Reducing environmental impacts of feed using multiobjective formulation: What benefits at the farm gate for pig and broiler production?

Feed production is the main contributor to several environmental impacts of livestock. To decrease environmental impacts of feed, those of feedstuffs should be considered during formulation. In particular, multiobjective feed formulation (MOF) can help reduce several environmental impacts simultaneously while keeping any increase in feed price moderate. The objective of this study was to assess environmental benefits of MOF at the farm gate for fattening pigs and broilers. For pigs, three feeding strategies were tested: classic 2-phase (2P), 2-phase with lower net energy content (2P-), and multiphase (MP). For broilers, two strategies were tested: classic 3-phase (3P) and 3-phase with higher digestible amino acid contents and lower metabolisable energy content (3P+). Diets were formulated using both least-cost formulation (LCF) and MOF, yielding six pig scenarios and four broiler scenarios. Environmental impacts at the farm gate were estimated using a modelling approach based on life cycle assessment. Indicators for six impact categories were then calculated: climate change (CC), cumulative non-renewable energy demand (CEDNR), acidification (AC), eutrophication (EU), land occupation (LO), and phosphorus demand (PD). As expected, MOF had lower farm-gate impacts than LCF (as much as -13%), but the degree of decrease varied by feeding strategy and impact. For pigs, MOF was equally effective in all strategies at reducing PD (-6 to -9%) and AC (-2%). In contrast, MOF was more effective in 2P and 2P- at decreasing CC (-5% to -7%), LO (-9% to -13%) and EU (-6% to -8%) than in MP (CC: -2%; LO: -4%; EU: -3%). The benefit of MOF was found greater in 2P (-7%) than in other pig strategies for CEDNR (-3 to +0%). For broilers, MOF was equally effective in both strategies tested at decreasing PD (-12%), AC (-2%), and EU (-4%). For CC and CEDNR, MOF was more effective in 3P (CC: -9%; CEDNR: -11%) than 3P+ (-6% for both impacts), but not for LO (+3% in 3P vs -1% in 3P+). These differences were due mainly to differences in animal performance (especially feed conversion ratio) among the strategies tested. Finally, in all scenarios, gross margin at the farm gate decreased with MOF comparatively to LCF (pigs: -3% to -11%); broilers: -7% to -11%). These results demonstrate the importance of comprehensive economic and environmental optimisation of feeding strategies by simultaneously considering feed impacts, animal performance, and manure management. To do so, further research is therefore required to develop new modelling tools.

Effects of interactions between feeding practices, animal health and farm infrastructure on technical, economic and environmental performances of a pig-fattening unit.

European pig production faces economic and environmental challenges. Modelling can help farmers simulate and understand how changes in their management practices affect the efficiency of their production system. We developed an individual-based model of a pig-fattening unit that considers individual variability in performance among pigs, farmers' feeding practices and animal management and estimates environmental impacts (using life cycle assessment) and economic results of the unit. We previously demonstrated that this model provides reliable estimates of farm performance for different combinations of management practices, pig types and building characteristics. The objectives of this study were to quantify how interactions between feeding practices and animal management influence fattening unit results in healthy or impaired health conditions using the model. A virtual experiment was designed to evaluate effects of interactions between feeding practices, health status of the pig herd and infrastructure constraints on the technical performance, economic results and environmental impacts of the unit. The virtual experiment consisted of 96 scenarios, which combined chosen values of 6 input parameters of the model: batch interval (35 days and 7 days), use or non-use of a buffer room to manage the lightest pigs, feed rationing (ad libitum and restricted) and sequence plans (two-phase (2P), daily-phase (DP)), scale at which the feeding plan is applied (i.e. room, pen and individual) and health status of the pig herd (i.e. healthy v. impaired). Variance analysis was used to test effects of the factors in these 96 scenarios, and multivariate data analyses were used to classify the scenarios. Healthy populations obtained on average higher economic results (e.g. gross margin of 11.20 v. 1.50 €/pig) and lower environmental impacts (e.g. 2.24 v. 2.38 kg CO2-eq/kg pig live weight gain) than the population with impaired health. With 35 days batch interval and DP feeding, populations with impaired health reached gross margin similar to healthy populations with 2P ad libitum feeding and 7 days batch interval. Restricted, DP and individual feeding plans improved the economic and environmental performances of the unit for both health statuses. This study highlighted that health status of the pig herd is the main factor that affects technical, economic and environmental performances of a pig-fattening unit, and that adequate feeding strategies and animal management can compensate, to some extent, the effects of impaired health on environmental impacts but not on gross margin.

