National Beef Quality Audit-2022: in-plant assessments of quality and yield determining carcass characteristics of fed steers and heifers.

The National Beef Quality Audit - 2022 serves as a benchmark of the current fed steer and heifer population of the U.S. beef industry and allows comparison to previous audits as a method of monitoring industry progress. In-plant cooler assessments and collections of beef carcass data took place from July 2021 to November 2022. During in-plant evaluations, 10% of 1-d production was surveyed for quality and yield indicating characteristics of fed beef carcasses (n = 9,746 beef carcasses). Distributions of sex classes among sampled carcasses were steer (65.0%) and heifer (35.0%), whereas distributions of breed type were native (87.7%), dairy (11.3%), and Bos indicus (0.9%). Mean values were observed for USDA Yield Grades (YG; 3.3), USDA Quality Grade (QG; Choice16), marbling score (Small98), ribeye area (91.0 cm2), adjusted fat thickness (1.49 cm), hot carcass weight (401.9 kg), and KPH (2.5%). Mean overall maturity was A66, with a mean lean maturity of A56 and mean skeletal maturity of A72. There were 28.1% of carcasses identified for use in a USDA-certified beef G-Schedule Program. Defects, such as dark cutting and blood splash, were observed at 1.8% and 0.5%, respectively. Distributions of USDA YG were YG 1 (8.2%), YG 2 (30.7%), YG 3 (40.2%), YG 4 (16.6%), and YG 5 (4.3%). USDA QGs were observed at 7.5% Prime, 69.2% Choice, 16.4% Select, and 6.8% other. The results of this study provide an updated look at the current grading trends of beef carcasses in the United States to drive progress in the fed beef industry.

Short-term Outcomes After Hip Arthroscopic Surgery in Patients Participating in Formal Physical Therapy Versus a Home Exercise Program: A Prospectively Enrolled Cohort Analysis.

BACKGROUND: Physical therapy is frequently utilized in the postoperative care of femoroacetabular impingement syndrome (FAIS). There has been limited research into the efficacy of a structured home exercise program (HEP) compared with formal physical therapy (FPT) in this patient population. PURPOSE/HYPOTHESIS: The purpose was to evaluate the short-term outcomes of patients utilizing FPT versus an HEP after hip arthroscopic surgery for FAIS. It was hypothesized that both groups would show similar improvements regarding outcome scores, which would improve significantly compared with their preoperative scores. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: Patients undergoing hip arthroscopic surgery for FAIS at a single center between October 2020 and October 2021 were prospectively enrolled. Patients were allowed to self-select FPT or an HEP and were administered a survey preoperatively and at 1 month, 3 months, 6 months, and 12 months postoperatively. The survey included the Single Assessment Numeric Evaluation, visual analog scale for pain, 12-item International Hip Outcome Tool, Patient-Reported Outcomes Measurement Information System Physical Function, and patient satisfaction with physical therapy and overall care. Statistical analysis was conducted between the 2 groups and within groups to compare preoperative and postoperative scores. RESULTS: The patients' mean age was 32.6 ± 10.4 years, with 47.2% being female and 57.4% choosing the HEP. At 12 months postoperatively, no significant differences were reported between the FPT and HEP groups regarding the Single Assessment Numeric Evaluation score (P = .795), visual analog scale for pain score (P > .05), Patient-Reported Outcomes Measurement Information System Physical Function T-score (P = .699), 12-item International Hip Outcome Tool score (P = .582), and patient satisfaction (P > .05). Outcome scores at 12 months postoperatively were significantly improved from the preoperative scores across all measures in both groups (P < .001). CONCLUSION: There were no significant differences regarding patient outcomes between FPT and the HEP at 1-year follow-up after hip arthroscopic surgery for FAIS when patients selected their own treatment, with both groups demonstrating significant improvements in their outcome scores from their preoperative values. These findings suggest that a structured HEP may be a viable alternative to FPT after hip arthroscopic surgery in patients who prefer a self-directed rehabilitation program.

Tibial Tubercle Osteotomy With and Without Medial Patellofemoral Ligament Reconstruction in Adolescent Patients Leads to Decrease in Patellar Height and Patella Tendon Length.

