Nerve and Arterial Supply Pattern of the Popliteus Muscle and Clinical Implications

Introduction. The aim of this study was to investigate the nerve and artery supply and the tibial attachment of the popliteus muscle using anatomical methods. Methods. Forty-four nonembalmed and embalmed extremities were dissected for this study. To measure the attachment area of the popliteus, the most prominent points of the medial epicondyle of the femur and the medial malleolus of the tibia were identified before dissection. A line connecting these two prominent points was used as the reference line, with the most prominent point of the medial epicondyle of the femur as the starting point. This study also investigated the area where the popliteus attaches to the bone and the points where nerves and arteries enter the popliteus muscle when it is divided into three equal parts in the coronal plane. Results. The mean length of the reference line was 34.6 ± 2.1 cm . The origin of the popliteus was found to be at a distance of 16.6% to 35.2% on the tibial bone from the proximal region. The popliteus was innervated by only the tibial nerve in 90% of the cases and by the tibial and the sciatic nerves in the remaining 10% of the cases. The inferior medial genicular artery and the posterior tibial artery supplied blood to the popliteus in 90% and 65% of the cases, respectively. When the popliteus muscle was divided into three equal parts in the coronal plane, the nerve and the artery were found to enter the muscle belly in zones II and III and zones I and II in 92% and 98% of the specimens, respectively. Discussion. The anatomical investigation of the popliteus in this study will help identify patients with clinically relevant syndromes.

Altered sense of self during seizures in the posteromedial cortex

The posteromedial cortex (PMC) is known to be a core node of the default mode network. Given its anatomical location and blood supply pattern, the effects of targeted disruption of this part of the brain are largely unknown. Here, we report a rare case of a patient (S19_137) with confirmed seizures originating within the PMC. Intracranial recordings confirmed the onset of seizures in the right dorsal posterior cingulate cortex, adjacent to the marginal sulcus, likely corresponding to Brodmann area 31. Upon the onset of seizures, the patient reported a reproducible sense of self-dissociation—a condition he described as a distorted awareness of the position of his body in space and feeling as if he had temporarily become an outside observer to his own thoughts, his “me” having become a separate entity that was listening to different parts of his brain speak to each other. Importantly, 50-Hz electrical stimulation of the seizure zone and a homotopical region within the contralateral PMC induced a subjectively similar state, reproducibly. We supplement our clinical findings with the definition of the patient’s network anatomy at sites of interest using cortico-cortical–evoked potentials, experimental and resting-state electrophysiological connectivity, and individual-level functional imaging. This rare case of patient S19_137 highlights the potential causal importance of the PMC for integrating self-referential information and provides clues for future mechanistic studies of self-dissociation in neuropsychiatric populations.

The Angiotensin-Converting Enzyme Inhibitory State Promotes the Transformation of Non-Small Cell Lung Cancer Blood Supply Pattern Toward Vasculogenic Mimicry Formation

Tumor microenvironment plays an important role in tumor proliferation, metastasis, and angiogenesis. Local RAS is a key factor to tumor proliferation and metastasis in NSCLC microenvironment, but its role on angiogenesis and VM formation remains unclear. Although overwhelming majority of previous studies suggested that VM is well established in aggressive tumor and facilitates tumor growth and metastasis, we put forward different views from another angle. We proved that status of tumor blood supply patterns, including VM channels and endothelial vessels, can dynamically exchange with each other along with local RAS fluctuations in microenvironment. Quantitatively, ACE2/ACEI promotes VM formation via Nodal/Notch4 activation; while structurally, ACE2/ACEI leads to a strong and solid structure of VM via inhibition of VE-cadherin internalization. These changes induced by ACE2/ACEI relate to relatively low metastasis rate and comforting prognoses of NSCLC patients.

Treatment of a rare and complex carotid-cavernous fistula

Carotid-cavernous fistulas (CCFs) are abnormal connections between arteries and the cavernous sinuses. Traditionally, the Barrow Classification system has been used to characterise these fistulas based on their arterial supply from the internal carotid artery (ICA), external carotid artery (ECA) or both. We present a unique case of a patient with a complex CCF with arterial feeders from dural branches of the ECA, ICA and vertebral artery (VA), which, to our knowledge, has not been reported in the literature. Given unique arterial supply pattern involving contribution from the extracranial VA, this CCF falls outside of the traditional Barrow Classification system. The patient ultimately underwent a transfemoral transvenous coil embolisation using multiple dynamic venous routes with obliteration of bilateral CCFs and near complete resolution of her preoperative symptoms.

