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1.
BMC Biol ; 22(1): 91, 2024 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-38654271

RESUMO

BACKGROUND: Elephant seals exhibit extreme hypoxemic tolerance derived from repetitive hypoxia/reoxygenation episodes they experience during diving bouts. Real-time assessment of the molecular changes underlying protection against hypoxic injury in seals remains restricted by their at-sea inaccessibility. Hence, we developed a proliferative arterial endothelial cell culture model from elephant seals and used RNA-seq, functional assays, and confocal microscopy to assess the molecular response to prolonged hypoxia. RESULTS: Seal and human endothelial cells exposed to 1% O2 for up to 6 h respond differently to acute and prolonged hypoxia. Seal cells decouple stabilization of the hypoxia-sensitive transcriptional regulator HIF-1α from angiogenic signaling. Rapid upregulation of genes involved in glutathione (GSH) metabolism supports the maintenance of GSH pools, and intracellular succinate increases in seal but not human cells. High maximal and spare respiratory capacity in seal cells after hypoxia exposure occurs in concert with increasing mitochondrial branch length and independent from major changes in extracellular acidification rate, suggesting that seal cells recover oxidative metabolism without significant glycolytic dependency after hypoxia exposure. CONCLUSIONS: We found that the glutathione antioxidant system is upregulated in seal endothelial cells during hypoxia, while this system remains static in comparable human cells. Furthermore, we found that in contrast to human cells, hypoxia exposure rapidly activates HIF-1 in seal cells, but this response is decoupled from the canonical angiogenesis pathway. These results highlight the unique mechanisms that confer extraordinary tolerance to limited oxygen availability in a champion diving mammal.


Assuntos
Antioxidantes , Células Endoteliais , Focas Verdadeiras , Transdução de Sinais , Regulação para Cima , Animais , Focas Verdadeiras/fisiologia , Focas Verdadeiras/metabolismo , Células Endoteliais/metabolismo , Células Endoteliais/efeitos dos fármacos , Antioxidantes/metabolismo , Humanos , Hipóxia/metabolismo , Hipóxia Celular , Neovascularização Fisiológica/efeitos dos fármacos , Neovascularização Fisiológica/fisiologia , Células Cultivadas , Glutationa/metabolismo , Subunidade alfa do Fator 1 Induzível por Hipóxia/metabolismo , Subunidade alfa do Fator 1 Induzível por Hipóxia/genética
2.
J Hered ; 115(1): 139-148, 2024 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-37712349

RESUMO

The Yuma myotis bat (Myotis yumanensis) is a small vespertilionid bat and one of 52 species of new world Myotis bats in the subgenus Pizonyx. While M. yumanensis populations currently appear relatively stable, it is one of 12 bat species known or suspected to be susceptible to white-nose syndrome, the fungal disease causing declines in bat populations across North America. Only two of these 12 species have genome resources available, which limits the ability of resource managers to use genomic techniques to track the responses of bat populations to white-nose syndrome generally. Here we present the first de novo genome assembly for Yuma myotis, generated as a part of the California Conservation Genomics Project. The M. yumanensis genome was generated using a combination of PacBio HiFi long reads and Omni-C chromatin-proximity sequencing technology. This high-quality genome is one of the most complete bat assemblies available, with a contig N50 of 28.03 Mb, scaffold N50 of 99.14 Mb, and BUSCO completeness score of 93.7%. The Yuma myotis genome provides a high-quality resource that will aid in comparative genomic and evolutionary studies, as well as inform conservation management related to white-nose syndrome.


Assuntos
Quirópteros , Animais , Quirópteros/genética , América do Norte , Genoma , Genômica , Evolução Biológica
3.
Trends Genet ; 39(11): 830-843, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37714733

RESUMO

Aging is a nearly inescapable trait among organisms yet lifespan varies tremendously across different species and spans several orders of magnitude in vertebrates alone. This vast phenotypic diversity is driven by distinct evolutionary trajectories and tradeoffs that are reflected in patterns of diversification and constraint in organismal genomes. Age-specific impacts of selection also shape allele frequencies in populations, thus impacting disease susceptibility and environment-specific mortality risk. Further, the mutational processes that spawn this genetic diversity in both germline and somatic cells are strongly influenced by age and life history. We discuss recent advances in our understanding of the evolution of aging and lifespan at organismal, population, and cellular scales, and highlight outstanding questions that remain unanswered.

