A Novel Ligamentous Complex in the Anteromedial Region of the Knee: A Cadaveric Study.

Background: The medial knee structures have a primary role in stabilizing valgus and rotational stress, which makes them important in assessing the ligament-injured knee globally and choosing the most adequate treatment. Purpose: To conduct a layer-by-layer dissection of the knee's anteromedial side and provide a qualitative and quantitative description of the anatomy and histology of a ligament in the anteromedial region of the knee, which we have termed the anterior oblique ligament (AOL). Also, to describe the AOL relationship with what we have termed the medial cross-a ligament complex that stabilizes the medial pivot. Study Design: Descriptive laboratory study. Methods: A total of 35 fresh-frozen knees from transfemoral amputations that were exclusively performed for vascular reasons were dissected. Structures were identified after meticulous dissection, respecting the same protocol, measured with a digital caliper rule, and histologically studied for data. Results: The AOL was found in all dissected knees, with a mean length of 31.47 ± 5.06 mm. This structure presented a ligament histology with densely organized collagen fibrils. The medial cross was represented by the superficial medial collateral ligament, AOL (anterior region), and posterior oblique ligament. Conclusion: This study demonstrated the presence of a ligament in the anteromedial region of the knee, termed the AOL. This structure was in the anterior part of a ligament complex-the medial cross. Clinical Relevance: Studying and revisiting the medial compartment can provide important information for understanding joint instability and promoting better results in ligament reconstructions.

From sensor fusion to knowledge distillation in collaborative LIBS and hyperspectral imaging for mineral identification.

Multimodal spectral imaging offers a unique approach to the enhancement of the analytical capabilities of standalone spectroscopy techniques by combining information gathered from distinct sources. In this manuscript, we explore such opportunities by focusing on two well-known spectral imaging techniques, namely laser-induced breakdown spectroscopy, and hyperspectral imaging, and explore the opportunities of collaborative sensing for a case study involving mineral identification. In specific, the work builds upon two distinct approaches: a traditional sensor fusion, where we strive to increase the information gathered by including information from the two modalities; and a knowledge distillation approach, where the Laser Induced Breakdown spectroscopy is used as an autonomous supervisor for hyperspectral imaging. Our results show the potential of both approaches in enhancing the performance over a single modality sensing system, highlighting, in particular, the advantages of the knowledge distillation framework in maximizing the potential benefits of using multiple techniques to build more interpretable models and paving for industrial applications.

Identification of Relevant Spectral Ranges in Laser-Induced Breakdown Spectroscopy Imaging Using the Fourier Space.

Laser-induced breakdown spectroscopy (LIBS) imaging has now a well-established position in the subject of spectral imaging, leveraging multi-element detection capabilities and fast acquisition rates to support applications both at academic and technological levels. In current applications, the standard processing pipeline to explore LIBS imaging data sets revolves around identifying an element that is suspected to exist within the sample and generating maps based on its characteristic emission lines. Such an approach requires some previous expert knowledge both on the technique and on the sample side, which hinders a wider and more transparent accessibility of the LIBS imaging technique by non-specialists. To address this issue, techniques based on visual analysis or peak finding algorithms are applied on the average or maximum spectrum, and may be employed for automatically identifying relevant spectral regions. Yet, maps containing relevant information may often be discarded due to low signal-to-noise ratios or interference with other elements. In this context, this work presents an agnostic processing pipeline based on a spatial information ratio metric that is computed in the Fourier space for each wavelength and that allows for the identification of relevant spectral ranges in LIBS. The results suggest a more robust and streamlined approach to feature extraction in LIBS imaging compared with traditional inspection of the spectra, which can introduce novel opportunities not only for spectral data analysis but also in the field of data compression.

ARDS Mortality Prediction Model Using Evolving Clinical Data and Chest Radiograph Analysis.