THE EFFECT OF SUPPLY AUTOMATION SYSTEMS TECHNICAL OPERATIONS READINESS OF INDONESIAN WARSHIP (CASE STUDY: DOPUSBEKTIM)

In the system of guiding material for the Navy the spare parts are supporting material because of their nature as a provision that supports the maintenance of the main material so that it is always maintained and maintained its quality. The Eastern Region Procurement Center Depot or Dopusbektim is the Technical Implementation Unit (UPT) of Head quarter of Indonesian Navy Service, which has the duty and responsibility to receive, store, maintain and distribute provisions to the user unit or user unit including of Indonesian Warship In especially those located in the Koarmatim region or currently is Second Fleet of Indonesian Navy (Koarmada II). In supporting its duties and functions as a storage and distribution facility, Dopusbektim has a structured and implemented supply pattern supported by an automated system that uses special applications so that the distribution process can be carried out better in supporting technical operations readiness of Indonesian Warship. However, in carrying out the Dopusbektim debriefing, it was felt that it was not optimal although it was supported by infrastructure because there were still obstacles and obstacles. This results in Dopusbektim's duties and functions, one of which is providing services in order to support technical operations readiness of Indonesian Warship has not been maximized. Therefore it is necessary to analyze which effects need to be improved in optimally supporting technical operations readiness of Indonesian Warship .Keywords: Supplies Pattern, Automation System, Indonesian Warship Technical Operational Readiness, Multiple Regression analysis.

Cost-Minimized Nutritionally Adequate Food Baskets as Basis for Culturally Adapted Dietary Guidelines for Ethiopians

The high prevalence of undernutrition, especially stunting, in Ethiopia hampers the country’s economic productivity and national development. One of the obstacles to overcome undernutrition is the relatively high cost of food for low economic groups. In this study, linear programming was used to (i) identify urban and rural nutritionally adequate food baskets (FBs) with the highest affordability for an Ethiopian family of five and (ii) create urban and rural FBs, optimized for cultural acceptability, which are affordable for a family with the lowest income. Nutritionally adequate rural and urban FBs with highest affordability cost as little as Ethiopian Birr (ETB) 31 and 38 (~USD 1.07 and 1.31), respectively, but have poor dietary diversity (16 and 19 foods). FBs that cost ETB 71.2 (~USD 2.45) contained 64 and 48 foods, respectively, and were much more similar to the food supply pattern reported by FAO (15% and 19% average relative deviation per food category). The composed FBs, which are affordable for the greater part of the Ethiopian population, may serve as a basis for the development of culturally acceptable food-based dietary guidelines. These guidelines would recommend a diet composed of approximately up to 60% cereals, up to 20% roots and tubers, 10% legumes, and 10% fruits and vegetables by weight, plus only a small share from animal foods.

Source Identification and Quantification of Seepage Water in a Coastal Mine, in China

The Sanshandao gold mine, which is the largest coastal mine in China, is under threat from seawater intrusion and water inrush. The objective of this study is to determine the water end-members (seawater, freshwater, and brine) of the seepage water in the mine and quantify the proportion of end-members. Non-conservative ions and ion exchange were identified by using hydrogeochemical analysis. Then, the principal component analysis (PCA) was used to identify the end-members of mine water. Three end-members were identified, so a ternary mixture model was applied to compute the mixing ratios. The potential water flow channels and the prevailing supply patterns were inferred by combining the results of mixing ratios with the tectonic and engineering geological conditions. The results indicate that the proportion of seawater in mine water is about 57%, the freshwater is about 16% and the brine is about 27% for the entire mine area, the prevailing supply pattern of seawater was lateral recharge, the water samples which were located in −510 m sublevel or in the northeast of prospecting line 2260 had high proportions of seawater, the freshwater supplied the groundwater mainly through the secondary fractures developed area in a vertical recharge and the influence depth was about −500 m, and F3 was the largest tensile-shear fault in the study area and it was both a watercourse for seawater and fresh water.