OBJECTIVE: Patellar height changes after tibial tubercle osteotomy (TTO) have not yet been described. We aimed to evaluate whether TTO ± medial patellofemoral ligament reconstruction (MPFL-R) influences patellar height and tendon length, hypothesizing that TTO would decrease patellar height and tendon length. METHODS: A retrospective review was performed of skeletally mature adolescents (<18 y) receiving primary anteromedialization or medialization TTO ± MPFL-R. Patients with at least 6 months of radiographic follow-up were included in the study. Pre and postoperative patellar heights were assessed on lateral, weight-bearing, and flexion (30 to 70 degrees) radiographs using the Blackburne-Peel Index (BPI), Caton-Deschamps Index (CDI), and Insall-Salvati Ratio (ISR). Subgroup analyses were performed to compare patellar height changes in patients with preoperative patella alta, norma, and baja, as well as between patients undergoing medialization and anteromedialization TTO. Data were analyzed for normality using a Shapiro-Wilk test, and paired-sample t tests were performed. RESULTS: Forty-nine knees were included (mean age: 15 y; range: 12 to 17). A significant decrease in mean patellar height after TTO ± MPFL-R was observed across all measures: BPI (0.12, P = 0.000783), CDI (0.08, P = 0.01062), and ISR (0.15, P = 0.00000075). Patellar tendon length decreased by 2.26 mm ( P = 0.001272). Subgroup analyses demonstrated a decrease in mean patellar height across all 3 measurements ( P < 0.001; BPI, CDI, and ISR) for patients with preoperative patella alta but not patella norma or baja. Additional subgroup analysis showed a patellar height decrease using BPI (0.15, P = 0.004583) and ISR (0.14, P = 0.0002806) for patients receiving medialization TTO but not anteromedialization. The anteromedialization cohort did not demonstrate patellar height change using BPI and CDI; ISR demonstrated a decrease (0.10, P = 0.00917). CONCLUSIONS: Mean patellar height and tendon length decreases after TTO ± MPFL-R in skeletally mature, adolescent patients. Subgroup analyses suggest these changes occur in patients with preoperative patella alta and/or patients who undergo medialization TTO. These data suggest that some distalization in patellar positioning may be achieved without formal distalization osteotomy.

Epidemiology of Injuries Among National Basketball Association Players: 2013-2014 Through 2018-2019.

BACKGROUND: Understanding the epidemiology of injuries to athletes is essential to informing injury prevention efforts. HYPOTHESIS: The incidence and impact of basketball-related injuries among National Basketball Association (NBA) players from 2013-2014 through 2018-2019 is relatively stable over time. STUDY DESIGN: Descriptive epidemiology study. LEVEL OF EVIDENCE: Level 3. METHODS: Injuries from 2013-2014 through 2018-2019 were analyzed using the NBA Injury and Illness Database from an electronic medical record system. Descriptive statistics were calculated for injuries by season, game-loss, and onset. Incidence rates were estimated using Poisson models and linear trend tests. RESULTS: Between 552 and 606 players participated in ≥1 game per season during the study. Annual injury incidence ranged from 1550 to 1892, with 33.6% to 38.5% resulting in a missed NBA game. Game-loss injury rates ranged from 5.6 to 7.0 injuries per 10,000 player-minutes from 2014-2015 through 2018-2019 (P = 0.19); the rate was lower in 2013-2014 (5.0 injuries per 10,000 player-minutes), partly due to increased preseason injury rates and transition of reporting processes. The 6-year game-loss injury rate in preseason and regular season games was 6.9 (95% CI 6.0, 8.0) and 6.2 (95% CI 6.0, 6.5) injuries per 10,000 player-minutes; the rate in playoff games was lower (P < 0.01) at 2.8 (95% CI 2.2, 3.6). Most (73%) game-loss injuries had acute onset; 44.4% to 52.5% of these involved contact with another player. CONCLUSION: From 2013-2014 through 2018-2019, over one-third of injuries resulted in missed NBA games, with highest rates of game-loss injuries in preseason games and lowest rates in playoff games. Most game-loss injuries had acute onset, and half of those involved contact with another player. CLINICAL RELEVANCE: These findings - through reliable data reporting by team medical staff in an audited system - can guide evidence-based injury reduction strategies and inform player health priorities.