INTRODUCTION: Within primary ARDS, SARS-CoV-2-associated ARDS (C-ARDS) emerged in late 2019, reaching its peak during the subsequent two years. Recent efforts in ARDS research have concentrated on phenotyping this heterogeneous syndrome to enhance comprehension of its pathophysiology. METHODS AND RESULTS: A retrospective study was conducted on C-ARDS patients from April 2020 to February 2021, encompassing 110 participants with a mean age of 63.2 ± 11.92 (26-83 years). Of these, 61.2% (68) were male, and 25% (17) experienced severe ARDS, resulting in a mortality rate of 47.3% (52). Ventilation settings, arterial blood gases, and chest X-ray (CXR) were evaluated on the first day of invasive mechanical ventilation and between days two and three. CXR images were scrutinized using a convolutional neural network (CNN). A binary logistic regression model for predicting C-ARDS mortality was developed based on the most influential variables: age, PaO2/FiO2 ratio (P/F) on days one and three, CNN-extracted CXR features, and age. Initial performance assessment on test data (23 patients out of the 110) revealed an area under the receiver operating characteristic (ROC) curve of 0.862 with a 95% confidence interval (0.654-0.969). CONCLUSION: Integrating data available in all intensive care units enables the prediction of C-ARDS mortality by utilizing evolving P/F ratios and CXR. This approach can assist in tailoring treatment plans and initiating early discussions to escalate care and extracorporeal life support. Machine learning algorithms for imaging classification can uncover otherwise inaccessible patterns, potentially evolving into another form of ARDS phenotyping. The combined features of these algorithms and clinical variables demonstrate superior performance compared to either element alone.

Reproductive evaluation of Luisa, the last jaguar of the Caatinga.

The in situ population of jaguars in the Caatinga is less than 250 individuals, subdivided into five subpopulations, and is classified as endangered regarding its risk of extinction. Luisa, a 15-year-old female weighing 36 kg, was the last known ex situ jaguar from this biome. Her reproductive evaluation is detailed in this manuscript. Luisa was subjected to both a clinical and laparoscopic evaluation of her reproductive system. After 45 days of reproductive investigation, she died unexpectedly, and skin fragments were taken to establish the postmortem fibroblast lineage. At the clinical evaluation, Luisa had small, undeveloped mammary gland and a small vulva, characteristic of a nulliparous female, with no mammary gland nodules, edema, or abnormal masses. By laparoscopy, normal-appearing bladder and bowel loops were observed, as were uterine horns with standard color, shape, and length with no striae. Ovaries and uterine horns seem free of fibrinous adhesions. Both ovaries showed a yellowish color, a fibrous consistency, a decreased size (atrophied), and no follicles, hemorrhagic corpus, corpus luteum, luteal scars, or other abnormal structures. We may assume that this jaguar female was infertile based on Luisa's mature age and the absence of birthing or ovarian activity signs. The harsh conditions of the Caatinga biome, which included low food availability and frequent conflicts with humans, may have impacted both the pregnancy and lactation of Luisa's mother and her development after birth.

Peroneus Longus Tendon Graft to Reconstruct the Posterolateral Corner of the Knee.

The posterolateral corner is critical to knee stability. Neglected injuries have a direct impact on the prognosis due to residual instability, chronic pain, deformities, and failure to repair other structures. Several techniques are used to reconstruct the posterolateral corner, often with autologous ischiotibial grafts or homologous grafts. An option little used for knee ligament reconstructions is the peroneus longus tendon graft. Although reported as a good alternative for anterior cruciate ligament reconstruction, we found no case using a peroneus longus tendon graft for posterolateral corner reconstruction. Here, we describe the case of a patient who underwent a non-anatomical reconstruction of the posterolateral corner using a peroneus longus tendon graft. The patient underwent surgical procedures for ligament reconstruction and correction of the deformity caused by a failed graft, but his knee remained unstable. During the preoperative planning, it was decided to reconstruct the posterolateral corner with an ipsilateral peroneus longus tendon graft. Studies have shown that the peroneus longus tendon graft does not increase ankle morbidity, and that its length and diameter favor ligament reconstruction. Thus, the present article highlights the importance of the proper diagnosis of ligament injuries in the acute phase, and describes a new technique for posterolateral corner reconstruction that must be included in the surgeon's body of knowledge, increasing the amount of technical options.