Modelling interactions between farmer practices and fattening pig performances with an individual-based model.

European pig production continues to encounter economic and environmental challenges. To address these issues, methods have been developed to assess performances of pig production systems. Recent studies indicate that considering variability in performances among pigs improves the accuracy and reliability of results compared with modelling an average animal. Our objective was to develop a pig fattening unit model able to (i) simulate individual pig performances, including their variability in interaction with farmers' practices and management, and (ii) assess their effects on technical, economic and environmental performances. Farmer practices included in the model were chosen from a typology generated from on-farm surveys focused on batch management, pig allocation to pens, pig feeding practices, practices of shipping to the slaughterhouse, and management of the remaining pigs. Pigs are represented using an individual-based model adapted from the InraPorc® model. To illustrate the model's abilities, four scenarios were simulated that combine two feed rationing plans (ad libitum, restricted to 2.5 kg/day) and two feed sequence plans (two-phase, 10-phase). Analysis of variance was performed on the simulated technical, economic and environmental indicators (calculated via Life Cycle Assessment). The feed rationing plan and feed sequence plan significantly affected all indicators except for the premium per pig, for which the feed sequence plan did not have a significant effect. The 'restricted 10-phase' scenario maximised gross margin of the fattening unit (14.2 €/pig) and minimised environmental impacts per kg of pig produced. In contrast, the 'ad libitum two-phase' scenario generated the lowest margin (8.20 €/pig) and the highest environmental impacts. The model appears to be a promising tool to assess effects of farmers' practices, pig characteristics and farm infrastructure on technical, economic and environmental performances of the fattening unit, and to investigate the potential of improvement. However, further work is needed, based on virtual experiments, in order to evaluate the effects of a larger diversity of practices.

Operative management of supracondylar humeral fractures in children: Comparison of five fixation methods.

BACKGROUND: The best method for stabilising supracondylar humeral fractures (SHFs) in children remains unclear. The objective of this study was to compare the outcomes of five different fixation methods for SHFs in children. HYPOTHESIS: Differences in intra-operative and short-term post-operative parameters can be demonstrated across different fixation methods for SHFs in children. PATIENTS AND METHODS: We reviewed the medical files of paediatric patients managed at our centre between 2006 and 2016 for SHF with major displacement (type 3 or 4 in the Lagrange-Rigault classification). Clinical and radiological parameters collected post-operatively and at last follow-up included Baumann's angle, anteversion of the distal humeral epiphysis, and operative time. Over the 11-year study period, 251 patients were included; mean age was 6.4 years and mean follow-up 4.7 months. The five fixation methods used were elastic stable intra-medullary nailing (ESIN, n=16), two pins in an X configuration (n=33), two lateral pins and one medial pin (n=144), two lateral pins (n=33), and three lateral pins (n=25). A minimally invasive 2-cm approach was used to insert the medial pins. Immediate instability of the fixation was considered in patients with an at least 15° deficit in Baumann's angle or anteversion, or with rotational malalignment, on the radiographs taken on day 1. Outcomes were analysed in each of the five internal fixation groups. RESULTS: Immediate instability showed no significant differences across the five groups. Operative time was significantly shorter with two lateral pins (33min, P=0.046). Time to hardware removal was longer in the ESIN group (54 days, P=0.03). Use of a medial pin was associated with a lower risk of secondary displacement (2.0% vs. 8.6%, P=0.04) but did not affect the risk of nerve injury (4% vs. 3%, P=0.86). DISCUSSION: This is one of the largest retrospective cohort studies of outcomes according to the fixation technique used to treat SHFs in children. Adding a medial pin through a minimally invasive approach is associated with a longer operative time but limits the risk of secondary displacement without increasing the frequency of iatrogenic nerve injury and improves fracture site stability. Use of a medial pin therefore deserves to be considered in paediatric SHFs. LEVEL OF EVIDENCE: IV, retrospective cohort study.

