12th Rib Research Articles

Image feature extraction via local binary patterns for marbling score classification in beef cattle using tree-based algorithms

The objective of this study was to investigate the potential of creating a pipeline to classify the marbling score obtained from ribeye area (REA) images using computer vision and machine learning methods. Our database consisted of images and measurements (N = 2,446) from the transversal cut between the 12th and 13th ribs of the Longissimus dorsi muscle from carcasses of a beef cattle population (Bos taurus). Each sample was previously labeled by the industry using a low, medium or high marbling score. The prediction accuracies of two tree-based Machine Learning (ML) algorithms (Decision Tree - DT and Random Forest - RF) were compared, as well as different measures for extracting features from the REA images, which were used as input for the ML algorithms. In order to extract features based on detectable color patterns and textures contained in smaller parts of the grayscale image, we proposed the application of the local binary pattern (LBP) method prior to the adoption of ML methods. Mean classification accuracies for the test set ranged from 45.78% to 91.25% for different test scenarios. The results were mostly impacted by the feature extraction metrics, ML methods, potential subjectivity during the classification process by the industry, and the number of classes evaluated together. The best prediction accuracy results were achieved after performing the cross-validation (20% in each balanced group, 5 folds, and 10 repetitions), considering solely the extreme groups (low and high marbling scores) and pre-selecting from each group the 400 most visually representative samples. The RF algorithm outperformed the DT for most scenarios. After increasing the number of images to 580 samples for the same two groups, the highest testing accuracies were reduced to 83.05% for RF and 75.58% for DT. Such a decrease in the classification accuracies may be associated with the addition of erroneously classified images, due to the subjective nature of the industry evaluation. In conclusion, our preliminary studies showed the LBP method as a powerful feature extraction strategy considering a scenario where the labels were well defined. Our results revealed high accuracies for the classification of marbling extremes, but there is an evident need to improve the understanding of the biological and visual aspects that led to a sharp drop in classification accuracy after the insertion of the intermediate groups of marbling. In addition, the authors highlight the importance of an accurate labeling process for achieving better classification accuracy when applying supervised classification methods.

The effects of a Nutritional Packet (live yeast, vitamins C and B1, and electrolytes) offered during the final phase of feedlot steers on growth performance, nutrient digestion, and feeding behavior

The effects of a Nutritional Packet offered to beef steers during the final 64 d of the feedlot-finishing phase on growth performance, carcass characteristics, nutrient digestibility, and feeding behavior were evaluated. Angus-crossbred steers (N = 120; initial body weight = 544 ± 52 kg) were assigned to 30 pens (4 steers per pen; 15 pens per treatment) in a randomized complete block design where pen was the experimental unit. A steam-flaked corn-based finishing diet was offered to ad libitum, and the treatments were as follows: 1) control and 2) 30 g per steer-daily (dry matter basis) of the Nutritional Packet. The Nutritional Packet was formulated to provide 1.7 × 1010 CFU per steer-daily of Saccharomyces cerevisiae, 162 mg per steer-daily of vitamin C; 400 mg per steer-daily of vitamin B1; 2.4 g per steer-daily of NaCl, and 2.4 g per steer-daily of KCl. Data were analyzed using the GLIMMIX procedure of SAS with the fixed effect of treatment and the random effect of block. The average daily gain (P = 0.89), dry matter intake (P = 0.57), and gain efficiency (P = 0.82) were not affected by the inclusion of the Nutritional Packet. Digestibility of dry and organic matter, and neutral and acid detergent fiber increased (P ≤ 0.02) for steers offered the Nutritional Packet, while a trend for the same response was observed for hemicellulose (P = 0.08). The 12th rib backfat thickness increased (P = 0.02) for carcasses of steers offered the Nutritional Packet, followed by a greater (P = 0.03) calculated yield grade, whereas other carcass traits were not affected (P ≥ 0.32). While the steers under the control diet decreased behavior activities on day 63, a consistent pattern of feeding behavior measurements (activity min/d and min/kg of dry and organic matter, fiber fractions, and digestible nutrients) were observed for steers consuming the Nutritional Packet during both feeding behavior assessment periods (treatment × period interactions, P ≤ 0.03). Overall time (min/d) spent on rumination, drinking, active, chewing, and resting were not affected (P ≥ 0.28) by treatments. The Nutritional Packet offered to steers during the final 64 d on feed induced an improvement in apparent digestibility of nutrients and carcass fat deposition, without affecting growth performance or other carcass quality indices. Such effects associated with the more consistent feeding behavior of steers receiving the Nutritional Packet may warrant a shorter time on feed during the final portion of the finishing phase.