Characterization of Functional Coatings on Cork Stoppers with Laser-Induced Breakdown Spectroscopy Imaging.

Evaluating the efficiency of surface treatments is a problem of paramount importance for the cork stopper industry. Generically, these treatments create coatings that aim to enhance the impermeability and lubrification of cork stoppers. Yet, current methods of surface analysis are typically time-consuming, destructive, have poor representativity or rely on indirect approaches. In this work, the use of a laser-induced breakdown spectroscopy (LIBS) imaging solution is explored for evaluating the presence of coating along the cylindrical surface and in depth. To test it, several cork stoppers with different shaped areas of untreated surface were analyzed by LIBS, making a rectangular grid of spots with multiple shots per spot, to try to identify the correspondent shape. Results show that this technique can detect the untreated area along with other features, such as leakage and holes, allowing for a high success rate of identification and for its performance at different depths, paving the way for future industry-grade quality control solutions with more complex surface analysis.

Imprinted Hydrogel Nanoparticles for Protein Biosensing: A Review.

Over the past decade, molecular imprinting (MI) technology has made tremendous progress, and the advancements in nanotechnology have been the major driving force behind the improvement of MI technology. The preparation of nanoscale imprinted materials, i.e., molecularly imprinted polymer nanoparticles (MIP NPs, also commonly called nanoMIPs), opened new horizons in terms of practical applications, including in the field of sensors. Currently, hydrogels are very promising for applications in bioanalytical assays and sensors due to their high biocompatibility and possibility to tune chemical composition, size (microgels, nanogels, etc.), and format (nanostructures, MIP film, fibers, etc.) to prepare optimized analyte-responsive imprinted materials. This review aims to highlight the recent progress on the use of hydrogel MIP NPs for biosensing purposes over the past decade, mainly focusing on their incorporation on sensing devices for detection of a fundamental class of biomolecules, the peptides and proteins. The review begins by directing its focus on the ability of MIPs to replace biological antibodies in (bio)analytical assays and highlight their great potential to face the current demands of chemical sensing in several fields, such as disease diagnosis, food safety, environmental monitoring, among others. After that, we address the general advantages of nanosized MIPs over macro/micro-MIP materials, such as higher affinity toward target analytes and improved binding kinetics. Then, we provide a general overview on hydrogel properties and their great advantages for applications in the field of Sensors, followed by a brief description on current popular routes for synthesis of imprinted hydrogel nanospheres targeting large biomolecules, namely precipitation polymerization and solid-phase synthesis, along with fruitful combination with epitope imprinting as reliable approaches for developing optimized protein-imprinted materials. In the second part of the review, we have provided the state of the art on the application of MIP nanogels for screening macromolecules with sensors having different transduction modes (optical, electrochemical, thermal, etc.) and design formats for single use, reusable, continuous monitoring, and even multiple analyte detection in specialized laboratories or in situ using mobile technology. Finally, we explore aspects about the development of this technology and its applications and discuss areas of future growth.

Anterior Cruciate and Anterior Oblique Ligament Reconstruction Using Hamstrings and Peroneus Longus' Anterior Half Grafts.

Anterior cruciate ligament injuries are common in high school and college with an estimated 120,000 cases per year in the United States. Most sports injuries occur without direct contact, and knee valgus with external rotation of the foot is the most common movement. This movement may be related to the injury of the anterior oblique ligament located in the anteromedial quadrant of the knee. This technical note presents anterior cruciate ligament reconstruction with extraarticular anteromedial reinforcement using hamstring and the anterior half of the peroneus longus grafts.

Magnetic resonance imaging of the knee anteromedial quadrant.