Evaluation of the external fixator TrueLok Hexapod System for tibial deformity correction in children.

BACKGROUND: Tibial deformities are common in paediatric orthopaedic practice. Correcting multiplanar tibial deformities associated with lower limb length discrepancy can be challenging. Hexapod external fixation with gradual correction has been proven effective in this situation. OBJECTIVE: To assess clinical and radiological outcomes of gradual tibial deformity correction using the external fixator TL-HEX™ (Orthofix) in children. HYPOTHESIS: TL-HEX™ is effective in correcting tibial deformities in children. PATIENTS AND METHODS: This multicentre retrospective study collected data from the medical files of 26 patients with 31 tibial deformities treated by gradual correction using TL-HEX™. The tibial deformities were due to congenital defects in 11 (35%) cases, Blount's disease in 9 (29%) cases, pseudo-achondroplasia in 4 (13%) cases, and other causes in 7 (23%) cases. Mean age at surgery was 11.9 years. In each patient, antero-posterior long leg radiographs obtained pre-operatively and at last follow-up were used to measure parameters including the mechanical axis deviation (MAD), medial proximal tibia angle (MPTA), and leg length discrepancy (LLD). RESULTS: The mean healing index was 39.3 days/cm (range, 32-58 days/cm). The overall complication rate was 61%, with 11 unplanned visits. Superficial pin tract infection was the most common complication. Significant decreases between the pre-operative and post-operative assessments occurred in mean MAD (from 32.1mm to 10.2mm, P<0.001) and mean LLD (from 36.8mm to 9.1mm, P<0.001). Patients who underwent proximal tibial osteotomy had a significant improvement in MPTA, from 80.6° to 88.5° (P=0.006). DISCUSSION: This is the first clinical study specifically designed to assess outcomes of TL-HEX™ limb lengthening and deformity correction. MAD, MPTA, and LLD were significantly improved at last follow-up. MAD was greater than 10mm at last follow-up in only 11patients. The complication rate was similar to those reported with other external fixators. TL-HEX™ is effective in the management of tibial deformities in children. LEVEL OF EVIDENCE: IV (retrospective study).

Correction of axial deformity during lengthening in fibular hypoplasia: Hexapodal versus monorail external fixation.

INTRODUCTION: Childhood fibular hypoplasia is a rare pathology which may or may not involve limb-length discrepancy and axial deformity in one or more dimensions. The objective of the present study was to compare the quality of the axial correction achieved in lengthening procedures by hexapodal versus monorail external fixators. The hypothesis was that the hexapodal fixator provides more precise correction. MATERIAL AND METHODS: A retrospective multicenter study included 52 children with fibular hypoplasia. Seventy-two tibias were analyzed, in 2 groups: 52 using a hexapodal fixator, and 20 using a monorail fixator. Mean age was 10.2 years. Mean lengthening was 5.7cm. Deformities were analyzed and measured in 3 dimensions and classified in 4 preoperative types and 4 post-lengthening types according to residual deformity. RESULTS: Complete correction was achieved in 26 tibias in the hexapodal group (50%) and 2 tibias in the monorail group (10%). Mean post-correction mechanical axis deviation was smaller in the hexapodal group: 12.83mm, versus 14.29mm in the monorail group. Mean post-correction mechanical lateral distal femoral angle was 87.5° in the hexapodal group, versus 84.3° in the monorail group (P=0.002), and mean mechanical medial proximal tibial angle 86.9° versus 89.5°, respectively (P=0.015). DISCUSSION: No previous studies focused on this congenital pathology in lengthening and axial correction programs for childhood lower-limb deformity. The present study found the hexapodal fixator to be more effective in conserving or restoring mechanical axes during progressive bone lengthening for fibular hypoplasia. CONCLUSION: The hexapodal fixator met the requirements of limb-length equalization in childhood congenital lower-limb hypoplasia, providing better axial correction than the monorail fixator. LEVEL OF EVIDENCE: IV.