Relationship Between Thoracic Flexibility and Spinal Curvature During Trunk Extension in Healthy Adults

Background: Non-specific lower back pain is a common medically and economically impactful condition that affects patients’ quality of life. Purpose: This study aimed to determine the relationship between thoracic expansion and spinal curvature angle during trunk extension in healthy participants. Results: The participants comprised 24 men aged 18–21 years. The measurement items included the lateral and longitudinal diameters of the thorax, measured at the level of the xiphoid process and 10th rib, and spinal curvature angle, measured in the upright posture and trunk extension position. The difference in thoracic expansion levels during trunk extension tended to be greater in the lower thorax than in the upper thorax, with the lateral diameter higher than the longitudinal diameter. The inferior thoracic and lumbar curvatures increased with trunk extension. Regarding the relationship between the difference in thoracic expansion and the amount of change in the spinal curvature, the difference in the expiratory lateral diameter of the lower thorax during trunk extension was positively correlated with the superior thoracic curvature during trunk extension. Conclusions: These results indicate that expansion of the lower thoracic lateral diameter increased the thoracic curvature during trunk extension exercises. Consequently, the lumbar curvature may be suppressed. Reduced lower thorax flexibility may enhance lumbar curvature during trunk extension. Therefore, flexibility of the lower lateral thoracic diameter may be a factor when preventing lower back pain. KEY WORDS: Thorax, Lateral Diameter, Longitudinal Diameter, Trunk Extension, Chest Griping.

A case of incidental multiple Myeloma presenting with pathologically proven large frontal skull plasmacytoma and review of therapeutic targets: Case report

Introduction: Multiple myeloma and plasmacytoma are both plasma cell malignancies that belong to the family of blood dyscrasias. They are thought to be different entities but can occur simultaneously in some patients. Case Report: We present a unique case of a large plasmacytoma heralding the diagnosis of multiple myeloma with a preceding history of trauma which makes this case peculiar as this is an important addition to the limited existing scientific literature. The index patient was largely asymptomatic despite having a massive frontal skull/lobe lesion measuring approximately 8 × 6 cm in size alongside a chest wall mass involving the anterior left 6th rib, and a mildly displaced acute pathological fracture of the left clavicle. A primary diagnosis of multiple myeloma was made following serum protein electrophoresis with pathological confirmation of frontal skull plasmacytoma. After multidisciplinary discussion, radiotherapy was administered for plasmacytoma with complete resolution of the frontal skull mass without the need for resection and chemotherapy for multiple myeloma with daratumumab in combination with lenalidomide-dexamethasone—chosen due to anticipated poor outcome at the time of diagnosis. Autologous stem cell transplantation was subsequently instituted for multiple myeloma with a good outcome to date. Conclusion: Solitary plasmacytoma can co-exist with multiple myeloma and the prognosis remains poor in such circumstance. Patients should be followed up closely with yearly imaging—magnetic resonance imaging (MRI)/computed tomography (CT), and positron emission tomography (PET) scans. A pivotal lesson from this case report emphasizes the atypical presentation of plasmacytoma and multiple myeloma with the peculiarity of a prior history of trauma which is believed to be associated with plasma dyscrasias. Over the last decade, novel therapeutic agents such as chimeric antigen receptor T-cell therapy, which is the first approved cell-based therapy for multiple myeloma, antibody-drug conjugates, and a dozen of bi-specific antibodies/immunotherapy have been developed and shows promising outcome in the future, especially for refractory cases of multiple myeloma.

Determination of Optimal Harvest Weight for Mangalica Pigs Using a Serial Harvest Approach to Measure Growth Performance and Carcass Characteristics.