OBJECTIVE: This study aims to evaluate the possibility of characterizing an extra-articular thickening in the knee anteromedial quadrant in routine MRI scans. MATERIALS AND METHODS: Firstly, in a pilot study, for a better understanding of this extra-articular thickening trajectory in MRI, polytetrafluoroethylene (PTFE) tubes were attached to the ligament structure topography in two dissected pieces. Afterward, 100 knee MRI studies were randomly selected from our database, and 97 met the inclusion criteria. Two musculoskeletal radiologists interpreted the exams separately. Both had previously studied the ligament in the cadaveric knee MRI with the PTFE tube. RESULTS: The intraobserver and interobserver agreement for the ligament identification was calculated using Cohen's Kappa coefficient. The first radiologist identified the structure in 41 of the 97 scans (42.2%), and the second radiologist in 38 scans (39.2%). The interobserver agreement was substantial, with a Kappa of 0.68 and an agreement of 84.5%. The results suggest that this extra-articular thickening, recently called Anterior Oblique Ligament (AOL) in the literature, is a structure that can be frequently visualized on MRI scans with a high level of interobserver agreement in a relatively large number of exams. CONCLUSION: Therefore, this study indicates that MRI is a promising method for evaluating this anteromedial thickening, and it may be used for future studies of the Anterior Oblique Ligament.

Epidemiological profile of amateur athletes at a medical school in the city of são paulo / Perfil epidemiológico de deportistas amateurs de una facultad de medicina de la ciudad de são paulo / Perfil epidemiológico de atletas amadores em faculdade de medicina da cidade de são paulo

ABSTRACT Introduction: Epidemiologic data about sports injuries among college athletes in Brazil is scarce. The aim of this study was to analyze the epidemiology of sports injuries in a single center. Methods: We interviewed 262 athletes from 10 different sports retrospectively about injuries sustained in their university careers and whose injuries sustained during one season were monitored prospectively. The characterization of the injuries included data on the location of the injury, type of injury, time of year, injury mechanism, and the moment of the injury during training or a game. Results: In the university history, the incidence of injuries was higher in men (81.5%) than in women (67.8%). Lower limb injuries were the most frequent both in the university history and the season. The sports with the highest injury rate for the season was handball (34.2%) and for the university history was basketball (80.8%). The main injury mechanism was non-contact. The months with the highest incidence of injuries were those at the beginning of the season (53.3%). The most frequent diagnoses were ligament injuries, followed by fractures. Both the presence of a previous injury in the same region and the practice of weight training were predictive factors for injury. Conclusion: College athletes at this center are more likely to suffer injuries during the first months of the season, especially in contact sports involving lower limbs. Level of Evidence III; Study of non-consecutive patients, without uniformly applied "gold" reference standard .

RESUMEN Introducción: Hay muy pocos datos en Brasil sobre la epidemiologia de las lesiones deportivas en atletas universitarios. El objetivo de este estudio es analizar la epidemiologia de las lesiones en deportes en un único centro. Métodos: Fueron entrevistados 262 atletas de 10 deportes distintos retrospectivamente con respecto a las lesiones sufridas en su historial universitario y fueron acompañados prospectivamente con respecto a las lesiones sufridas durante una temporada. La caracterización de las lesiones se basó en los datos del lugar de la lesión, el tipo de lesión, la época del año, el mecanismo de la lesión y el momento en que se produjo la lesión durante el entrenamiento o el partido. Resultados: En el historial universitario, la incidencia de las lesiones fue mayor en los hombres (81,5%) que en las mujeres (67,8%). Las lesiones en los miembros inferiores fueron más frecuentes tanto en el historial universitario como en la temporada. El deporte con mayor índice de lesiones en la temporada fue el balonmano (34,2%) y en el historial universitario fue el baloncesto (80,8%). El principal mecanismo de lesión fue sin contacto. Los meses con mayor incidencia de lesiones son el inicio de la temporada (53,3%). Los diagnósticos más frecuentes son las lesiones de ligamentos seguida de las fracturas. Tanto la presencia de una lesión previa en la misma topografía como la práctica de musculación fueron factores predictivos de lesión. Conclusiones: Los atletas universitarios de esta institución son más susceptibles de sufrir lesiones durante los primeros meses de la temporada, especialmente en los deportes de contacto y con mayor incidencia en los miembros inferiores. Nivel de evidencia III; Estudio de pacientes no consecutivos, sin patrón "oro" de referencia aplicado uniformemente .