Effect of feeding strategy on environmental impacts of pig fattening in different contexts of production: evaluation through life cycle assessment.

Life cycle assessment (LCA) has been used in many studies to evaluate the effect of feeding strategy on the environmental impact of pig production. However, because most studies have been conducted in European conditions, the question of possible interactions with the context of production is still under debate. The objective of this study was to evaluate these effects in 2 contrasted geographic contexts of production, South America (Brazil) and Europe (France). The LCA considered the process of pig fattening, including production and transport of feed ingredients and feed, raising of fattening pigs, and manure storage, transport, and spreading. Impacts were calculated at the farm gate, and the functional unit considered was 1 kg of BW gain over the fattening period. The performances of pigs were simulated for each scenario using the InraPorc population model (2,000 pigs per scenario considering between-animal variability). The LCA calculations were performed for each pig according to its own performance and excretion, and the results were subjected to variance analysis. The results indicate that for some impacts there are clear interactions between the effects of the feeding program, the origin of soybean, and the location of production. For climate change, interest in phase feeding and incorporation of crystalline AA (CAA) is limited and even counterproductive in Brazil with soybeans from the South (without deforestation), whereas they appear to be efficient strategies with soybeans from the Center West (with deforestation), especially in France. Rather similar effects, as those for climate change, were observed for cumulative energy demand. Conversely, potential eutrophication and acidification impacts were reduced by phase feeding and CAA addition in a rather similar way in all situations. Individual daily feeding, the only strategy that took into account between-animal variability, was the most effective approach for reducing the life cycle impact of pig fattening in all situations, whereas the potential of phase feeding programs and CAA was dependent on soybean origin and the geographical context of pig production, in contrast with previous results.

[Clubfoot treatment: Implementation of the Ponseti method in emerging countries]. / Traitement du pied bot varus équin idiopathique Mise en place de la méthode Ponseti dans un pays émergent.

Idiopathic clubfoot is one of the most frequent congenital deformities throughout the world. The Ponseti method is the gold standard for its treatment. This simple, low-cost method is very effective and very appropriate for countries with resource-limited or otherwise precarious health services. It is based on correction of the deformity by successive castings associated with a percutaneous Achilles tenotomy and then foot abduction bracing to maintain the correction. The Ponseti method is now well implemented in most emerging countries, largely due to internet development, but some barriers still limit its diffusion. This study aims to determine the principal barriers, to suggest some improvements, and to stress the essential points of its effective utilization by non-physicians.

Transplantar intramedullary locking nailing in childhood congenital pseudarthrosis of the tibia: A report of 3 cases.

The treatment objectives in congenital pseudarthrosis of the tibia are bone consolidation and a restored lower-limb axis. They are difficult to achieve, and various surgical techniques have been described, with varying results in terms of bone consolidation and complications. The present study reports clinical and radiographic results in 3 patients managed by the same original technique of transplantar intramedullary nailing using a custom-made proximal locking nail, without surgical approach or resection of the pseudarthrosis site. Good assembly stability allowed immediate weight-bearing. The technique is relatively noninvasive, offering a first-line alternative in under-3 year-olds.

Modeling of intramuscular lipids in different muscles in bulls, steers, and cows.