Mangalica pigs are a popular niche breed given their reputation for superior pork quality. However, growth and carcass parameters for this breed are poorly documented. To better characterize optimal harvest weights for the Mangalica, a growth trial was conducted whereby pigs (n = 56) were randomly distributed across stratified harvest weights (50, 57, 68, 82, 93, 102, 127 kg) in a completely randomized design. Pigs were fed standard finisher rations with individual daily feed intakes and weekly body weights recorded for all animals. At 24 h postmortem, carcasses were split and ribbed with marbling and loin eye area (LEA) measured at the 10th rib. Primal cuts were fabricated and individually weighed. Fat back was separated from the loin and weighed. As expected, live weight significantly increased across the weight class (p < 0.0001). ADG was similar across classes up to 82 kg live weight, before steadily declining with increasing weight class (p < 0.0025). Likewise, feed efficiency did not differ between classes until weights heavier than 82 kg (p < 0.03). LEA significantly increased by class up to 82 kg and then plateaued as harvest weight increased further (p < 0.003). Marbling score significantly increased with increasing weight class up to 102 kg, where they then plateaued (p < 0.04). Fat back dramatically increased across all weight classes (p < 0.0001) despite negligible increases in LEA or marbling after 102 kg. Primal cut weights for the ham (p < 0.0001), loin (p < 0.0001), Boston butt (p < 0.0001), shoulder (p < 0.0001), and belly (p < 0.0001) all significantly increased with increasing live weight though significant fat deposition contributed to this gain. These data suggest an optimal harvest weight occurs between 82 to 102 kg, while offering little objective justification for harvesting Mangalica pigs at heavier live weights.

An observational simulation-based study of the accuracy of intercostal drain placement and factors influencing placement

South Africa's significant burden of trauma and respiratory disease requires the regular need for intercostal drain (ICD) insertion. ICD misplacement is associated with significant complications. The aim of this study was to assess ICD insertion site accuracy and the factors affecting accuracy by Emergency Department doctors. This was a prospective, observational simulation-based study. Prior to participant admission, pertinent thoracic structures were marked on two simulated patients using an invisible marker which could only be seen using ultraviolet light. One by one, study participants were then asked to place a sticker on each side of each patient's chest to indicate where they would insert an ICD. Sticker placements were photographed under ultraviolet light. Placement sites were compared according to the most appropriate and accurate position for insertion (within the area superior to the 6th rib, posterior to pectoralis major and 1cm anterior to the mid-axillary line) as well as the British Thoracic Society's 'triangle of safety'. Comparisons of accuracy were made between participant rank (junior vs senior doctor), participant experience, simulated patient BMI category and placement side. Insertion site was accurate in 47% of placements and within the 'triangle of safety' in 51% of placements. Improved accuracy was associated with greater participant experience (61% vs. 37%, p<0.01), and left-sided chest placement (54% vs 40%, p=0.02). No difference was found when comparing simulated patient BMI category (low vs high, 43% vs 51%, p=0.18) or participant rank (junior vs senior, 41% vs 51%, p=0.10). Overall accuracy of ICD insertion site was low, and appropriate accuracy was only associated with greater participant experience and left sided placement. Further studies to determine methods to improve ICD placement accuracy are needed.

Abstract 14825: Utilizing a Novel Horizontal Approach for Implantable Loop Recorders

Introduction: Implantable Loop Recorders (ILR) are used in detecting and monitoring arrhythmias. These subcutaneous devices remain in place for years for continuous cardiac monitoring. There have been few studies on how best to position an ILR for maximum accuracy and comfort. Currently, manufacturers recommend insertion of the ILR at a 45-degree angle from the sternum at the 4th intercostal space and a minimum R wave amplitude of 0.2mV for adequate sensing. We adopted the technique of implanting all ILRs horizontally between the 4th and 5th ribs and examined patient outcomes. Methods: Data was obtained through chart review of 288 patients who received a horizontally placed ILR from 2019 to 2021. Patient’s age, sex, BMI, indication for ILR, ILR manufacturer, episodes of artifact and complications were collected. The R wave magnitude (mV) immediately succeeding implantation was recorded from the procedure note. Results: Of our patients, 91% received a Medtronic ILR, 6% had a Boston Scientific ILR and 3% had a Biotronik ILR. The mean age was 60 ± 14 years, with 51% of patients being male. Within the sample, 27% had a BMI less than 25 kg/m 2 , 33% were overweight, and 40% were obese. Approximately 271 patients had a documented R wave amplitude at implantation, with the average being 0.44 mV ± 0.41 (95% CI 0.39 to 0.48). Of 240 patients with follow-up, 8% had an arrhythmia recorded that was found to be a false positive episode. There were no major complications. Conclusions: Using the horizontal approach, we obtained adequate sensing based on average R wave amplitude. We had very few false positive arrhythmias, as only 8% of our patients were noted to have a false positive reading versus 25% reported in other studies. This approach minimizes involvement of breast tissue and thus reduces risk of peri-procedural bleeding and ILR migration and increases patient comfort. The outcomes of our population indicate that this is a viable approach and may be superior to standard.