RESUMO Introdução: Há escassez de dados no Brasil sobre a epidemiologia de lesões esportivas em atletas universitários. O objetivo deste estudo é fazer uma análise sobre a epidemiologia das lesões esportivas em um único centro. Métodos: Foram entrevistados 262 atletas de 10 esportes diferentes, de forma retrospectiva, com relação às lesões sofridas em seu histórico universitário e foram acompanhados de forma prospectiva quanto às lesões sofridas ao longo de uma temporada. A caracterização das lesões contava com dados de local da lesão, tipo de lesão, época do ano, mecanismo de lesão, momento de ocorrência da lesão durante treino ou jogo. Resultados: No histórico universitário, a incidência de lesões foi maior em homens (81,5%) do que em mulheres (67,8%). As lesões de membros inferiores foram as mais frequentes tanto no histórico universitário, quanto na temporada. O esporte com maior índice de lesão na temporada foi o handebol (34,2%) e no histórico universitário foi o basquete (80,8%). O principal mecanismo de lesão foi sem contato. Os meses de maior incidência de lesão são os do começo da temporada (53,3%). Os diagnósticos mais frequentes são as lesões ligamentares, seguidas por fraturas. Tanto a presença de lesão prévia na mesma topografia, quanto a prática de musculação foram fatores preditivos de lesão. Conclusões: Os atletas universitários deste centro estão mais susceptíveis a sofrer lesões durante os primeiros meses da temporada, especialmente em esportes de contato e maior incidência nos membros inferiores. Nível de Evidência III; Estudo de pacientes não consecutivos, sem padrão de referência "ouro" aplicado uniformemente .

Peroneus Longus Tendon Graft to Reconstruct the Posterolateral Corner of the Knee / Enxerto do tendão fibular longo na reconstrução do canto posterolateral do joelho

Abstract The posterolateral corner is critical to knee stability. Neglected injuries have a direct impact on the prognosis due to residual instability, chronic pain, deformities, and failure to repair other structures. Several techniques are used to reconstruct the posterolateral corner, often with autologous ischiotibial grafts or homologous grafts. An option little used for knee ligament reconstructions is the peroneus longus tendon graft. Although reported as a good alternative for anterior cruciate ligament reconstruction, we found no case using a peroneus longus tendon graft for posterolateral corner reconstruction. Here, we describe the case of a patient who underwent a non-anatomical reconstruction of the posterolateral corner using a peroneus longus tendon graft. The patient underwent surgical procedures for ligament reconstruction and correction of the deformity caused by a failed graft, but his knee remained unstable. During the preoperative planning, it was decided to reconstruct the posterolateral corner with an ipsilateral peroneus longus tendon graft. Studies have shown that the peroneus longus tendon graft does not increase ankle morbidity, and that its length and diameter favor ligament reconstruction. Thus, the present article highlights the importance of the proper diagnosis of ligament injuries in the acute phase, and describes a new technique for posterolateral corner reconstruction that must be included in the surgeon's body of knowledge, increasing the amount of technical options.