Effect of traditional roughage-based or limit-fed, high-energy diets on growth performance and digestion in newly received growing cattle and subsequent implications on feedlot growth performance and carcass characteristics.

The objective was to determine the effects of ad libitum-fed roughage-based diets or limit-fed high-energy diets on growth performance, behavior, health, and digestion in newly received growing cattle and subsequent implications on feedlot growth performance and carcass characteristics. In experiment 1, 409 crossbred heifers (initial body weight [BW] = 279 ±â€…24 kg) in 32 pens were used in a randomized block design. Heifers were fed one of two dietary treatments: a total mixed ration with 0.99 Mcal net energy for gain (NEg)/kg dry matter (DM) fed ad libitum (0.99AL) or 1.32 Mcal NEg/kg DM limit-fed at 85% of intake of heifers fed 0.99AL (1.32LF85%). Both diets contained 40% DM as a branded wet corn gluten feed. In experiment 2, 370 crossbred heifers (initial BW = 225 ±â€…20 kg) were used in a randomized block design and were fed a diet formulated to contain 0.99 Mcal of NEg/kg DM for ad libitum intake or a diet formulated to contain 1.32 Mcal of NEg/kg DM and fed at 2.2% of BW daily (DM basis; 1.32LF2.2). For experiments 1 and 2, treatment integrity was maintained through the finishing phase where cattle were fed a common diet. Cattle were sorted by BW into heavy and light groups prior to finishing, with light cattle fed longer than heavy cattle to reach similar harvest BW. In experiment 3, eight ruminally cannulated heifers (average BW = 305 ±â€…23 kg) were used in a 2-period cross-over design and fed treatments from experiment 1 to assess digestibility and ruminal fermentation characteristics. Gain:feed was 47% and 35% greater (P < 0.01) in experiments 1 and 2, respectively, for limit-fed heifers compared with 0.99AL heifers. Rumination time was greater (P < 0.01) for 0.99AL compared with limit-fed treatments in experiments 1 and 2. Activity was greater (P < 0.01) for 1.32LF2.2 than for 0.99AL in experiment 2. In experiment 1, more (P = 0.03) carcasses from light-sort heifers than carcasses from heavy-sort heifers had livers with large, active abscesses. In experiment 2, finishing phase morbidity was greater (P < 0.01) for 1.32LF2.2 than for 0.99AL. Light-sort groups had fewer (P < 0.01) edible livers than heavy-sort groups, suggesting that greater number of days on feed may increase the risk of liver abscess prevalence and condemnation. In experiment 3, apparent total-tract DM and organic matter digestibilities were greater (P < 0.01) for 1.32LF85% than for 0.99AL. Overall, dietary treatments during the growing phase had little carryover effect on feedlot growth performance, carcass characteristics, or liver abscesses prevalence at harvest.

Physeal Location on the Distal Femoral Cortical Surface Is Consistently Proximal to Apparent Location on the Perfect Lateral Radiograph: A 3-Dimensional Digitally Reconstructed Radiograph Study.