Intramuscular fat depot is of major interest for consumers, producers, and the industry. To predict intramuscular (i.m.) lipid deposition in cattle of continental breeds, different models were constructed for different muscles in bulls, steers, and cows. Two independent databases (DB1 and DB2) were developed with homogeneous individual data collected in the same slaughterhouse and total lipids, phospholipids, and triglycerides were analyzed in the same lab with the same procedures. Database DB1 was used with the meta-analysis methodology to fit the predictive models of i.m. lipids, phospholipids, and triglycerides with carcass fatness. Database DB2 was used to evaluate the accuracy of the models predicted. Total lipid and triglyceride contents varied linearly with carcass fatness in bulls, steers, and cows, but phospholipids were more independent of carcass fatness, regardless of the type of cattle studied. In bulls, LM had a lower minimal value (intercept in the model) and greater slope than semitendinosus (ST) and triceps brachii (TB) muscles. In cows, LM showed a greater intercept than ST and TB muscles but a similar slope. In steers, lipid content increased similarly in LM, rectus abdominis (RA) muscle, and ST muscle with carcass fatness. Bulls had a lower intercept than steers but showed a similar trend with carcass fatness. According to the external evaluation using DB2, the models obtained to predict total lipids in LM were more accurate than those obtained in the ST muscle in bulls and cows and in the RA muscle in steers. The models proposed for cows should be used only in the range of carcass fatness used to fit the equations, and further data are needed to fully validate them.

War-related extremity injuries in children: 89 cases managed in a combat support hospital in Afghanistan.

BACKGROUND: Meeting paediatric needs is among the priorities of western healthcare providers working in Afghanistan. HYPOTHESIS: Insufficient information is available on paediatric wartime injuries to the extremities. Our objective here was to describe these injuries and their management on the field. MATERIALS AND METHODS: We retrospectively reviewed consecutive cases of injuries to the extremities in children (< 16 years of age) due to weapons and managed at the Kabul International Airport (KaIA) Combat Support Hospital between June 2009 and April 2013. We identified 89 patients with a mean age of 10.2 ± 3.5 years and a total of 137 elemental lesions. RESULTS: Explosive devices accounted for most injuries (78.6%) and carried a significantly higher risk of multiple lesions. There were 54 bone lesions (traumatic amputations and fractures) and 83 soft-tissue lesions. The amputation rate was 18%. Presence of bone lesions was associated with a higher risk of injury to blood vessels and nerves. Of the 89 patients, four (4.5%) died and eight (9%) were transferred elsewhere. Of the 77 remaining patients, at last follow-up (median, one month; range, 0.1-16 months), 73 (95%) had achieved a full recovery (healed wound and/or fracture) or were recovering with no expectation that further surgery would be needed. DISCUSSION: Despite the absence of paediatric surgeons, the combat support hospital provided appropriate care at the limb salvage and reconstruction phases. The highly specialised treatments needed to manage sequelae were very rarely provided. These treatments probably deserve to be developed in combat support hospitals.

Sports-related overuse injuries in children.

Increased intensity of sports activities combined with a decrease in daily physical activity is making overuse injuries in children more common. These injuries are located mainly in the epiphyseal cartilage. The broad term for these injuries is osteochondrosis, rather than osteochondritis, which more specifically refers to inflammatory conditions of bone and cartilage. The osteochondrosis may be epiphyseal, physeal, or apophyseal, depending on the affected site. The condition can either be in the primary deformans form or the dissecans form. While there is no consensus on the etiology of osteochondrosis, multiple factors seem to be involved: vascular, traumatic, or even microtraumatic factors. Most overuse injuries involve the lower limbs, especially the knees, ankle and feet. The most typical are Osgood-Schlatter disease and Sever's disease; in both conditions, the tendons remain relatively short during the pubescent grown spurt. The main treatment for these injuries is temporary suspension of athletic activities, combined with physical therapy in many cases. Surgery may be performed if conservative treatment fails. It is best, however, to try to prevent these injuries by analyzing and correcting problems with sports equipment, lifestyle habits, training intensity and the child's level of physical activity, and by avoiding premature specialization. Pain in children during sports should not be considered normal. It is a warning sign of overtraining, which may require the activity to be modified, reduced or even discontinued.

Rangeland Rummy - a board game to support adaptive management of rangeland-based livestock systems.