Resumo O canto posterolateral tem grande importância na estabilidade do joelho. Sua lesão pode ser negligenciada, o que tem um impacto direto no prognóstico e resulta em instabilidade residual, dor crônica, deformidades e falha do reparo de outras estruturas. Existem diversas técnicas de reconstrução do canto posterolateral e o uso de enxertos autólogos dos isquiotibiais ou homólogos são as mais comuns. Uma opção pouco utilizada para reconstruções ligamentares no joelho é o enxerto do tendão fibular longo. Apesar de descrito como boa opção na reconstrução do ligamento cruzado anterior, não foi encontrado nenhum caso de uso do enxerto do tendão fibular longo na reconstrução do canto posterolateral. Neste artigo, descrevemos o caso de um paciente submetido a reconstrução não anatômica do canto posterolateral com uso do enxerto do tendão fibular longo. O paciente foi submetido a procedimentos cirúrgicos para reconstrução ligamentar e correção de deformidade ocasionada pela falha do enxerto, mas manteve instabilidade ligamentar. No planejamento pré-operatório, optou-se pela reconstrução do canto posterolateral com enxerto do tendão fibular longo ipsilateral. Estudos evidenciaram que o enxerto do tendão fibular longo não provoca aumento de morbidadeem relação aotornozelo abordado, bem comoseapresenta com comprimento e diâmetro favoráveis à reconstrução ligamentar. Dessa forma, este artigo aponta para a importânciadodiagnóstico correto das lesões ligamentaresnafase aguda,e para uma nova técnica na reconstrução do canto posterolateral, que deve fazer parte do arsenal de conhecimentos do cirurgião, pois aumenta as opções de técnicas.

CryoEM structural exploration of catalytically active enzyme pyruvate carboxylase.

Pyruvate carboxylase (PC) is a tetrameric enzyme that contains two active sites per subunit that catalyze two consecutive reactions. A mobile domain with an attached prosthetic biotin links both reactions, an initial biotin carboxylation and the subsequent carboxyl transfer to pyruvate substrate to produce oxaloacetate. Reaction sites are at long distance, and there are several co-factors that play as allosteric regulators. Here, using cryoEM we explore the structure of active PC tetramers focusing on active sites and on the conformational space of the oligomers. The results capture the mobile domain at both active sites and expose catalytic steps of both reactions at high resolution, allowing the identification of substrates and products. The analysis of catalytically active PC tetramers reveals the role of certain motions during enzyme functioning, and the structural changes in the presence of additional cofactors expose the mechanism for allosteric regulation.

Anatomical Study of the Medial Region of the Knee: Qualitative, Quantitative Analysis and Description of the Anterior Oblique Ligament.

Objective To describe all ligamentous, capsular, tendinous and bone landmarks structures of the medial region of the knee, as well as a new ligamentous structure identified in a series of anatomical dissections of cadaveric specimens. Methods Twenty cadaver knees were dissected to study the medial compartment. The main structures of this region were identified during dissection. The morphology of the structures and their relationship with known anatomical parameters were determined both qualitatively and quantitatively. The collected data were analyzed and interpreted using descriptive statistics. Results In the dissection of all specimens, all ligamentous structures previously described in the anatomical study of the medial part of the knee were identified, and objective measures that can help as parameters for surgical ligament reconstruction were identified. When dissecting the medial collateral ligament, a bony prominence immediately distal to its proximal tibial insertion was observed and described, as well as a bursa below the ligament, in which it was not inserted. We also described a ligamentous structure with extracapsular location, originated anteriorly to the medial epicondyle and following obliquely towards the tibia. These structures were named, respectively, interinsertional tubercle, interinsertional bursa and anterior oblique ligament. Conclusion In addition to the description and measurement of the structures and parameters already existing in the anatomical study of the medial part of the knee, it was possible to describe three new structures not yet described in the literature: the interinsertional tubercle, the interinsertional bursa, and the anterior oblique ligament. These structures were found in all dissections performed.