INTRODUCTION: The perfect knee lateral radiograph visualizes anatomic landmarks on the distal femur for clinical and scientific purposes. However, radiographic imaging is a two-dimensional (2D) representation of a three-dimensional (3D) physis. The aim of this study was to characterize the perceived radiographic projection of the femoral physis using perfect lateral digitally reconstructed radiographs (DRRs) and to evaluate discrepancies from this projection to the physis at the lateral and medial cortices. METHODS: Pediatric patients from a cohort of CT scans were analyzed. Inclusion criteria were an open physis; exclusion criteria were any implant or pathology affecting the physis. CT scans were imported into 3D imaging software and transformed into lateral DRRs and 3D renderings of the femur. The physis was divided into four equal segments, with fiducial markers placed at the "anterior," "midpoint," and "posterior" points. Lines extended from these points in the lateral and medial direction. The vertical distance from these lines, representing the radiographic projection of the physis, was measured relative to the physis at the lateral and medial cortex of the femur on coronal CT slices. RESULTS: Thirty-one patients were included. On the perfect lateral radiograph DRR, the physis on the medial cortex was located proximal to the visualized physis by 6.64 ± 1.74 mm, 11.95 ± 1.67 mm, and 14.30 ± 1.75 mm at the anterior (25%), midpoint (50%), and posterior (75%) locations, respectively. On the lateral side, the physis on the lateral cortex was proximal to the visualized physis by 2.19 ± 1.13 mm, 3.71 ± 1.19 mm, and 6.74 ± 1.25 mm at the anterior, midpoint, and posterior locations, respectively. DISCUSSION: In this cohort of pediatric patients, the location of the cortical physis was, in all areas measured, proximal to the projection of the visualized physis as seen on the perfect knee lateral DRR. The distance from radiographic physis to cortical physis was greater at the medial cortex compared with the lateral cortex. STUDY DESIGN: Descriptive laboratory study. LEVEL OF EVIDENCE: III, observational radiographic anatomic study.

National Beef Quality Audit-2022: Transportation, mobility, live cattle, and hide assessments to determine producer-related defects that affect animal welfare and the value of market cows and bulls at processing facilities.

The National Beef Quality Audit (NBQA)-2022 serves as a benchmark of the current market cow and bull sectors of the U.S. beef industry and allows comparison to previous audits as a method of monitoring industry progress. From September 2021 through May 2022, livestock trailers (n = 125), live animals (n = 5,430), and post-slaughter hide-on animals (n = 6,674) were surveyed at 20 commercial beef processing facilities across the U.S. Cattle were transported in a variety of trailer types for an average distance of 490.6 km and a mean transport time of 6.3 h. During transit, cattle averaged 2.3 m2 of trailer space per animal indicating sufficient space was provided according to industry guidelines. Of all trailers surveyed, 55.3% transported cattle from an auction barn to a processing facility. When surveyed, 63.6% of all truck drivers reported to be Beef Quality Assurance certified. The majority (77.0%) of cattle were sound when evaluated for mobility. Mean body condition scores (9-point scale) for beef cows and bulls were 3.8 and 4.4, respectively, whereas mean body condition scores (5-point scale) for dairy cows and bulls were 2.3 and 2.6, respectively. Of the cattle surveyed, 45.1% had no visible live animal defects, and 37.9% had only a single defect. Of defects present in cows, 64.6% were attributed to an udder problem. Full udders were observed in 47.5% of all cows. Nearly all cattle were free of visible abscesses and knots (97.9% and 98.2%, respectively). No horns were observed in 89.4% of all cattle surveyed. Beef cattle were predominantly black-hided (68.9% and 67.4% of cows and bulls, respectively). Holstein was the predominant dairy animal observed and accounted for 85.7% of the cows and 98.0% of the bulls. Only 3.1% of all animals had no form of identification. Findings from the NBQA-2022 show improvements within the industry and identify areas that require continued education and research to improve market cow and bull welfare and beef quality.

Effect of accelerated aging on shelf-stability, product loss, sensory and biochemical characteristics in 2 lower quality beef cuts.

The aim of this study was to determine the impact of accelerated aging (AA) on shelf stability, product loss, sensory and biochemical characteristics of 2 lower quality beef cuts. Triceps brachii (TB) and semimembranosus (SM) were collected and fabricated from 10 USDA Choice beef carcasses and assigned to 1 of 6 treatments: 3 d cooler aged (control), 21 d cooler aged, AA 49 °C for 2 h, AA 49 °C for 3 h, AA 54 °C for 2 h, and AA 54 °C for 3 h. The results showed that AA can decrease APC counts on steak surface and in purge and redness, but increase lightness and product loss of the steaks (P < 0.01). Lower shear force was also found for AA steaks compared to those from the control (P < 0.01), with the AA 54 °C treatments being comparable to 21 d cooler aging. However, the trained sensory panel determined AA steaks were less juicy and flavorful than those from the control and 21 d cooler aged samples (P < 0.05). There was no off-flavor detected in AA steaks though lipid oxidation was higher in AA samples than those in the control steaks (P < 0.01). The AA treatments stimulated cathepsin activity (P < 0.05), which may have enhanced the solubilization of stromal proteins and led to a different troponin-T degradation pattern compared to those from the 21 d aged samples (P < 0.01). Although AA is an economical and time-efficient method to increase tenderness of lower-quality beef cuts, further research is needed to determine strategies to mitigate the decrease in juiciness from AA treatments.

