Rugby TM supports dedicated women's welfare, injury surveillance and medical/technical interventions, yet breast health has received limited attention. This article aims to provide insights into breast health issues in rugby, including breast impacts and injuries. We discuss how breast anatomy and position may be problematic in rugby. Breast volume relates to body size, which may be increasing in women's rugby, suggesting increased breast surface area and mass, potentially increasing injury risk. Breast health issues in rugby have been reported previously, with 58% of contact footballers (including rugby) experiencing breast injuries. There are damaging effects related to these breast health issues, with breast impacts often causing pain and swelling. Breast impacts may lead to haematomas, cysts and fat necrosis which can calcify over time making them difficult to distinguish from breast carcinoma, causing further investigation and anxiety. In sport, poor bra fit and insufficient support are associated with pain, skin strain and performance decrements. This article reports the potential implications of these breast health issues on performance in rugby. Recent breast-related projects supported by rugby communities may address recommendations identified in the literature for robust breast injury classifications, updated injury surveillance systems and prospective data collection on breast injury prevalence, severity and impact in rugby. These data should inform breast injury care pathways and intervention research, including evidence-based bra design. Understanding the implications of breast impacts on tissue properties, health and wellbeing is vital. Finally, data should inform rugby-specific breast education, raising awareness of this aspect of athlete health., (© 2024 The Author(s). European Journal of Sport Science published by Wiley‐VCH GmbH on behalf of European College of Sport Science.)

The coronavirus disease 2019 pandemic highlighted the need for more rapid and routine application of modeling approaches such as quantitative microbial risk assessment (QMRA) for protecting public health. QMRA is a transdisciplinary science dedicated to understanding, predicting, and mitigating infectious disease risks. To better equip QMRA researchers to inform policy and public health management, an Advances in Research for QMRA workshop was held to synthesize a path forward for QMRA research. We summarize insights from 41 QMRA researchers and experts to clarify the role of QMRA in risk analysis by (1) identifying key research needs, (2) highlighting emerging applications of QMRA; and (3) describing data needs and key scientific efforts to improve the science of QMRA. Key identified research priorities included using molecular tools in QMRA, advancing dose-response methodology, addressing needed exposure assessments, harmonizing environmental monitoring for QMRA, unifying a divide between disease transmission and QMRA models, calibrating and/or validating QMRA models, modeling co-exposures and mixtures, and standardizing practices for incorporating variability and uncertainty throughout the source-to-outcome continuum. Cross-cutting needs identified were to: develop a community of research and practice, integrate QMRA with other scientific approaches, increase QMRA translation and impacts, build communication strategies, and encourage sustainable funding mechanisms. Ultimately, a vision for advancing the science of QMRA is outlined for informing national to global health assessments, controls, and policies., (© 2024 The Author(s). Risk Analysis published by Wiley Periodicals LLC on behalf of Society for Risk Analysis.)

Competing Interests: The authors declare no competing financial interest.

Background: Robust surveillance of injury aetiology and epidemiology is recognised as fundamental for effective injury reduction and management programmes. However, while sex-specific differences in injury type and nature are noted in the literature, it is unclear if these are reflected in surveillance practices, and how the athlete is affected., Objective: Therefore, this study aimed to systematically review contact breast injuries (CBIs) among adult female athletes., Methods: The following databases were searched: PubMed, EMBASE, SPORTDiscus including MEDLINE, Web of Science and Scopus. The literature search was conducted in May 2023 and the search was limited to articles in the English and German language. Studies including female athletes, aged 18 years and above, in any sports (team or individual) at any level (amateur, semi-professional and professional), where an occurrence of CBI was documented were included. Studies were included irrespective of their investigated timeframes (e.g. the whole career, one or multiple seasons). Findings were categorised (e.g. sport, level of competition and investigated timeframe of the study) to enable possible comparisons. Case studies were excluded due to the non-generalisability of findings., Results: Of the six studies included, rugby codes (rugby union, rugby league and rugby sevens) had the highest occurrence rate (62.0%) of CBIs among eight different investigated sports (rugby codes 62.0%, softball 59.5%, Australian Football League (AFL) 51.0%, water polo 50.0%, soccer 46.7%, basketball 27.6-48.8%, volleyball 34.6%, boxing 0.0%). Between 25.6% and 62.0% of participants reported incurring a CBI and between 0.0% and 42.9% of CBIs were reported to a medical professional or support staff. The reported treatment rate for CBIs ranged between 0.0% and 2.1%, The main mechanisms for CBIs (where reported) were contact with another athlete (AFL 37.6%, rugby codes 56%) the ball (AFL 31.6%, rugby codes 25.5%) and the ground (AFL 6.6%, rugby codes 22%). Between 18.2% and 48% of the participants reported that CBIs negatively affected their performance. Risk factors increasing CBIs were positional differences, larger breast size and higher body mass index (BMI). In-season injury data collection and surveillance supported through education of both players and medical staff were identified to be of relevance for future CBI prevention. None of the studies reported incidence rate., Conclusion: Despite the frequent occurrence of CBIs among female athletes, reporting and treatment remains low. Awareness and education of all stakeholders are fundamental to ensuring better breast safety in female sport. Identifying the mechanics, severity and risk factors of CBIs through thorough injury surveillance must be a focus of further research., Registration: The study was preregistered on Open Science Framework (OSF)., (© 2024. The Author(s).)