Anatomical Study of the Medial Region of the Knee: Qualitative, Quantitative Analysis and Description of the Anterior Oblique Ligament / Estudo anatômico da região medial do joelho: Análise qualitativa, quantitativa e descrição do ligamento oblíquo anterior

Abstract Objective To describe all ligamentous, capsular, tendinous and bone landmarks structures of the medial region of the knee, as well as a new ligamentous structure identified in a series of anatomical dissections of cadaveric specimens. Methods Twenty cadaver knees were dissected to study the medial compartment. The main structures of this region were identified during dissection. The morphology of the structures and their relationship with known anatomical parameters were determined both qualitatively and quantitatively. The collected data were analyzed and interpreted using descriptive statistics. Results In the dissection of all specimens, all ligamentous structures previously described in the anatomical study of the medial part of the knee were identified, and objective measures that can help as parameters for surgical ligament reconstruction were identified. When dissecting the medial collateral ligament, a bony prominence immediately distal to its proximal tibial insertion was observed and described, as well as a bursa below the ligament, in which it was not inserted. We also described a ligamentous structure with extracapsular location, originated anteriorly to the medial epicondyle and following obliquely towards the tibia. These structures were named, respectively, interinsertional tubercle, interinsertional bursa and anterior oblique ligament. Conclusion In addition to the description and measurement of the structures and parameters already existing in the anatomical study of the medial part of the knee, it was possible to describe three new structures not yet described in the literature: the interinsertional tubercle, the interinsertional bursa, and the anterior oblique ligament. These structures were found in all dissections performed.

Resumo Objetivo Descrever todas as estruturas ligamentares, capsulares, tendinosas e marcos ósseos da região medial do joelho, assim como uma nova estrutura ligamentar identificada em uma série de dissecções anatômicas de espécimes cadavéricos. Métodos Vinte joelhos de cadáveres foram dissecados para estudar o compartimento medial. As principais estruturas dessa região foram identificadas durante a dissecção. A morfologia das estruturas e sua relação com parâmetros anatômicos conhecidos foram determinados tanto de forma qualitativa quanto de forma quantitativa. Os dados coletados foram analisados e interpretados por meio de estatística descritiva. Resultados Na dissecção de todos os espécimes, foram identificadas todas as estruturas ligamentares já descritas anteriormente no estudo anatômico da porção medial do joelho, e foram realizadas medidas objetivas que podem auxiliar como parâmetros para a reconstrução ligamentar cirúrgica. Foram observados e descritos, ainda, ao se desprender o ligamento colateral medial superficial, uma proeminência óssea imediatamente distal à sua inserção tibial proximal, uma bursa abaixo do ligamento, na qual o mesmo não se mostrava inserido, assim como uma estrutura ligamentar localizada extracapsularmente e com origem na face anterior do epicôndilo medial, seguindo obliquamente em direção à tíbia, aos quais foram dados os nomes, respectivamente, de tubérculo interinsercional, bursa interinsercional e ligamento oblíquo anterior. Conclusão Além da descrição e medida das estruturas e parâmetros já existentes no estudo anatômico da porção medial do joelho, foi possível a descrição de três novas estruturas: o tubérculo interinsercional a bursa interinsercional e o ligamento oblíquo anterior, ainda não descritos na literatura. Essas estruturas foram encontradas em todas as dissecções realizadas.

Differential Refractometric Biosensor for Reliable Human IgG Detection: Proof of Concept.

A new sensing platform based on long-period fiber gratings (LPFGs) for direct, fast, and selective detection of human immunoglobulin G (IgG; Mw = 150 KDa) was developed and characterized. The transducer's high selectivity is based on the specific interaction of a molecularly imprinted polymer (MIPs) design for IgG detection. The sensing scheme is based on differential refractometric measurements, including a correction system based on a non-imprinted polymer (NIP)-coated LPFG, allowing reliable and more sensitive measurements, improving the rejection of false positives in around 30%. The molecular imprinted binding sites were performed on the surface of a LPFG with a sensitivity of about 130 nm/RIU and a FOM of 16 RIU-1. The low-cost and easy to build device was tested in a working range from 1 to 100 nmol/L, revealing a limit of detection (LOD) and a sensitivity of 0.25 nmol/L (0.037 µg/mL) and 0.057 nm.L/nmol, respectively. The sensor also successfully differentiates the target analyte from the other abundant elements that are present in the human blood plasma.