Rangeland-based livestock systems have to deal with the significant instability and uncertainty of the agricultural context (policy changes, volatility of input prices, etc.), and especially of the climatic context. Thus, they are particularly concerned by adaptive management strategies. To support the development of such strategies, we developed a board game including a computer model called "Rangeland Rummy". It is to be used by groups of farmers and agricultural consultants in the context of short workshops (about 3 h). Rangeland Rummy builds upon five types of material object: (i) a game board; (ii) a calendar stick indicating the starting date of the game board; (iii) sticks marked with the feed resources available for combinations of vegetation types and their management practices; (iv) cards to define animal groups and their feeding requirements throughout the year; (v) cards related to types of feed that can be attributed to animal groups throughout the year. Using these material objects, farmers collectively design a rangeland-based livestock system. This system is immediately evaluated using a computer model, i.e. a spreadsheet providing graphs and indicators providing information on, among other things, the extent to which quantitative and qualitative animal feeding requirements are covered across the year. Playing the game thus consists in collectively and iteratively designing and evaluating rangeland-based livestock systems, while confronting the players with new contextual challenges (e.g. interannual variability of weather, volatility of input prices) or new farmers' objectives (e.g. being self-sufficient for animal feeding). An example of application of Rangeland Rummy with 3 farmers in southern France is reported. Applications show that it tends to develop farmers' adaptive capacity by stimulating their discussions and the exchange of locally-relevant knowledge on management strategies and practices in rangeland-based livestock systems.

[OVERUSE INJURIES IN THE YOUNG ATHLETE]. / Lésions osseuses de sollicitation excessive chez l'enfant sportif.

Sport injuries are common in children and teenaggers, especially overuse injuries. Typical musculoskelotal disorders include apophyseal pains or avulsion, stess fractures, and also epiphyseal ostoochondritis. Some lesions are specific according the practice, such spine or wrist lesions. Prevention of sport injury should be the main priority as well for the parents than the coaches and children themselves. Proper education and preparation, specific training and streching are essential for all sports activities.

"Femoroacetabular impingement". Legg-Calve-Perthes disease: from childhood to adulthood.

OBJECTIVES: The objective of this study was to investigate cases of femoroacetabular impingement (FAI) and analyze the risk factors for a painful hip at skeletal maturity after Perthes disease. We hypothesized that FAI occurs as a sequela of Perthes disease and that coxa plana and triple osteotomy of the pelvis (TOP) may be risk factors. METHODS: Ninety-five hips were included from 1981 to 2011, 56 of which were operated on with TOP (53) or shelf acetabuloplasty (3). The results were evaluated at a mean 13years of follow-up (range, 2-23years) with Oxford score and hip radiograph analysis including the Stulberg grade, coxometry, and presence of a femoral bump. FAI was characterized by positional hip pain with preserved joint space and aspherical/nonspherical femoral head. RESULTS: The Oxford score was optimal (12) in 79 hips (75%) and 20 or above in nine hips (9.5%). Seventeen hips were rated Stulberg I (18%), 36 Stulberg II (38%), 27 Stulberg III (28%), and 15 Stulberg IV or V (16%). The average acetabular angle was 10° (range, -4 to 25), VCE 41.5° (range, 18-80), and VCA 38.5° (range, 13-70). A femoral bump was noted in 31 hips (33%). Five cases of FAI were managed operatively with at least pain relief. Hip pain at the latest follow-up correlated with coxa plana (P=0.0003) and femoral bump (P=0.007). No significant correlation was found with a history of hip surgery or coxometry parameters. CONCLUSION: Perthes hips bear risk for later FAI. Risk factors include coxa plana and femoral bump. In case of TOP, it is advocated to avoid excessive tilt, which may cause FAI. LEVEL OF EVIDENCE: IV.

Proximal migration of fibular malleolus during tibial lengthening despite syndesmotic screw fixation: a series of 22 cases.