4.
Fish Physiol Biochem ; 2023 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-37733196

RESUMO

Aquaculture routine practices may cause stress induction on the fish and compromise their welfare affecting the production. This experiment aimed to evaluate the potential links between handling during culture with stress responses and growth on Senegalese sole (Solea senegalensis). We worked with two fish cohorts in terms of initial body weight and culture stage: Trial 1 included specimens in the fattening stage (226 ± 4.96 g) and Trial 2 animals in the pre-fattening stage (27.20 ± 0.44 g). The tested culture protocol, which lasted 6 and 4 months for Trial 1 and 2, respectively, mainly reduced handling-derived stressors in the experimental tanks via lowering routine samplings to a minimum. This decrease of the handling-derived stress was reflected in both trials with lower concentration of circulating cortisol in blood plasma from the experimental fish when compared to controls. Moreover, the proposed protocol promoted higher growth in the fish cultured in the less disturbing protocol in Trial 2. Higher specific growth rates and mean body weight and length were reported. In order to further explore the potential beneficial effects of our protocol, we studied the musculoskeletal from Trial 2 gene expression of key genes regulating glucocorticoid signaling pathway and apoptosis: glucocorticoid receptors 1 and 2 (gr1, gr2), heat shock protein 90 AA (hsp90aa), and caspase 6 (casp6). In line with the cortisol reduced level in this trial, gr1, hsp90aa, and casp6 genes showed lower expression in the samples coming from the experimental group. The findings of this study provide valuable information to the aquaculture industry for the management of Solea senegalensis stress and welfare.

5.
bioRxiv ; 2023 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-37461722

RESUMO

Elephant seals experience extreme hypoxemia during diving bouts. Similar depletions in oxygen availability characterize pathologies including myocardial infarction and ischemic stroke in humans, but seals manage these repeated episodes without injury. However, the real-time assessment of the molecular changes underlying protection against hypoxic injury in seals remains restricted by their at-sea inaccessibility. Hence, we developed a proliferative arterial endothelial cell culture system to assess the molecular response to prolonged hypoxia. Seal and human cells exposed to 1% O 2 for up to 6 h demonstrated differential responses to both acute and prolonged hypoxia. Seal cells decouple stabilization of the hypoxia-sensitive transcriptional regulator HIF-1α from angiogenic signaling at both the transcriptional and cellular level. Rapid upregulation of genes involved in the glutathione (GSH) metabolism pathway supported maintenance of GSH pools and increases in intracellular succinate in seal but not human cells during hypoxia exposure. High maximal and spare respiratory capacity in seal cells after hypoxia exposure occurred in concert with increasing mitochondrial branch length and independent from major changes in extracellular acidification rate, suggesting seal cells recover oxidative metabolism without significant glycolytic dependency after hypoxia exposure. In sum, our studies show that in contrast to human cells, seal cells adapt to hypoxia exposure by dampening angiogenic signaling, increasing antioxidant protection, and maintaining mitochondrial morphological integrity and function.

6.
Elife ; 122023 06 21.
Artigo em Inglês | MEDLINE | ID: mdl-37342968

RESUMO

Simulation is a key tool in population genetics for both methods development and empirical research, but producing simulations that recapitulate the main features of genomic datasets remains a major obstacle. Today, more realistic simulations are possible thanks to large increases in the quantity and quality of available genetic data, and the sophistication of inference and simulation software. However, implementing these simulations still requires substantial time and specialized knowledge. These challenges are especially pronounced for simulating genomes for species that are not well-studied, since it is not always clear what information is required to produce simulations with a level of realism sufficient to confidently answer a given question. The community-developed framework stdpopsim seeks to lower this barrier by facilitating the simulation of complex population genetic models using up-to-date information. The initial version of stdpopsim focused on establishing this framework using six well-characterized model species (Adrion et al., 2020). Here, we report on major improvements made in the new release of stdpopsim (version 0.2), which includes a significant expansion of the species catalog and substantial additions to simulation capabilities. Features added to improve the realism of the simulated genomes include non-crossover recombination and provision of species-specific genomic annotations. Through community-driven efforts, we expanded the number of species in the catalog more than threefold and broadened coverage across the tree of life. During the process of expanding the catalog, we have identified common sticking points and developed the best practices for setting up genome-scale simulations. We describe the input data required for generating a realistic simulation, suggest good practices for obtaining the relevant information from the literature, and discuss common pitfalls and major considerations. These improvements to stdpopsim aim to further promote the use of realistic whole-genome population genetic simulations, especially in non-model organisms, making them available, transparent, and accessible to everyone.