Surgical flap delay to allow primary transabdominal transplantation of extended rectus abdominis myocutaneous flaps in increasingly complex pelvic wound reconstructions

Primary intra- or transabdominal transplantation of an extended rectus abdominis myocutaneous (ERAM) flap may help prevent surgical complications of pelvic resections. Surgical delay of the ERAM flap may help prevent intra-abdominal (partial) flap loss after transplantation in highly complex situations including previous irradiation. We report on the outcome of this approach and the risk-factors associated with an eventful outcome. From 2012 to 2020, 105 delayed ERAM flaps were consecutively applied immediately following extended pelvic resections after chemoradiation or hyperthermic intraperitoneal chemotherapy. We addressed the increased reconstructive demands by designing the flap in line with the 10th rib and delaying the flap’s skin island. All post-operative complications were assessed in light of patient-related or procedure-related potential risk-factors. Major complications occurred in 39 patients. These were correlated with surgery for residual or recurrent malignancy (p < 0.01), with tip necrosis after flap delay (p = 0.02), and with the use of a mesh to close the abdominal donor site (p < 0.01). (Partial) flap loss occurred in 4 cases. We observed a comparably high rate of major complications after ERAM transplantations for increasingly extending indications of perineal-pelvic resections. We consider this to be attributable to poorer patients’ conditions and disease processes, rather than to flap viability. Delay of the flap allowed for the use of large and voluminous flaps with comparably little (partial) flap loss.

Thoracic Complications in Supracostal Percutaneous Nephrolithotomy

Due to the risk of pleural injury leading to thoracic complications, many urologist still hesitate to perform supracostal puncture during percutaneous nephrolithotomy. Our aim of this study was to evaluate the thoracic complications in supracostal access percutaneous nephrolithotomy. This is a retrospective analysis of 101 patients who were treated with supracostal access percutaneous nephrolithotomy at our institute from September 2013 and December 2019. Indications for supracostal punctures were staghorn 28(27.7%), middle calyceal stones 10(9.9%), pelvic stones 29(28.7%), complex inferior calyceal stones 26(25.7%), upper calyceal stone 10(9.9%)and upper ureteric stone17(16.8%).The intercostal space between the 11th and 12th ribs was used in all the cases. Among the 101 patients who undergone percutaneous nephrolithotomy by supracostal access, three patients (2.97%) had pleural injury. Among them one patient developed hydrothorax and needed chest tube insertion and remaining two patients had minimal pneumo thorax with blunting of costo-phrenic angle, which was managed conservatively. The lung parenchymal or other viscera injury was not observed in our study. Most punctures were, a single supracostal superior calyceal access 18(17.8%) and middle posterior calyceal access 88(82.2%), except for staghorn and multiple complex lower calyceal calculi needed multiple tracts 23(22.8%). Complete clearance was observed in 77(76.2%) patients. The supracostal puncture was a safe and effective approach with high stone clearance rate and acceptable morbidity in selected cases of staghorn, upper ureteral, and upper calyceal calculi. It should be adapted whenever needed and should not be avoided due to fear of chest complications.

PMON110 Panhypopituitarism as a Rare Presentation of Erdheim – Chester disease (ECD) in an Adolescent Patient