Demand for natural gas continues to climb in the United States, having reached a record monthly high of 104.9 billion cubic feet per day (Bcf/d) in November 2023. Hydraulic fracturing, a technique used to extract natural gas and oil from deep underground reservoirs, involves injecting large volumes of fluid, proppant, and chemical additives into shale units. This is followed by a "shut-in" period, during which the fracture fluid remains pressurized in the well for several weeks. The microbial processes that occur within the reservoir during this shut-in period are not well understood; yet, these reactions may significantly impact the structural integrity and overall recovery of oil and gas from the well. To shed light on this critical phase, we conducted an analysis of both pre-shut-in material alongside production fluid collected throughout the initial production phase at the Hydraulic Fracturing Test Site 2 (HFTS 2) located in the prolific Wolfcamp formation within the Permian Delaware Basin of west Texas, USA. Specifically, we aimed to assess the microbial ecology and functional potential of the microbial community during this crucial time frame. Prior analysis of 16S rRNA sequencing data through the first 35 days of production revealed a strong selection for a Clostridia species corresponding to a significant decrease in microbial diversity. Here, we performed a metagenomic analysis of produced water sampled on Day 33 of production. This analysis yielded three high-quality metagenome-assembled genomes (MAGs), one of which was a Clostridia draft genome closely related to the recently classified Petromonas tenebris . This draft genome likely represents the dominant Clostridia species observed in our 16S rRNA profile. Annotation of the MAGs revealed the presence of genes involved in critical metabolic processes, including thiosulfate reduction, mixed acid fermentation, and biofilm formation. These findings suggest that this microbial community has the potential to contribute to well souring, biocorrosion, and biofouling within the reservoir. Our research provides unique insights into the early stages of production in one of the most prolific unconventional plays in the United States, with important implications for well management and energy recovery., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Stemple, Gulliver, Sarkar, Tinker and Bibby.)

Aims: This study aimed to compare the heat inactivation kinetics of viable human norovirus with the surrogate, MS2 bacteriophage as well as assess the decay of the RNA signal., Methods and Results: Human intestinal enteroids were used to analyze the heat inactivation kinetics of viable human norovirus compared to the surrogate MS2 bacteriophage, which was cultured using a plaque assay. Norovirus decay rates were 0.22 min-1, 0.68 min-1, and 1.11 min-1 for 50°C, 60°C, and 70°C, respectively, and MS2 bacteriophage decay rates were 0.0065 min-1, 0.045 min-1, and 0.16 min-1 for 50°C, 60°C, and 70°C, respectively. Norovirus had significantly higher decay rates than MS2 bacteriophage at all tested temperatures (P = .002-.007). No decrease of RNA titers as measured by reverse transcription-PCR for both human norovirus and MS2 bacteriophage over time was observed, indicating molecular methods do not accurately depict viable human norovirus after heat inactivation and treatment efficiency is underestimated., Conclusions: Overall, our data demonstrate that MS2 bacteriophage is a conservative surrogate to measure heat inactivation and potentially overestimates the infectious risk of norovirus. Furthermore, this study corroborates that measuring viral RNA titers, as evaluated by PCR methods, does not correlate with the persistence of viable norovirus under heat inactivation., (© The Author(s) 2024. Published by Oxford University Press on behalf of Applied Microbiology International.)

