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Background Intraoperative manipulation of the craniocervical junction with the Cervical Management Base Unit (CMBU) has been used as an adjunct for achieving optimal anatomic alignment during instrumented fusion procedures in a variety of disease settings. Here, we present our experience using the CMBU as a supplement to achieving a successful reduction and fixation of a reducible craniocervical subluxation with associated basilar impression/medullary compression in the setting of Grisel syndrome. Case Description Under fluoroscopy and neuromonitoring guidance, the elevator and axial translation mechanisms of the CMBU safely allowed for presurgical assessment of reducibility and facilitated complete reduction of the deformity with restitution of a normal atlantodental interval, spinolaminar line, and clivoaxial angle. Magnetic resonance imaging acquired 1 month after surgery and antibiotic therapy showed resolution of a large epidural abscess in the region of the dens and no evidence of residual neural impingement. Upright plain films at 9 months showed maintenance of the desired craniocervical alignment. Conclusions Intraoperative manipulation of the craniocervical junction using the CMBU, when implemented under fluoroscopy and neuromonitoring, can safely facilitate an enduring anatomic correction of craniocervical deformity in the setting of Grisel syndrome. The dynamic utility of the CMBU for translation of the head and neck obviated the need to apply forces directly to hardware-bone interfaces, and its utility may extend to craniocervical disorders of other etiologies, especially those of a reducible nature and in the setting of poor bone quality and joint laxity.

OBJECTIVES: Proactive Health is a comprehensive study on consumer perception of added functionality in food and beverages, and ingredient preferences linked with specific perceived functional benefits. We wanted to more deeply understand consumer acceptance, knowledge and expectation from added functionality and functional ingredients. In particular, we asked questions to understand preference for certain ingredients and how these vary across different functional benefits. This study aligns sought on uncover rational for why consumers add nutrition functionality and proactive health. Our research focused on how consumer perceptions can inform the food and beverage industry and influence future innovation in food and beverages. METHODS: The study is based on 965 US consumers, conducted in 2019 with the goal to understand and determine consumer expectation and importance of functional benefits derived from food and beverages. The study included consumers across gender, age groups, and ethnicities, uncovering specific preferences of functional benefits, and corresponding functional ingredients. The research was conducted across health conscious consumers in the US, who always pay attention to on pack details and claims, read the ingredient deck, as well as the nutritional panel. A quantitative online research study was conducted to estimate specific consumer preferences of 85 different ingredients across various functional benefits were surveyed in addition to specifics on various food and beverages category insights as it pertains to added functionality. All differences across age, gender, ethnicities and life stages highlighted in the research are at a 95% significant difference level. RESULTS: In this study we found that 67% of Americans are proactive with their health and 57% are trying to manage their diet via a healthy diet. Gen Z and Older Millennials are the most proactive with their Health (76% and 72%, respectively). Sleep stress and energy are the most common types of health priorities for proactive health consumers (51%, 50%, and 40%, respectively). However, proactive consumers priorities change toward cardiovascular health while eating out. Dietary supplements and medication are used extensively to help consumers meet their goals, but supplements are much more likely used for weight control (65%). Foods commonly used for proactive health were nutritional beverages (55%), yogurts (52%) and proteins powders (50%). CONCLUSIONS: The past decade has witnessed a dramatic increase in consumer proactivity with regards to their health. Consumer management of personal health is no longer limited to periodic medical checkups, prescription medication, or dietary supplements alone. The results of this study can better help us identify which methods consumers use to proactively improve health, and allow nutrition practitioners to formulate solutions that match consumer demand. FUNDING SOURCES: Kerry, Inc. SUPPORTING TABLES, IMAGES AND/OR GRAPHS