Abstract Background Erdheim-Chester disease (ECD) is a rare multisystemic histiocytic disorder. Only a dozen pediatric cases are reported. Here, we present a case of ECD in a pediatric patient who presented with short stature and delayed puberty. Clinical Case A 14-year-old male with history of autism and ADHD presented with short stature and pubertal delay. He grew along the 40th percentile until age 7 years when growth velocity declined. On exam, his height was 145.6 cm (0.98%ile, z-score -2.34), weight was 55.6 kg (63.19%ile, z-score 0.34), and testicular size was 5-6 mL. He had increased thirst and episodes of bedwetting since age 7. Bone age was delayed at 11 years 6 months. Further workup was recommended, but family was lost to follow up. At 16, he returned with continued poor growth, polydipsia, and nocturia. Height was 153 cm (0.26%ile, z-score -2.80), weight 61.1 kg (40%ile, z-score -0.25). Labs revealed IGF-BP3 2.8mcg/mL(3.1-8.9), IGF-1 35ng/mL(245-522), LH 1.2mIU/mL(0.29-4.77), and total testosterone &amp;lt;7.0 ng/dL(250-1100). Prolactin, cortisol, thyroid, and karyotype were normal. Growth hormone (GH) stimulation test confirmed GH deficiency. He was referred to oncology clinic when a brain MRI revealed a nodular enhancing suprasellar mass extending from the third ventricular floor to the dorsum sella along the pituitary stalk and rounded sclerotic lesion in the frontal bone. Biopsy of the suprasellar lesion was remarkable for foamy histiocytes positive for CD68, negative for S100 and CD1a, an eosinophilic cell background highlighted by S100 and synaptophysin, SALL4 negative. A diagnosis of xanthomatous hypophysitis was made. Additionally, lab studies confirmed diabetes insipidus (DI), treated with DDAVP. Growth hormone was trialed for 2 weeks, but he developed acute pancreatitis, so it was discontinued. He subsequently developed recurrent pancreatitis of unclear etiology requiring frequent hospitalization with development of insulin-dependent diabetes mellitus due to pancreatic damage. He was lost to follow up for 12 months after leaving home at age 18. He returned to our institution after incidental findings of 7th right rib expansile lytic bony lesions on abdominal CT during a pancreatitis admission. Biopsy of the rib lesion was positive for a BRAF-V600E mutation. Skeletal survey revealed new multiple small lytic skull lesions. Repeat brain MRI demonstrated new calvarial lesions, increased suprasellar mass. Chest CT scan showed a micronodular pattern with mediastinal lymph node enlargement. PET confirmed widespread multifocal FDG hypermetabolic lesions. Final diagnosis of ECD was made; he was started on targeted therapy with Vemurafenib, a BRAF inhibitor. Conclusion Erdheim-Chester disease (ECD) is a non-Langerhans cell histiocytosis, which rarely affects pediatric patients who present with bone pain and DI; however, here we present a case of ECD in an adolescent with short stature and multiple pituitary deficiencies to highlight the varied presentation of the disorder. Presentation: Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.

ODP079 BCG-Osis, a Rare Cause of 1,25 Hydroxy Vitamin D Mediated Hypercalcemia

Abstract Background Non-parathyroid hormone (PTH) mediated hypercalcemia is mostly related to malignancy and less commonly caused by granulomatous diseases. We report a rare case of severe hypercalcemia caused by systemic granulomatous disease after intravesical Bacillus Calmette-Guerin (BCG) treatment for bladder cancer (BCGosis). Clinical Case 74-year-old male with history of bladder cancer treated with intravesical BCG a year ago, was hospitalized with confusion, weakness, recurrent falls and polyuria for a few days. He had night sweats and 50 lb weight loss over 6 months. Lab evaluation showed hypercalcemia with calcium 10.9 mg/dL, albumin 3.6 g/dL, corrected calcium 11.2 mg/dL, PTH 12 pg/ml, and 25 OH vitamin D 44ng/ml. He had normal thyroid hormone levels, serum electrophoresis and PTHrP &amp;lt;2 pmol/L. CT chest/abdomen/pelvis without contrast revealed sub-cm pulmonary nodules and non-obstructive renal calculi and bone scan showed no evidence of osseous metastases. He was treated with intravenous (IV) hydration and pamidronate 60 mg infusion, and his corrected calcium improved to 9.7 mg/dL. He was admitted again 3 weeks later with hypercalcemia, calcium 11.9 mg/DL, albumin 3.2 g/dL, corrected calcium 12.5 mg/dL, 25 OH vitamin D 24 ng/ml, PTH 14.6 pg/ml, and PTHrP &amp;lt;2 pmol/L. He received IV hydration and zoledronic acid 4 mg infusion. 3 weeks later he was hospitalized for the third time for recurrent hypercalcemia and worsening renal failure, calcium 13.2, albumin 2.6 g/dL, corrected calcium 14.2 mg/dL, PTH 19.2 pg/ml. 1,25 OH vitamin D checked this time was elevated at 113 pg/mL. He received another infusion of zoledronic acid 4 mg infusion and 10 days later required denosumab 120 mg for resistant hypercalcemia. PET CT scan showed multiple hypermetabolic foci in right neck, right anterior 4th rib, scrotum, and around left kidney and aorta. He underwent biopsy of the right rib lesion which demonstrated + AFB on smear and histiocytic inflammation, which led to diagnosis of BCGosis, with subsequent cultures positive for Mycobacterium bovis. He was started on multi drug regimen with rifampin, isoniazid and ethambutol. Follow up labs at 4 weeks showed normalization of calcium 8.9 mg/dL, albumin 3.2 g/dL, corrected calcium 9.78 mg/dL, PTH 54 pg/ml and low 1,25 OH vitamin D 17 pg/mL. Calcium and 1,25 OH vitamin D levels were stable at 4 months follow up. Conclusion Intravesical BCG treatment can be associated with systemic reactions in 1- 5% of patients. Granulomas associated with disseminated BCG infection can lead to hypercalcemia due to increased 1-alpha-hydroxylase activity in macrophages, causing elevated 1,25 OH vitamin D levels. Therefore, evaluation of 1,25 OH vitamin D levels is critical to determine the etiology of hypercalcemia. Treatment of underlying BCGosis with anti-tuberculosis treatment is key in management of hypercalcemia along with supportive treatments that may include IV hydration, bisphosphonates and/or glucocorticoids. Presentation: No date and time listed

The Effects of Experimental Whole-Body Burning on Histological Age-at-Death Estimation from Human Cortical Bone and Dental Cementum.