INTRODUCTION: During tibial lengthening procedures, it is recommended to prevent fibular malleolus proximal migration using a distal tibiofibular syndesmotic screw, which is removed at 6 months. We have observed proximal migrations of the fibular malleolus despite placement of this syndesmotic screw. OBJECTIVE: The objective of this study was to demonstrate this migration and to study the influence of two factors that may favor its occurrence: positioning of the syndesmotic screw and union of the fibula at the time of removal. HYPOTHESIS: An unhealed fibula at the time the distal tibiofibular syndesmotic screw is removed and its tricortical position promote the proximal migration of the fibular malleolus. MATERIAL AND METHODS: This was a retrospective, single-center, analytical study that included 22 lengthening procedures in 18 patients from 5 to 17 years of age who had undergone tibial lengthening and presented a preoperative continuous fibula. The position of the fibular malleolus, union of the fibula, and the tri- or quadricortical position of the screw were assessed based on four successive x-rays. RESULTS: Tricortical positioning of the syndesmotic screw was significantly associated with proximal migration of the fibular malleolus during lengthening (P=0.0248<0.05). However, there was no significant relation between an unhealed fibula and proximal migration of the fibular malleolus when the screw was removed (P=0.164>0.05). DISCUSSION: Proximal migration of the fibular malleolus during lengthening is promoted by placing a non-quadricortical syndesmotic screw. Quadricortical positioning of the screw should be recommended. Migration of the fibular malleolus after ablation of the syndesmotic screw seems to be related to absence of fibular union but this series was too small to demonstrate this clearly. LEVEL OF EVIDENCE: Level IV: Retrospective study.

Impact of animal and management factors on collagen characteristics in beef: a meta-analysis approach.

The aim of this paper was to identify pre-slaughter factors that modify total and insoluble collagen contents in bovine muscle to construct a model of collagen dynamics. The meta-analyses were performed with primary data of total (n = 1165) and insoluble (n = 1145) collagen contents from INRA experiments obtained from different muscles in young bulls, cows and steers. According to both the bibliography and meta-analyses, total collagen content and solubility were greatly affected by the muscle (type). Moreover, the pattern of the evolution of collagen characteristics was similar among Longissimus, Semitendinosus and Triceps brachii muscles in young bulls. In cows, collagen contents in the Triceps brachii muscle had delayed dynamics compared with the other muscles. Collagen characteristics differed among breeds because of variation in the maturity of the breed. Similarly, according to the meta-analyses, total and insoluble collagen content evolutions with the degree of maturity (DOM; proportion of adult weight reached at slaughter) were different in dairy and rustic breeds from those of beef breeds, especially in bulls. Although the relationships between collagen content and DOM were quantified in different muscles and sexes, the precision of the fitted equations was not sufficient for prediction. Consequently, relying on the hypotheses raised by the meta-analysis and the literature, an approach to further develop a dynamic mechanistic model of soluble and insoluble collagen content is proposed.

Effect of farming practices for greenhouse gas mitigation and subsequent alternative land use on environmental impacts of beef cattle production systems.

This study evaluated effects of farming practice scenarios aiming to reduce greenhouse gas (GHG) emissions and subsequent alternative land use on environmental impacts of a beef cattle production system using the life cycle assessment approach. The baseline scenario includes a standard cow-calf herd with finishing heifers based on grazing, and a standard bull-fattening herd using a diet mainly based on maize silage, corresponding to current farm characteristics and management by beef farmers in France. Alternative scenarios were developed with changes in farming practices. Some scenarios modified grassland management (S1: decreasing mineral N fertiliser on permanent grassland; S2: decreasing grass losses during grazing) or herd management (S3: underfeeding of heifers in winter; S4: fattening female calves instead of being reared at a moderate growth rate; S5: increasing longevity of cows from 7 to 9 years; S6: advancing first calving age from 3 to 2 years). Other scenarios replaced protein sources (S7: partially replacing a protein supplement by lucerne hay for the cow-calf herd; S8: replacing soya bean meal with rapeseed meal for the fattening herd) or increased n-3 fatty acid content using extruded linseed (S9). The combination of compatible scenarios S1, S2, S5, S6 and S8 was also studied (S10). The impacts, such as climate change (CC, not including CO2 emissions/sequestration of land use and land-use change, LULUC), CC/LULUC (including CO2 emissions of LULUC), cumulative energy demand, eutrophication (EP), acidification and land occupation (LO) were expressed per kg of carcass mass and per ha of land occupied. Compared with the baseline, the most promising practice to reduce impacts per kg carcass mass was S10 (all reduced by 13% to 28%), followed by S6 (by 8% to 10%). For other scenarios, impact reduction did not exceed 5%, except for EP (up to 11%) and LO (up to 10%). Effects of changes in farming practices (the scenarios) on environmental impacts varied according to impact category and functional unit. For some scenarios (S2, S4, S6 and S10), permanent grassland area and LO per kg of carcass decreased by 12% to 23% and 9% to 19%, respectively. If the 'excess' permanent grassland was converted to fast-growing conifer forest to sequester carbon in tree and soil biomass, CC/LULUC per kg of carcass could be reduced by 20%, 25%, 27% and 48% for scenarios S2, S4, S6 and S10, respectively. These results illustrate the potential of farming practices and forest as an alternative land use to contribute to short- and mid-term GHG mitigation of beef cattle production systems.

