Yeast Platforms for Production and Screening of Bioactive Derivatives of Rauwolscine.

Monoterpene indole alkaloids (MIAs) make up a highly bioactive class of metabolites produced by a range of tropical and subtropical plants. The corynanthe-type MIAs are a stereochemically complex subclass with therapeutic potential against a large number of indications including cancer, psychotic disorders, and erectile dysfunction. Here, we report yeast-based cell factories capable of de novo production of corynanthe-type MIAs rauwolscine, yohimbine, tetrahydroalstonine, and corynanthine. From this, we demonstrate regioselective biosynthesis of 4 fluorinated derivatives of these compounds and de novo biosynthesis of 7-chlororauwolscine by coexpression of a halogenase with the biosynthetic pathway. Finally, we capitalize on the ability of these cell factories to produce derivatives of these bioactive scaffolds to establish a proof-of-principle drug discovery pipeline in which the corynanthe-type MIAs are screened for bioactivity on human drug targets, expressed in yeast. In doing so, we identify antagonistic and agonistic behavior against the human adrenergic G protein-coupled receptors ADRA2A and ADRA2B, and the serotonergic receptor 5HT4b, respectively. This study thus demonstrates a proto-drug discovery pipeline for bioactive plant-inspired small molecules based on one-pot biocatalysis of natural and new-to-nature corynanthe-type MIAs in yeast.

A novel portable anechoic chamber using ultra-thin 2D microwave absorber for industrial 5.0.

In this paper, the authors, for the first time, have shown the use of 2D conformal microwave absorbing material (MAM) in the design and fabrication of a portable Anechoic chamber (AC). The MAM is fabricated on the transparent and conductive metal oxide layer named indium-tin-oxide (ITO) with Polyethylene terephthalate as the substrate and the ground plane for zero transmission having overall thickness of 0.012 λ where λ is calculated at 0.7 GHz. The MAM is characterized for 0.7 to 18 GHz for both TE- and TM-polarisation and oblique incidence. High sheet resistance, dipole-like resonance structure patterned on the ITO, and the air-spacing between the layers is optimized to achieve broadband absorption. The MAM is used to line the six sides of the rectangular anechoic chamber having inner dimensions of: (L × W × H: 850 × 650 × 720 mm3). The return loss (RL), gain, and radiation pattern of three antenna working at 1.56, 2.43, and 4.93 GHz are analyzed inside the AC. The measurement results for all frequencies very well match with the simulation studies, thus validating and opening the door for the future use of ultra-thin and planar MAM in the AC.

Remote Emotion Recognition Using Continuous-Wave Bio-Radar System.

The Bio-Radar is herein presented as a non-contact radar system able to capture vital signs remotely without requiring any physical contact with the subject. In this work, the ability to use the proposed system for emotion recognition is verified by comparing its performance on identifying fear, happiness and a neutral condition, with certified measuring equipment. For this purpose, machine learning algorithms were applied to the respiratory and cardiac signals captured simultaneously by the radar and the referenced contact-based system. Following a multiclass identification strategy, one could conclude that both systems present a comparable performance, where the radar might even outperform under specific conditions. Emotion recognition is possible using a radar system, with an accuracy equal to 99.7% and an F1-score of 99.9%. Thus, we demonstrated that it is perfectly possible to use the Bio-Radar system for this purpose, which is able to be operated remotely, avoiding the subject awareness of being monitored and thus providing more authentic reactions.

ChaMP-CMD: A Phenotype-Blinded, Randomized Controlled, Cross-Over Trial.

BACKGROUND: Angina with nonobstructive coronary arteries is a common condition for which no effective treatment has been established. We hypothesized that the measurement of coronary flow reserve (CFR) allows identification of patients with angina with nonobstructive coronary arteries who would benefit from anti-ischemic therapy. METHODS: Patients with angina with nonobstructive coronary arteries underwent blinded invasive CFR measurement and were randomly assigned to receive 4 weeks of amlodipine or ranolazine. After a 1-week washout, they crossed over to the other drug for 4 weeks; final assessment was after the cessation of study medication for another 4 weeks. The primary outcome was change in treadmill exercise time, and the secondary outcome was change in Seattle Angina Questionnaire summary score in response to anti-ischemic therapy. Analysis was on a per protocol basis according to the following classification: coronary microvascular disease (CMD group) if CFR<2.5 and reference group if CFR≥2.5. The study protocol was registered before the first patient was enrolled (International Standard Randomised Controlled Trial Number: ISRCTN94728379). RESULTS: Eighty-seven patients (61±8 years of age; 62% women) underwent random assignment (57 CMD group and 30 reference group). Baseline exercise time and Seattle Angina Questionnaire summary scores were similar between groups. The CMD group had a greater increment (delta) in exercise time than the reference group in response to both amlodipine (difference in delta, 82 s [95% CI, 37-126 s]; P<0.001) and ranolazine (difference in delta, 68 s [95% CI, 21-115 s]; P=0.005). The CMD group reported a greater increment (delta) in Seattle Angina Questionnaire summary score than the reference group in response to ranolazine (difference in delta, 7 points [95% CI, 0-15]; P=0.048), but not to amlodipine (difference in delta, 2 points [95% CI, -5 to 8]; P=0.549). CONCLUSIONS: Among phenotypically similar patients with angina with nonobstructive coronary arteries, only those with an impaired CFR derive benefit from anti-ischemic therapy. These findings support measurement of CFR to diagnose and guide management of this otherwise heterogeneous patient group.