Nanostructured CeO2 photocatalysts: optimizing surface chemistry, morphology, and visible-light absorption.

Emerging photocatalytic applications of cerium dioxide (CeO2) include green hydrogen production, CO2 conversion to fuels, and environmental remediation of various toxic molecules. These applications leverage the oxygen storage capacity and tunable surface chemistry of CeO2 to photocatalyze the chosen reaction, but many open questions remain regarding the fundamental physics of photocatalysis over CeO2. The commonly ascribed 'bandgap' of CeO2 (∼3.1 eV) differs fundamentally from other photocatalytic oxides such as TiO2; UV light excites an electron from the CeO2 valence band into a 4f state, generating a polaron as the lattice distorts around the localized charge. Researchers often disregard the distinction between the 4f state and a traditional, delocalized conduction band, resulting in ambiguity regarding mechanisms of charge transfer and visible-light absorption. This review summarizes modern literature regarding CeO2 photocatalysis and discusses commonly reported photocatalytic reactions and visible light-sensitization strategies. We detail the often misunderstood fundamental physics of CeO2 photocatalysis and supplement previous work with original computational insights. The exceptional progress and remaining challenges of CeO2-based photocatalysts are highlighted, along with suggestions for further research directions based on the observed gaps in current understanding.

When Minutes Matter: A Comparison of Whole Blood Collection Techniques.

BACKGROUND: Fast and reliable blood collection is critical to emergency walking blood banks (WBB) because mortality significantly declines when blood is quickly administered to a warfighter with hemorrhagic shock. Phlebotomy for WBB is accomplished via either the "straight stick" (SS) or "ruggedized lock" (RL) method. SS comprises a 16-gauge phlebotomy needle connected to a blood collection bag via tubing. The RL device collects blood through the same apparatus, but has a capped, intravenous (IV) catheter between the needle and the donor's arm. This is the first study to compare these two methods in battlefield-relevant metrics. METHODS: Military first responders and licensed medical providers (N=86) were trained in SS and RL as part of fresh whole blood training exercises. Outcomes included venipuncture success rates, time to IV access, blood collection times, total time, and user preferences, using a within-subjects crossover design. Data were analyzed using ANOVA and nonparametric statistics at p<0.05. RESULTS: SS outperformed RL in first venipuncture success rates (76% vs. 64%, p=0.07), IV access times (448 [standard error of the mean; SE 23] vs. 558 [SE 31] s, p<0.01), and blood collection bag fill times (573 [SE 48] vs. 703 [SE 44] s, p<0.05), resulting in an approximate 3.5-minute faster time overall. Survey data were mixed, with users perceiving SS as simpler and faster, but RL as more reliable and secure. CONCLUSION: SS is optimal when timely collection is imperative, while RL may be preferable when device stability or replacing the collection bag is a consideration.

Correlation of Tibial Tubercle Overgrowth With Increased Posterior Tibial Slope: A Novel Radiographic Assessment.