Whole-body donations (n = 6) were placed in various experimental fire-death scenarios to understand the histological effects of thermal alteration on bones and teeth. Midshaft samples of the femur, 6th rib, and metatarsal were removed from each donor pre- and post-burning to examine histomorphometric differences and test established age-at-death estimation methods. Dental samples were taken post-burning to test the applicability of dental cementum analysis for age-at-death estimation. Significant differences in osteon area or Haversian canal area between some pre- and post-burn samples were found although no patterns related to temperature or element were observable. The femoral age estimates across pre- and post-burn samples were 91% accurate across all donors. The point age estimates from the ribs compared to known age were significantly different (t(10) = 6.88, p &lt; 0.001) with an average difference of -18.53 years. Dental age estimates of post-burn samples were not significantly different from the known donor age (t(3) = -0.74, p = 0.512) with an average difference of -3.96 years. Overall, the results of this study show that thermally altered remains can be used for histologic age-at-death analysis of cortical bone and dental cementum, within certain burning parameters.

12 Growth Performance, Physiology, and Carcass Merit of Supplementing Brahman Steers with Zilpaterol Hydrochloride Under Heat Stress Conditions

Abstract Supplementation with a β- adrenergic agonist (β-AA) for 21 days in Brahman steers under heat stress conditions (HS) was evaluated with respect to feedlot performance and carcass merit. Twenty-four Brahman steers (kg = 338 ± 39) were housed in two controlled environment chambers with one of two environmental (ENV) conditions 1) heat stress (HS; THI = 73 to 85) and 2) thermoneutral (TN; THI = 68) with either Zilpaterol hydrochloride (ZL) or soymeal supplementation (CN) using a randomly assigned in a 2 x 2 factorial design (n=6/group). Daily data were collected for dry matter intake, water intake, respiratory rate (RR), and rectal temperature (RT). At the end of 21 d period, total weight gain was used to calculate average daily gain (ADG) and gain to feed. Blood samples were collected from the jugular vein on days -7, 3, 10, and 21 for cortisol analysis, and biological impedance analysis (BIA) was determined on days 3, 10, and 21 on each animal. Steers were harvested at 544 kg on average post supplementation/environment conditions, and carcass merit was determined. There were no differences (P &amp;gt; 0.05) in feedlot performance. Brahmans exposed to heat stress had greater RR during the heat stress periods of the experiment, regardless of supplementation. Environment and day interactions (P &amp;lt; 0.04) were observed for RT, HS steers had a greater RT on d 8 but similar RT on d 15 and 19. Stressed steers with ZL had higher RT (P &amp;lt; 0.05) than TN/CN steers on d 11. There was no interaction (P &amp;gt; 0.05) between environmental conditions and CN and ZH supplementation for cortisol concentrations. Regardless of environmental treatment or supplementation, no difference (P &amp;gt; 0.05) was associated with BIA characteristics. There were no differences (P &amp;gt; 0.05) for hot carcass weight, cold carcass weight, USDA yield grade, 12th rib loin eye area, marbling score, KPH percentage, and 12th rib fat thickness between groups. Twelfth-rib loin eye area lean color from HS/CN had higher lightness (L*) (P &amp;lt; 0.05) than TN/CN steers. HS/CN steers present a similar (L*) to ZL in TN and HS conditions. Redness-greenness (a*) was greater (P = 0.01) in carcasses from HS steers with or without ZL than TN/ZL but similar to TN/CN. Steers exposed to HS and CN had a higher (P = 0.02) change of 12th rib lean color from yellow to blue (b*) than TN steers with CN and ZL. Supplementation with β-AA did not negatively impact growth, carcass performance, or carcass merit in heat-stressed steers.