Fracture following lower limb lengthening in children: a series of 58 patients.

INTRODUCTION: Fracture is one of the main complications following external fixator removal used in cases of progressive lower limb lengthening; rates as high as 50% are found in the literature. The aim of this study was to determine the factors influencing this complication. MATERIALS AND METHODS: One hundred and eleven cases of lower limb lengthening were performed in 58 patients (40 femurs and 71 tibias). The mean age at surgery was 10.1years old. Lengthening was performed in all cases with an external fixator alone, associated in 39.6% of cases with intramedullary nailing. The patients were divided into three groups according to disease etiology (congenital, achondroplasia and other). The fractures were classified according to the Simpson classification. RESULTS: Twenty fractures were recorded (18%). Sixteen fractures were found in patients with congenital disease, four with achondroplasia and none in the group of other etiologies. The fracture was more often in the femur (27.5%) than in the tibia (12.7%). DISCUSSION: The rate of fracture is influenced by different factors depending on the etiology of disease. In congenital diseases, the fracture rate is higher when there is lengthening of more than 15% of the initial length and a delay between surgery and the beginning of lengthening of less than 7days. In patients with achondroplasia, the influence of a relative percentage of lengthening is less important than in those with congenital disease. However, to avoid fractures, lengthening should not be started in children under the age of nine. Moreover, lengthening should begin at least 7days after the fixator has been placed. TYPE OF STUDY: Retrospective. LEVEL OF EVIDENCE: Level IV.

Teleconsultation in paediatric orthopaedics in Djibouti: evaluation of response performance.

BACKGROUND: Djibouti has no paediatric orthopaedics department and three options are available for difficult cases: transfer of the patient to another country; overseas mission transfer to Djibouti by a specialised surgical team; and management by a local orthopaedic surgeon receiving guidance from an expert. The extreme poverty of part of the population of Djibouti often precludes the first two options. Telemedecine can allow the local orthopaedic surgeon to receive expert advice. HYPOTHESES AND STUDY DESIGN: We prospectively recorded all the paediatric orthopaedics teleconsultations that occurred between November 2009 and November 2011. Our objective was to assess the performance of the teleconsultations. We hypothetized that this option was influential in decision making. MATERIALS AND METHODS: We assessed the influence of the teleconsultation on patient management (i.e., change in the surgical indication and/or procedure). We then used the electronic patient records to compare the actual management to that recommended retrospectively by two independent orthopaedic surgeon consultants who had experience working overseas. Finally, we assessed the clinical outcomes in the patients. RESULTS: Of 48 teleconsultations for 39 patients, 13 dealt with diagnostic problems and 35 with therapeutic problems. The teleconsultation resolved the diagnostic uncertainties in 90% of cases. Advice from the expert modified the management in 37 (77%) teleconsultations; the change was related to the surgical indication in 18 cases, the surgical technique in 13 cases, and both in six cases. Agreement between the advice from the independent consultants and the treatment delivered by the local surgeon was 2.2/3. Clinical outcomes were good or very good in 31 (81%) of the 38 treated patients. CONCLUSIONS: This study establishes the feasibility and usefulness of paediatric orthopaedics teleconsultations in Djibouti. The introduction of telemedicine has changed our approach to challenges raised by patients in remote locations or precarious situations. Input from experts considerably benefits patient management. LEVEL OF EVIDENCE: III, prospective comparative study.