Background: An elevated posterior tibial slope (PTS) is associated with an increased risk for anterior cruciate ligament and meniscal injury. Recent evidence suggests that the PTS is elevated in patients with Osgood-Schlatter disease. Purpose: To determine whether there is an association between objective measures of anterior tibial tubercle growth and PTS. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 100 radiographs were randomly selected from a sample of patients who had received a lateral knee radiograph that captured at least 15 cm of the tibia distal to the knee joint line at a single institution between December 2020 and March 2022. The PTS was measured, and tibial tubercle growth was quantified with 2 novel measurements. For these measurements, a line was drawn on the radiograph from the most anterosuperior point on the tibia to the point on the anterior cortex of the tibia 10 cm distal from the starting point. The tibial tubercle height (TTH) was measured as the perpendicular distance from this line to the most prominent portion of the anterior tibia. The anterior tibial tubercle angle (TTA) was measured as the angle between the endpoints of the line made previously and the most prominent portion of the tibial tubercle, with a more acute angle indicating a more prominent tibial tubercle. The relationship between TTA, TTH, and PTS was evaluated using a univariate linear regression model. Results: The mean patient age was 33.1 ± 14.1 years. The mean TTA was 158.6°± 4.7°, the mean TTH was 8.8 ± 2.0 mm, and the mean PTS was 9.7°± 2.6°. A significant correlation was found between PTS and TTA (r = -0.46; ß = -0.46; P < .001) as well as TTH (r = 0.43; ß = 0.43; P < .001). Conclusion: Objective measures of anterior tibial tubercle overgrowth correlated with an elevated PTS. Every 2.2° of anterior TTA deviation from the mean and every 2.3 mm in TTH deviation from the mean correlated with a 1° difference in the PTS. This suggests a link between the development of the tibial tubercle and PTS, and it potentially helps to explain why the PTS is elevated in certain patients.

Prescreened Whole O Blood Group Walking Blood Bank Capabilities for Nontraditional Maritime Medical Receiving Platforms: A Case Series.

BACKGROUND: Tactical Combat Casualty Care (TCCC) guidelines recognize low-titer group O whole blood (LTOWB) as the resuscitative fluid of choice for combat wounded. Utilization of prescreened LTOWB in a walking blood bank (WBB) format has been well described by the Ranger O low-titer blood (ROLO) and the United States Marine Corps Valkyrie programs, but it has not been applied to the maritime setting. METHODS: We describe three WBB experiences of an expeditionary resuscitative surgical system (ERSS) team, attached to three nontraditional maritime medical receiving platforms, over 6 months. RESULTS: Significant variations were identified in the number of screened eligible donors, the number of LTOWB donors, and the timely arrival at WBB activation sites between the platforms. Overall, 95% and 84% of the screened eligible group O blood donors on the Arleigh Burke Class Destroyer (DDG) and Nimitz Class Aircraft Carrier (CVN), respectively, were determined to be LTOWB. However, only 37% of the eligible screened group O blood donors aboard the Harper's Ferry Class Dock Landing Ship (LSD) were found to be LTOWB. Of the eligible donors, 66% did not complete screening, with 52% citing a correctable reason for nonparticipation. CONCLUSION: LTOWB attained through WBBs may be the only practical resuscitative fluid on maritime platforms without inherent blood product storage capabilities to perform remote damage control resuscitation. Future efforts should focus on optimizing WBBs through capability development, education, and training efforts.

Botulinum neurotoxin X lacks potency in mice and in human neurons.

Botulinum neurotoxins (BoNTs) are a class of toxins produced by Clostridium botulinum (C. botulinum) and other species of Clostridia. BoNT/X is a putative novel botulinum neurotoxin identified through genome sequencing and capable of SNARE cleavage, but its neurotoxic potential in humans and vertebrates remained unclear. The C. botulinum strain producing BoNT/X, Strain 111, encodes both a plasmid-borne bont/b2 as well as the chromosomal putative bont/x. This study utilized C. botulinum Strain 111 from Japan as well as recombinantly produced full-length BoNT/X to more fully analyze this putative pathogenic toxin. We confirmed production of full-length, catalytically active native BoNT/X by C. botulinum Strain 111, produced as a disulfide-bonded dichain polypeptide similar to other BoNTs. Both the purified native and the recombinant BoNT/X had high enzymatic activity in vitro but displayed very low potency in human-induced pluripotent stem cell-derived neuronal cells and in mice. Intraperitoneal injection of up to 50 µg of native BoNT/X in mice did not result in botulism; however, mild local paralysis was observed after injection of 2 µg into the gastrocnemius muscle. We further demonstrate that the lack of toxicity by BoNT/X is due to inefficient neuronal cell association and entry, which can be rescued by replacing the receptor binding domain of BoNT/X with that of BoNT/A. These data demonstrate that BoNT/X is not a potent vertebrate neurotoxin like the classical seven serotypes of BoNTs. IMPORTANCE: The family of botulinum neurotoxins comprises the most potent toxins known to humankind. New members of this family of protein toxins as well as more distantly related homologs are being identified. The discovery of BoNT/X via bioinformatic screen in 2017 as a putative new BoNT serotype raised concern about its potential as a pathogenic agent with no available countermeasures. This study for the first time assessed both recombinantly produced and native purified BoNT/X for its vertebrate neurotoxicity.