7 Evaluation of Finishing Performance and Carcass Characteristics of Beef Heifers with Variable Degrees of Heart Failure Risk and Differing Reproductive Tract Type

Abstract Tremendous economic loss is attributed to high altitude disease mortality of calves in the Mountain West and Great Plains region. Additional economic losses may be associated with changes in feed efficiency and carcass quality in animals at higher risk of heart failure during the finishing phase. Thus, the objective of the current study is to evaluate economically relevant traits throughout the finishing period to determine inefficiencies associated with variable levels of heart failure risk and reproductive tract type of beef heifers. Both intact reproductive tract (n = 19) and ovariectomized (n = 18) heifers were stratified by risk category, where initial pulmonary arterial pressure (PAP) levels at or below 42 mmHg were designated as low risk and those above 42 mmHg as moderate/high risk. Heifers were fed a grain-based diet for 125 d before transportation to the harvest facility on d 126. All heifers were weighed in 2 wk intervals. Heifers were PAP tested by a qualified veterinarian in approximately 3 mo intervals during the feeding period. Feed intake data was collected for the last 55 d prior to harvest using the Vytelle SENSETM bunk system. Time of harvest was determined based on live weight and final ultrasound 12th rib fat thickness. Data were analyzed using the ANOVA function of R with tract type and risk as fixed effects. Comparisons were tested using a significance level of α = 0.05 and 0.05 (P ≤ 0.10) were considered tendencies. There were no interactions of risk category and tract type on performance or carcass characteristics (P ≥ 0.14). There was a tendency for higher total intake (P = 0.07) and relative growth rate (P = 0.04) among moderate/high risk heifers compared to the low-risk category. Hot carcass weight, marbling score, ribeye area, and USDA yield grade were not impacted (P ≥ 0.16) by risk category. Intact heifers had greater (P = 0.02) total gain than their ovariectomized contemporaries. However, marbling scores were higher (P = 0.04) among ovariectomized heifers compared to those from intact heifers. These data suggest that risk category and tract type minimally influence performance and carcass characteristics in a population that selects sires with low PAP scores. It remains unclear if more initial divergence in PAP scores would elicit greater impacts on performance and carcass characteristics in feedlot heifers.

P-130 LAPAROSCOPIC LUMBAR HERNIA REPAIR. BASED ON ANATOMICAL LANDMARKS AND SAFETY STATEMENTS

Abstract Aim Lumbar hernias are a rare clinical entity (less than 1% of all abdominal hernias) and their surgical treatment is constantly evolving and changing. The aim is to propose a technical systematization of the steps and landmarks to perform a safe and effective repair of an infrequent pathology. Material &amp; methods We use a tapp approach. The patient is placed in a dorsal decubitus position with a 45° elevation of the hernia side. The first port in the umbilicus access and two ports are placed along the middle line. Start the dissection using novel articulated instruments marking the anatomical limits of the rectangular trapezoid that involves the semilunar lines, epigastric vessels, spine, and imaginary line between the iliac crest and 11 th rib. Releasing the peritoneal flat until visualizing the psoas and quadratus muscles until the 12th rib, preserving the avascular plane avoids nerves and vascular damage. Hernia sac reduction. Tension-free or not closure of the orifice. Placement of a polypropylene mesh covering all the dissected areas. Mesh fixation using absorbable suture. Closure of the peritoneum.Vacuum maneuver and bulge compression. Results The systematic standardization has been applied to all patients. The mean operative time was 90 min. The articulated instruments were useful and allowed safe maneuvers. Outpatient surgery was achieved with a fast return to normal activity. The procedures were performed without intraoperative complications, mortality, or conversion to open surgery. Conclusion The step-by-step guide for anatomical landmarks and proven statements offers a safe and effective repair of this rare entity.

Characterization of Pork Loin Chop Color Stability Using Loin Quality Traits and Instrumental Discoloration Measures

The objective of this study was to characterize the color stability of pork loin chops using fresh quality traits and instrumental measures of discoloration. Boneless pork loins (N=484) were evaluated for quality traits at 11 or 14 d post-mortem. One chop was cut from each loin near the 10th rib for retail display, overwrapped, and displayed under constant fluorescent lighting for 7 d. Objective color, myoglobin redox forms, and subjective visual discoloration traits were evaluated daily. After retail display, chops were categorized based on final visual discoloration (Day 7) as Very Color Stable (VCS; 0% to 5% discoloration), Color Stable (CS; 5% to 10% discoloration), Neutral (10% to 25% discoloration), Color Labile (CL; 25% to 30% discoloration), or Very Color Labile (VCL; &amp;gt;30% discoloration). Quality and color traits were analyzed using the GLIMMIX (visual discoloration) or MIXED (all other measures) procedure of SAS. Retail display data were analyzed as repeated measures. Chops ultimately classified as CS or VCS were darker, redder, and had lesser surface metmyoglobin (P&amp;lt;0.01) than CL and VCL chops at both Day 1 of retail display and throughout display. Stable chops also had generally increased R630/580 values as well as decreased visual discoloration scores and yellowness during display. A group×day interaction was observed for all traits measured during retail display (P&amp;lt;0.0001). No differences in aged loin ventral surface redness were observed between color stability groups (P≥0.16). Overall, chops ultimately classified as CS came from aged loins that were generally darker, redder, and less yellow, with greater pH values, greater marbling scores,and decreased purge loss.