Assuntos
Genoma , Software , Simulação por Computador , Genética Populacional , Genômica
7.
BMC Biol ; 21(1): 70, 2023 04 03.
Artigo em Inglês | MEDLINE | ID: mdl-37013516

RESUMO

BACKGROUND: Chronic stress can produce a severe negative impact on health not only in the exposed individuals but also in their offspring. Indeed, chronic stress may be contributing to the current worldwide scenario of increasing infertility and decreasing gamete quality in human populations. Here, we evaluate the effect of chronic stress on behavior and male reproductive parameters in zebrafish. Our goal is to provide information on the impact that chronic stress has at molecular, histological, and physiological level in a vertebrate model species. RESULTS: We evaluated the effects of a 21-day chronic stress protocol covering around three full waves of spermatogenesis in Danio rerio adult males. The induction of chronic stress produced anxiety-like behavior in stressed males as assessed by a novel tank test. At a molecular level, the induction of chronic stress consistently resulted in the overexpression of two genes related to endoplasmic reticulum (ER) stress in the brain. Gene set enrichment analysis (GSEA) of testes suggested a dysregulation of the nonsense-mediated decay (NMD) pathway, which was also confirmed on qPCR analysis. Histological analysis of the testicle did not show significant differences in terms of the relative proportions of each germ-cell type; however, the quality of sperm from stressed males was compromised in terms of motility. RNA-seq analysis in stress-derived larval progenies revealed molecular alterations, including those predicted to affect translation initiation, DNA repair, cell cycle control, and response to stress. CONCLUSIONS: Induction of chronic stress during a few cycles of spermatogenesis in the vertebrate zebrafish model affects behavior, gonadal gene expression, final gamete quality, and progeny. The NMD surveillance pathway (a key cellular mechanism that regulates the stability of both normal and mutant transcripts) is severely affected in the testes by chronic stress and therefore the control and regulation of RNAs during spermatogenesis may be affected altering the molecular status in the progeny.


Assuntos
Sêmen , Peixe-Zebra , Animais , Masculino , Humanos , Peixe-Zebra/genética , Espermatozoides/metabolismo , Testículo/metabolismo , Espermatogênese
8.
Elife ; 112022 12 08.
Artigo em Inglês | MEDLINE | ID: mdl-36480266

RESUMO

The risk of developing cancer is correlated with body size and lifespan within species, but there is no correlation between cancer and either body size or lifespan between species indicating that large, long-lived species have evolved enhanced cancer protection mechanisms. Previously we showed that several large bodied Afrotherian lineages evolved reduced intrinsic cancer risk, particularly elephants and their extinct relatives (Proboscideans), coincident with pervasive duplication of tumor suppressor genes (Vazquez and Lynch, 2021). Unexpectedly, we also found that Xenarthrans (sloths, armadillos, and anteaters) evolved very low intrinsic cancer risk. Here, we show that: (1) several Xenarthran lineages independently evolved large bodies, long lifespans, and reduced intrinsic cancer risk; (2) the reduced cancer risk in the stem lineages of Xenarthra and Pilosa coincided with bursts of tumor suppressor gene duplications; (3) cells from sloths proliferate extremely slowly while Xenarthran cells induce apoptosis at very low doses of DNA damaging agents; and (4) the prevalence of cancer is extremely low Xenarthrans, and cancer is nearly absent from armadillos. These data implicate the duplication of tumor suppressor genes in the evolution of remarkably large body sizes and decreased cancer risk in Xenarthrans and suggest they are a remarkably cancer-resistant group of mammals.