Magnetic Resonance Imaging and Magnetic Resonance Arthrography Are Both Reliable and Similar When Measuring Hip Capsule Thickness in Patients With Femoroacetabular Impingement Syndrome.

Purpose: To propose an accurate method of measuring hip capsular thickness in patients with femoroacetabular impingement syndrome and to compare the reliability of these measurements between magnetic resonance imaging (MRI) and magnetic resonance arthrography (MRA). Methods: A previously established database of patients with femoroacetabular impingement syndrome (FAIS) was used to identify candidates with preoperative MRI or MRA from November 2018 to June 2021. Two reviewers independently examined preoperative imaging for 85 patients. Capsular thickness was measured in 12 standardized locations. Intraclass correlation coefficients (ICCs) were calculated using an absolute-agreement, 2-way random-effects model. Using the same method, 30 patients were randomly selected for repeat measurements by 1 reviewer following a washout period. Ten additional patients with preoperative MRI and MRA of the same hip were identified to compare measurements between modalities using paired samples t test. Results: ICCs for measurements on MRIs and MRAs using these proposed measurements to compare inter-rater reliability were 0.981 and 0.985. ICCs calculated using measurements by a single reviewer following a washout period for intrarater reliability were 0.998 and 0.991. When comparing MRI and MRA measurements in the same patient, t test for all pooled measurements found no difference between modality (P = .283), and breakdown of measurements by quadrant found no difference in measurements (P > .05), with the exception of the inferior aspect of the capsule on coronal sequences (P = .023). Conclusions: In patients with FAIS, both MRI and MRA have excellent reliability for quantifying hip capsular thickness. A difference in capsular thickness was found only when comparing MRI and MRA on inferior coronal aspects of the hip capsule, indicating interchangeability of these imaging modalities when measuring the clinically important aspects of the hip capsule. Level of Evidence: Level IV, diagnostic case series.

A current review of U.S. beef flavor I: Measuring beef flavor.

Historically, consumer acceptance of beef was determined by tenderness. Developments in genetics and management over the last couple of decades have improved tenderness to the point that it is secondary to other factors in beef's taste. Flavor, however, is an extraordinarily complex taste attribute dependent on biological sensors in the mouth, sinus cavity, and jaws. The culinary industry has recently focused on innovative ways to give consumers new products satisfying their curiosity about different foods, especially proteins. Competition from plant-based, cell-based, and even other animal-based proteins provides diversity in consumers' ability to select a protein that satisfies their desire to include unique products in their diet. Consequently, the beef industry has focused on flavor for the last 10 to 15 years to determine whether it can provide the guardrails for beef consumption in the future. The U.S. beef industry formed a Flavor Working Group in 2012 composed of the authors listed here to investigate new and innovative ways to manage and measure beef flavor. The results of this working group have resulted in dozens of papers, presentations, abstracts, and symposia. The objective of this manuscript is to summarize the research developed by this working group and by others worldwide that have investigated methodologies that measure beef flavor. This paper will describe the strengths of the research in beef flavor measurement and point out future needs that might be identified as technology advances.

A current review of U.S. beef flavor II: Managing beef flavor.

Beef flavor continues to be one of the largest drivers of beef demand and a differentiation point of beef from other competing proteins. Tenderness has long been identified as the most important palatability trait for consumer satisfaction. However, as technological advancements and industry practices evolve and improve in response to tenderness management, flavor has emerged as a key driver of consumer satisfaction. In response, the beef industry has recently invested in research focused on beef flavor development, measurement, and management to better understand the factors impacting flavor and help beef maintain this advantage. The current review paper is the second of two such papers focused on summarizing the present knowledge and identifying knowledge gaps. While the other review focuses on current practices related to beef flavor measurement, this review will cover research findings related to beef flavor management. Numerous production and product management factors influence beef flavor. Pre-harvest factors including marbling level, animal genetics/cattle type, diet, and animal age, can influence beef flavor. Moreover, numerous post-harvest product management factors, including product type, aging length and conditions, cookery methods, product enhancement, muscle-specific factors, packaging, retail display factors, and antimicrobial interventions, have all been evaluated for their impact on beef flavor characteristics. Results from numerous studies evaluating many of these factors will be outlined within this review in order to present management and production chain factors that can influence beef flavor.