Pulsed radiofrequency in the treatment of a patient with myofascial pain – a case report

In Myofascial pain is a type of chronic soft tissue pain that is localized in muscles, fasciae and/or surrounding tissues and is characterized by the presence of muscle trigger points, the palpation of which causes localized or referred pain. One of the myofascial pain syndromes is the Serratus Anterior Muscle Pain Syndrome. The condition manifests itself as deep, dull, diffuse pain between the 5th and 7th ribs along the midaxillary line that radiates to the front of the chest wall, shoulder, shoulder blade and, less frequently, to the 4th and 5th fingers of the upper limb. It most often occurs in people who work hard physically and in athletes, and is favored by injuries, overstrain and muscle cooling, mental stress, fatigue, and lack of sleep. A medical history, characteristic clinical picture, physical examination with palpation assessment of muscles, and the exclusion of other disease entities with similar symptoms, such as radiculopathies, fibromyalgia, rheumatic polymyalgia, chronic fatigue syndrome, polymyositis, are key in the diagnosis of the Serratus Anterior Muscle Pain Syndrome. It is recommended to combine conservative methods (pharmacotherapy, physiotherapy, psychotherapy) and interventional methods such as needling, blockades, botulinum toxin injection and pulsed radiofrequency in the management. This article describes a patient with Serratus Anterior Muscle Pain Syndrome refractory to conservative management, in which the pulsed radiofrequency of the affected muscle gave significant and long-lasting pain relief without significant side effects. In the opinion of the authors and based on the available publications, pulsed radiofrequency can be considered in the therapeutic management of patients with myofascial pain.

Video-assisted thoracoscopic segmentectomy with combined chest wall resection: A case report

BackgroundResection of lung cancer with chest wall involvement is an invasive procedure.Case presentationWe report a case of pulmonary adenocarcinoma with chest wall involvement that was resected through video-assisted thoracoscopic segmentectomy and combined en bloc resection of the chest wall (2nd to 4th ribs). Surgical stress was decreased by reducing the extent of lung parenchymal resection and applying a video-assisted technique with an additional posterior paravertebral incision.ConclusionA thoracoscopic surgical approach involving incisions in areas requiring resection of the proximal, lateral, and posterior sides of the involved ribs can be applied to tumors invading the chest wall.

KOMPOSISI ASAM LEMAK PADA DAGING SAPI RANCAH DAN PERANAKAN ONGOLE

Local beef is known for its low-fat content/lean meat. The fatty acid profile of beef could affect the meat quality, related to its texture, taste, and nutritional value. This study aims to determine the fatty acid profile of Rancah and Ongole Grade beef. This study used fourteen samples of meat from Rancah cattle 1.5 – 2.5 years, which were extensively reared with forage feed, and nine samples of Ongole Grade beef with forage and concentrate feeding as much as 2.5% dry matter of body weight. A fatty acid profile was analyzed from the longissimus dorsi muscle area, between the 12th and 13th ribs. The fatty acid profiles identified are saturated and unsaturated fatty acids (MUFA and PUFA). The fatty acid analysis used is the Gas Chromatography (GCMS) method. The data were analyzed descriptively and fatty acid composition differences of Rancah and Ongole grade beef were analyzed by T-test. The results showed that the fatty acid composition of Rancah and Ongole grade beef is relatively the same as the beef of other breeds. Saturated fatty acid in Ongole Grade beef is higher than Rancah beef, but the content of unsaturated fatty acids, PUFA/MUFA: SFA ratio in Rancah beef is higher than Ongole Grade.

RIB FRACTURE AS A RARE AND UNDER-REPORTED ETIOLOGY OF PLEURAL SPACE INFECTION: CASE REPORT AND REVIEW OF LITERATURE

RIB FRACTURE AS A RARE AND UNDER-REPORTED ETIOLOGY OF PLEURAL SPACE INFECTION: CASE REPORT AND REVIEW OF LITERATURE