Assuntos
Elefantes , Neoplasias , Bichos-Preguiça , Xenarthra , Animais , Xenarthra/genética , Bichos-Preguiça/genética , Tatus/genética , Filogenia , Mamíferos/genética , Elefantes/genética , Genes Supressores de Tumor , Neoplasias/epidemiologia , Neoplasias/genética , Evolução Biológica
9.
Nat Commun ; 13(1): 5803, 2022 10 03.
Artigo em Inglês | MEDLINE | ID: mdl-36192477

RESUMO

Age is the primary risk factor for many common human diseases. Here, we quantify the relative contributions of genetics and aging to gene expression patterns across 27 tissues from 948 humans. We show that the predictive power of expression quantitative trait loci is impacted by age in many tissues. Jointly modelling the contributions of age and genetics to transcript level variation we find expression heritability (h2) is consistent among tissues while the contribution of aging varies by >20-fold with [Formula: see text] in 5 tissues. We find that while the force of purifying selection is stronger on genes expressed early versus late in life (Medawar's hypothesis), several highly proliferative tissues exhibit the opposite pattern. These non-Medawarian tissues exhibit high rates of cancer and age-of-expression-associated somatic mutations. In contrast, genes under genetic control are under relaxed constraint. Together, we demonstrate the distinct roles of aging and genetics on expression phenotypes.


Assuntos
Envelhecimento , Locos de Características Quantitativas , Envelhecimento/genética , Expressão Gênica , Regulação da Expressão Gênica , Humanos , Fenótipo , Locos de Características Quantitativas/genética
10.
Diagnostics (Basel) ; 12(2)2022 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-35204324

RESUMO

Flying on fighter aircraft is the only human activity that exposes the body to acceleration levels for long periods of time. In this sense, the regular exposure to G forces has been related to a high incidence of flight-related neck pain. The aim is to evaluate flight pilots of the Spanish Air Force (instructors vs. students) diagnosed with flight-related neck pain from a biopsychosocial perspective. Eighteen fighter pilots with flight-related neck pain were divided into two groups: instructor fighter pilots (n = 7) and student fighter pilots (n = 11). The Neck Disability Index (NDI), Cervical Range of Motion (CRoM), Pain Pressure Threshold (PPT), cervical repositioning error, and myoelectric activity were evaluated. Cervical flexion, extension and left and right rotation showed a reduced range of motion in both groups with respect to the normative values of the healthy population. There were no statistically significant differences between the groups (p ≥ 05). The correlational analysis showed a strong association between the NDI and CRoM of the left rotation (ß =-0.880, p = 0.002). The NDI also had a positive association with the pilot's age (ß = 1.353, p < 0.01) and the number of flight hours (ß = 0.805, p = 0.003). In conclusion, the Cervical Range of Motion at the left rotation seems to determine the perceived degree of disability in both the instructors and students. This factor could be influenced by the number of flight hours and accumulated experience as an F-5 fighter pilot.

11.
Science ; 374(6569): 842-847, 2021 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-34762458

RESUMO

Pacific Ocean rockfishes (genus Sebastes) exhibit extreme variation in life span, with some species being among the most long-lived extant vertebrates. We de novo assembled the genomes of 88 rockfish species and from these identified repeated signatures of positive selection in DNA repair pathways in long-lived taxa and 137 longevity-associated genes with direct effects on life span through insulin signaling and with pleiotropic effects through size and environmental adaptations. A genome-wide screen of structural variation reveals copy number expansions in the immune modulatory butyrophilin gene family in long-lived species. The evolution of different rockfish life histories is coupled to genetic diversity and reshapes the mutational spectrum driving segregating CpG→TpG variants in long-lived species. These analyses highlight the genetic innovations that underlie life history trait adaptations and, in turn, how they shape genomic diversity.