Intraoperative Bivalirudin Use in Patient Undergoing Femoral Endarterectomy with Heparin-Induced Thrombocytopenia: Case Report and Review of the Literature.

PURPOSE: To describe the intraoperative use of bivalirudin during lower extremity revascularization in the setting of heparin-induced thrombocytopenia (HIT). CASE SUMMARY: A 65 year-old man presented with left common iliac, external iliac, and femoral artery occlusion necessitating revascularization with left femoral endarterectomy and common and external iliac stent angioplasty. Three months before the femoral endarterectomy, the patient was hospitalized for a coronary artery bypass procedure. During this admission, the patient tested positive for the presence of heparin-PF4 antibody complexes. With the patient's recent history of HIT, bivalirudin was selected as the optimal agent for intraoperative anticoagulation. Bivalirudin was administered as a 50 mg bolus, followed by a continuous infusion initiated at 1.75 mg/kg/hr. Repeated bivalirudin boluses were necessary to maintain an activated clotting time (ACT) necessary for the revascularization procedures and recurrent subacute thrombi despite appropriate ACT values. DISCUSSION: Bivalirudin has been utilized for cardiopulmonary bypass and carotid endarterectomy (CEA), but data for dosing in lower extremity revascularization are lacking. As the risk for thrombosis with HIT continues for months after diagnosis, it is important to elucidate optimal dosing of non-heparin anticoagulant options, such as the direct thrombin inhibitor, bivalirudin. The absence of validated dosing strategies for bivalirudin can result in prolonged operative times, increased risk of bleeding, and inadequate anticoagulation. CONCLUSION: Bivalirudin is an appropriate agent for intraoperative anticoagulation in lower extremity revascularization. However, further investigation into the optimal intraoperative bivalirudin dosing regimen is necessary.

A survey of Kansas beef producers and consumers who participate in business-to-consumer marketing of beef.

Following the coronavirus disease 2019 (COVID-19) pandemic, producer and consumer interest in business-to-consumer (B2C) beef sales increased. The objective of the current study was to assess current B2C beef producer and consumer attitudes and understandings of the B2C beef marketing process in order to identify knowledge gaps and strategies to improve producer/consumer interactions. Both producers and customers of local beef were recruited using a large online platform (https://shopkansasfarms.com), and descriptive statistics were used to summarize the data. In total, 41 B2C beef producers and 174 consumers who had either previously participated in B2C marketing or intended to participate were surveyed. Most producers (69.8%) only produced beef and produced only a small number (1 to 20 head) of animals per year. Many (43.9%) reported selling 100% of beef directly to consumers, while 29.3% reported selling less than 20% through this channel. Almost all (97.3%) of the producers indicated that increased sales directly to consumers would be desirable, with most (87.1%) considering this marketing channel as the most profitable. Marketing beef in smaller portions, including portioned cuts, was popular, reported by more than 62% of producers, while whole carcass sales were lower. Word-of-mouth (91.3%) and social media (65.8%) were the most popular forms of advertisement used by producers and more than one-third of producers (38.9%) reported having trouble with customers regarding a sale. Over 60% of consumers indicated they had purchased B2C beef less than 5 times, with more than 73% indicating that more than 75% of their beef purchased was local. Low take-home weights, portion sizes, and quality were among consumers' most cited troubles. Lack of freezer space (25%), price (24.9%), and quantity of product (41.7%) were reported as the largest barriers to consumer participation in B2C marketing. Both consumers and producers indicated that consumer testimonials would be the most beneficial in improving producer/consumer interactions, with educational materials from government sources viewed as the least beneficial. These results provide a baseline for B2C beef marketing and provide insight into impactful strategies to use to assist in this process.