Wastewater-based epidemiology (WBE) expanded rapidly in response to the COVID-19 pandemic. As the public health emergency has ended, researchers and practitioners are looking to shift the focus of existing wastewater surveillance programs to other targets, including bacteria. Bacterial targets may pose some unique challenges for WBE applications. To explore the current state of the field, the National Science Foundation-funded Research Coordination Network (RCN) on Wastewater Based Epidemiology for SARS-CoV-2 and Emerging Public Health Threats held a workshop in April 2023 to discuss the challenges and needs for wastewater bacterial surveillance. The targets and methods used in existing programs were diverse, with twelve different targets and nine different methods listed. Discussions during the workshop highlighted the challenges in adapting existing programs and identified research gaps in four key areas: choosing new targets, relating bacterial wastewater data to human disease incidence and prevalence, developing methods, and normalizing results. To help with these challenges and research gaps, the authors identified steps the larger community can take to improve bacteria wastewater surveillance. This includes developing data reporting standards and method optimization and validation for bacterial programs. Additionally, more work is needed to understand shedding patterns for potential bacterial targets to better relate wastewater data to human infections. Wastewater surveillance for bacteria can help provide insight into the underlying prevalence in communities, but much work is needed to establish these methods.IMPORTANCEWastewater surveillance was a useful tool to elucidate the burden and spread of SARS-CoV-2 during the pandemic. Public health officials and researchers are interested in expanding these surveillance programs to include bacterial targets, but many questions remain. The NSF-funded Research Coordination Network for Wastewater Surveillance of SARS-CoV-2 and Emerging Public Health Threats held a workshop to identify barriers and research gaps to implementing bacterial wastewater surveillance programs., Competing Interests: RUH is managing member of AquaVitas, LLC and founder of the ASU non-profit project OneWaterOneHealth operating in the same intellectual space. LPS is employed by Ceres Nanosciences.

Viral pathogens are typically dilute in environmental waters, necessitating a concentration step prior to subsequent quantification or analysis. Historically, studies on viral concentration efficiency have been done by spiking known viruses into the sample; however, spike-in controls may not have the same behavior as "native" viruses exposed to environmental conditions. In this study, four concentration methods, including polyethylene glycol precipitation (PEG), skimmed milk flocculation (SMF), pH drop followed by filtration through a 0.45 μm filter (pH), and centrifugation using an Amicon filter (Amicon), were evaluated to concentrate native viral targets in wastewater. Viral targets included both indicators (crAssphage and pepper mild mottle virus) and pathogens (adenovirus, norovirus GII, human polyomavirus, and SARS-CoV-2) in addition to a bacterial marker (HF183). A non-native spike-in control was also added to compare native and spike-in recoveries. Recovery varied widely across targets and methods, ranging from 0.1 to 39.3 %. The Amicon method was the most broadly effective concentration for recovery efficiency. For the lowest-titer target, the PEG method resulted in the lowest number of non-detections, with 96.7 % positive detections for SARS-CoV-2, compared to 66.7 %, 80 %, and 76.7 % positive detections for SMF, pH, and Amicon, respectively. The non-native spike-ins chosen were only representative of a few native recovery trends, varying by both target and concentration method, and consistently under or over-estimated recovery. Overall, this study suggests the utility of including native targets in viral concentration evaluation and determining the efficiency of concentration methods for a specific target of interest., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Kyle Bibby reports financial support was provided by United States National Science Foundation. Kyle Bibby has patent Cross-Assembly Phage DNA Sequences, Primers and Probes for PCR-based Identification of Human Fecal Pollution Sources pending to EPA., (Copyright © 2023 Elsevier B.V. All rights reserved.)

The use of environmental DNA (eDNA) as a sampling tool offers insights into the detection of invasive and/or rare aquatic species and enables biodiversity assessment without traditional sampling approaches, which are often labor-intensive. However, our understanding of the environmental factors that impact eDNA removal (i.e., how rapidly eDNA is removed from the water column by the combination of decay and physical removal) in flowing waters is limited. This limitation constrains predictions about the location and density of target organisms after positive detection. To address this question, we spiked Common Carp (Cyprinus carpio) eDNA into recirculating mesocosms (n = 24) under varying light (shaded versus open) and benthic substrate conditions (no substrate, bare substrate, and biofilm-colonized substrate). We then collected water samples from each mesocosm at four time points (40 min, 6 h, 18 h, and 48 h), and sequentially filtered the samples through 10, 1.0, and 0.2 μm filters to quantify removal rates for different eDNA particle sizes under varying light and substrate conditions. Combining all size classes, total eDNA removal rates were higher for mesocosms with biofilm-colonized substrate compared to those with no substrate or bare (i.e., no biofilm) substrate, which is consistent with previous findings linking biofilm colonization with increased eDNA removal and degradation. Additionally, when biofilm was present, light availability increased eDNA removal; eDNA levels fell below detection after 6-18 h for open mesocosms versus 18-48 h for shaded mesocosms. Among size classes, larger particles (>10 μm) were removed faster than small particles (1.0-0.2 μm). These results suggest that changes in the distribution of eDNA size classes over time (e.g., with downstream transport) and with differing environmental conditions could be used to predict the location of target organisms in flowing waters, which will advance the use of eDNA as a tool for species monitoring and management., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)