Assuntos
Evolução Biológica , Genoma , Longevidade/genética , Perciformes/genética , Perciformes/fisiologia , Animais , Butirofilinas/genética , Reparo do DNA/genética , Dosagem de Genes , Pleiotropia Genética , Especiação Genética , Variação Genética , Sequenciamento de Nucleotídeos em Larga Escala , Imunomodulação/genética , Características de História de Vida , Mutação , Oceano Pacífico , Filogenia , Seleção Genética , Sequenciamento Completo do Genoma
12.
Genome Biol Evol ; 13(12)2021 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-34792580

RESUMO

There are many costs associated with increased body size and longevity in animals, including the accumulation of genotoxic and cytotoxic damage that comes with having more cells and living longer. Yet, some species have overcome these barriers and have evolved remarkably large body sizes and long lifespans, sometimes within a narrow window of evolutionary time. Here, we demonstrate through phylogenetic comparative analysis that multiple turtle lineages, including Galapagos giant tortoises, concurrently evolved large bodies, long lifespans, and reduced cancer risk. We also show through comparative genomic analysis that Galapagos giant tortoises have gene duplications related to longevity and tumor suppression. To examine the molecular basis underlying increased body size and lifespan in turtles, we treated cell lines from multiple species, including Galapagos giant tortoises, with drugs that induce different types of cytotoxic stress. Our results indicate that turtle cells, in general, are resistant to oxidative stress related to aging, whereas Galapagos giant tortoise cells, specifically, are sensitive to endoplasmic reticulum stress, which may give this species an ability to mitigate the effects of cellular stress associated with increased body size and longevity.


Assuntos
Tartarugas , Animais , Tamanho Corporal/genética , Duplicação Gênica , Fenótipo , Filogenia , Tartarugas/genética
13.
Sci Rep ; 9(1): 11192, 2019 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-31371755

RESUMO

Nowadays a decrease tendency in human sperm quality has been reported mainly in developed countries. Reproductive technologies have been very valuable in achieving successful pregnancies with low quality sperm samples. However, considering that spermatozoa molecular contribution is increasingly important in recent studies, it is crucial to study whether fertilization with low sperm quality could leave a molecular mark on progeny. This study explores the consequences that fertilization with low sperm quality may have on progeny, using zebrafish as a model. Good and bad breeders were established attending to sperm quality analyses and were individually tracked. Significant differences in fertilization and malformation rates were obtained in progenies between high and low quality sperm samples. Moreover an altered miR profile was found in the progenies of bad zebrafish breeders (upregulation of miR-141 and miR -122 in 24 hpf embryos) and as a consequence, some of their targets involved in male sex development such as dmrt1, suffered downregulation. Our results indicate that fertilizing with high sperm quality samples becomes relevant from a new perspective: to avoid molecular alterations in the progeny that could remain masked and therefore produce unexpected consequences in it.


Assuntos
Anormalidades Congênitas/genética , Fertilização in vitro/normas , Fertilização/genética , MicroRNAs/metabolismo , Espermatozoides/metabolismo , Animais , Biomarcadores/análise , Biomarcadores/metabolismo , Modelos Animais de Doenças , Embrião não Mamífero , Feminino , Fertilização in vitro/efeitos adversos , Regulação da Expressão Gênica no Desenvolvimento , Humanos , Infertilidade/terapia , Masculino , MicroRNAs/análise , Análise do Sêmen/métodos , Análise do Sêmen/normas , Motilidade dos Espermatozoides/genética , Regulação para Cima , Peixe-Zebra , Proteínas de Peixe-Zebra/genética
14.
Reprod Fertil Dev ; 31(6): 1104-1115, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30944063

RESUMO

Senegalese sole (Solea senegalensis) is a species with a high commercial value that exhibits a reproductive dysfunction in males born and raised in captivity (F1) that hinders their sustainable culture. The present study evaluates the sperm quality and dopaminergic pathway of males born in the wild environment and of F1 males. Traditional sperm analyses were performed, finding only significant differences in curvilinear velocity (VCL) and no significant differences in viability and total motility. No differences in global sperm methylation were observed either in spermatozoa or brain between the two groups (F1 and wild-born males). However, our results point to a different sperm molecular signature between wild fish and fish born in captivity, specifically the differential expression in miR-let7-d and miR-200a-5p between these two groups. miR-let7-d has been correlated with spermatogenesis and sex preferences, whereas the miR-200 family is implied in target innervation of dopaminergic neurons in zebrafish. When we analysed the dopaminergic pathway, no differences were found in terms of different mRNA expression of dopaminergic markers. However, some differences were detected in terms of tyrosine hydroxylase protein expression by western blot analysis, thus suggesting an altered post-transcriptional regulation in F1 males. The results of this study suggest that an altered sperm miRNA signature in F1 males could be one possible mode of transmission of reproductive dysfunction to the progeny.