A Plasmonic Biosensor Based on Light-Diffusing Fibers Functionalized with Molecularly Imprinted Nanoparticles for Ultralow Sensing of Proteins.

Plasmonic bio/chemical sensing based on optical fibers combined with molecularly imprinted nanoparticles (nanoMIPs), which are polymeric receptors prepared by a template-assisted synthesis, has been demonstrated as a powerful method to attain ultra-low detection limits, particularly when exploiting soft nanoMIPs, which are known to deform upon analyte binding. This work presents the development of a surface plasmon resonance (SPR) sensor in silica light-diffusing fibers (LDFs) functionalized with a specific nanoMIP receptor, entailed for the recognition of the protein human serum transferrin (HTR). Despite their great versatility, to date only SPR-LFDs functionalized with antibodies have been reported. Here, the innovative combination of an SPR-LFD platform and nanoMIPs led to the development of a sensor with an ultra-low limit of detection (LOD), equal to about 4 fM, and selective for its target analyte HTR. It is worth noting that the SPR-LDF-nanoMIP sensor was mounted within a specially designed 3D-printed holder yielding a measurement cell suitable for a rapid and reliable setup, and easy for the scaling up of the measurements. Moreover, the fabrication process to realize the SPR platform is minimal, requiring only a metal deposition step.

Low Cancer Incidence in Naked Mole-Rats May Be Related to Their Inability to Express the Warburg Effect.

Metabolic flexibility in mammals enables stressed tissues to generate additional ATP by converting large amounts of glucose into lactic acid; however, this process can cause transient local or systemic acidosis. Certain mammals are adapted to extreme environments and are capable of enhanced metabolic flexibility as a specialized adaptation to challenging habitat niches. For example, naked mole-rats (NMRs) are a fossorial and hypoxia-tolerant mammal whose metabolic responses to environmental stressors markedly differ from most other mammals. When exposed to hypoxia, NMRs exhibit robust hypometabolism but develop minimal acidosis. Furthermore, and despite a very long lifespan relative to other rodents, NMRs have a remarkably low cancer incidence. Most advanced cancers in mammals display increased production of lactic acid from glucose, irrespective of oxygen availability. This hallmark of cancer is known as the Warburg effect (WE). Most malignancies acquire this metabolic phenotype during their somatic evolution, as the WE benefits tumor growth in several ways. We propose that the peculiar metabolism of the NMR makes development of the WE inherently difficult, which might contribute to the extraordinarily low cancer rate in NMRs. Such an adaptation of NMRs to their subterranean environment may have been facilitated by modified biochemical responses with a stronger inhibition of the production of CO2 and lactic acid by a decreased extracellular pH. Since this pH-inhibition could be deeply hard-wired in their metabolic make-up, it may be difficult for malignant cells in NMRs to acquire the WE-phenotype that facilitates cancer growth in other mammals. In the present commentary, we discuss this idea and propose experimental tests of our hypothesis.

Roux-en-Y Gastric Bypass Vs Sleeve Gastrectomy in Super Obesity: a Systematic Review and Meta-Analysis.

Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) are safe procedures that may present sub-optimal results in superobesity (SO). A meta-analysis was performed aiming to summarize the available evidence on weight loss (primary outcome) and comorbidities resolution of LRYGB and LSG in patients with SO (BMI ≥ 50 kg/m2). From the 16 included studies, 7 integrated the meta-analysis. LRYGB showed a significantly higher weight loss at 6 to 12-months, but not after 24 months and a higher dyslipidemia resolution at 12 months. When compared with LSG, LRYGB achieved better weight loss after 6 and 12 months and higher dyslipidemia resolution after 1 year. There were no significant differences for resolution of the other co-morbidities studied.