Assuntos
Dopamina/metabolismo , Reprodução/fisiologia , Espermatogênese/fisiologia , Espermatozoides/metabolismo , Animais , Metilação de DNA , Pesqueiros , Linguados , Regulação da Expressão Gênica , Masculino , MicroRNAs/genética , MicroRNAs/metabolismo , Proteômica
15.
Cell Rep ; 24(7): 1765-1776, 2018 08 14.
Artigo em Inglês | MEDLINE | ID: mdl-30110634

RESUMO

Large-bodied organisms have more cells that can potentially turn cancerous than small-bodied organisms, imposing an increased risk of developing cancer. This expectation predicts a positive correlation between body size and cancer risk; however, there is no correlation between body size and cancer risk across species ("Peto's paradox"). Here, we show that elephants and their extinct relatives (proboscideans) may have resolved Peto's paradox in part through refunctionalizing a leukemia inhibitory factor pseudogene (LIF6) with pro-apoptotic functions. LIF6 is transcriptionally upregulated by TP53 in response to DNA damage and translocates to the mitochondria where it induces apoptosis. Phylogenetic analyses of living and extinct proboscidean LIF6 genes indicates that its TP53 response element evolved coincident with the evolution of large body sizes in the proboscidean stem lineage. These results suggest that refunctionalizing of a pro-apoptotic LIF pseudogene may have been permissive (although not sufficient) for the evolution of large body sizes in proboscideans.


Assuntos
Elefantes/genética , Dosagem de Genes , Receptores de OSM-LIF/genética , Proteína Supressora de Tumor p53/genética , Proteína Killer-Antagonista Homóloga a bcl-2/genética , Proteína X Associada a bcl-2/genética , Animais , Apoptose/genética , Evolução Biológica , Tamanho Corporal , Dano ao DNA , Elefantes/metabolismo , Duplicação Gênica , Regulação da Expressão Gênica , Humanos , Mitocôndrias/genética , Mitocôndrias/metabolismo , Neoplasias/prevenção & controle , Filogenia , Mamífero Proboscídeo/classificação , Mamífero Proboscídeo/genética , Isoformas de Proteínas/genética , Isoformas de Proteínas/metabolismo , Pseudogenes , Receptores de OSM-LIF/metabolismo , Elementos de Resposta , Transcrição Gênica , Proteína Supressora de Tumor p53/metabolismo , Proteína Killer-Antagonista Homóloga a bcl-2/metabolismo , Proteína X Associada a bcl-2/metabolismo
17.
Acta Ortop Mex ; 24(4): 252-9, 2010.
Artigo em Espanhol | MEDLINE | ID: mdl-21305762

RESUMO

INTRODUCTION: The proximal interphalangeal (PIP) joint is the most commonly dislocated joint in the body and the hand. We did a review of the literature and report herein our experience treating this condition at the ABC Medical Center from 1991 to 2007. MATERIAL AND METHODS: Systematic review of the literature. Retrospective and descriptive study. RESULTS: A total of 13 patients were included between 1991 and 2007. Three of them were managed with ORIF with Kirschner nails, 3 with OR and Kirschner nails blocking extension, 2 with plasty with volar plate interposition, and one with CRIF with a Kirschner nail. Mean follow-up was 4.8 months in 8 patients, the ranges of motion were recorded. The following factors were negatively correlated with the range of motion: age, time elapsed between the injury and the treatment, the combined approaches, and the pins blocking extension. Those treated with interposition arthroplasty had a better range of motion. CONCLUSION: The fracture dislocation of the PIP joint is a rare pathology with multiple treatments and variable outcomes that usually result in the limitation of flexion and extension.


Assuntos
Traumatismos dos Dedos/cirurgia , Articulações dos Dedos , Luxações Articulares/cirurgia , Traumatismo Múltiplo/cirurgia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Ortopédicos , Estudos Retrospectivos , Adulto Jovem
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