Determinants of multimorbidity in low- and middle-income countries: A systematic review of longitudinal studies and discovery of evidence gaps.

Multimorbidity-the coexistence of at least two chronic health conditions within the same individual-is an important global health challenge. In high-income countries (HICs), multimorbidity is dominated by non-communicable diseases (NCDs); whereas, the situation may be different in low- and middle-income countries (LMICs), where chronic communicable diseases remain prominent. The aim of this systematic review was to identify determinants (including risk and protective factors) and potential mechanisms underlying multimorbidity from published longitudinal studies across diverse population-based or community-dwelling populations in LMICs. We systematically searched three electronic databases (Medline, Embase, and Global Health) using pre-defined search terms and selection criteria, complemented by hand-searching. All titles, abstracts, and full texts were independently screened by two reviewers from a pool of four researchers. Data extraction and reporting were according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Methodological quality and risk of bias assessment was performed using the Newcastle-Ottawa Scale for cohort studies. Data were summarized using narrative synthesis. The search yielded 1782 records. Of the 52 full-text articles included for review, 8 longitudinal population-based studies were included for final data synthesis. Almost all studies were conducted in Asia, with only one from South America and none from Africa. All studies were published in the last decade, with half published in the year 2021. The definitions used for multimorbidity were heterogeneous, including 3-16 chronic conditions per study. The leading chronic conditions were heart disease, stroke, and diabetes, and there was a lack of consideration of mental health conditions (MHCs), infectious diseases, and undernutrition. Prospectively evaluated determinants included socio-economic status, markers of social inequities, childhood adversity, lifestyle behaviors, obesity, dyslipidemia, and disability. This review revealed a paucity of evidence from LMICs and a geographical bias in the distribution of multimorbidity research. Longitudinal research into epidemiological aspects of multimorbidity is warranted to build up scientific evidence in regions beyond Asia. Such evidence can provide a detailed picture of disease development, with important implications for community, clinical, and interventions in LMICs. The heterogeneity in study designs, exposures, outcomes, and statistical methods observed in the present review calls for greater methodological standardisation while conducting epidemiological studies on multimorbidity. The limited evidence for MHCs, infectious diseases, and undernutrition as components of multimorbidity calls for a more comprehensive definition of multimorbidity globally.

Subjective memory complaints: Prevalence, associated factors and sex differences in the ELSI-Brazil study.

BACKGROUND: Subjective memory complaints (SMCs) are a possible prodrome of cognitive decline but are understudied in low- and middle-income countries (LMIC). We aimed to estimate the prevalence of SMCs in a large, nationally representative sample of older adults from Brazil and to identify sociodemographic and health-related factors that are associated with SMCs independently of objective memory. METHODS: Baseline data (n = 7831) from the ELSI-Brazil study, a national representative sample of adults aged 50 and over. They were asked to rate their memory and then divided into two groups - having or not having SMCs. Logistic regression models were used to estimate the association of demographic characteristics, health related factors, objective memory performance and disability in basic (b-ADL), instrumental (i-ADL), and advanced (a-ADL) activities of daily living associated with SMCs. Whether sex was an effect modifier of the association between age and objective memory performance and SMCs was also tested. RESULTS: Of the sample, 42% (95% CI; 39.9-43.9) had SMCs, and it was higher among women (46.9%) than men (35.9%). SMC prevalence decreased with age among women and increased among men, and for both it decreased with better cognitive performance. Fully adjusted logistic regression model showed that older age, higher education, higher b-ADL scores, and better cognitive performance were associated with decreased SMCs, while being female, with higher number of chronic conditions, higher i-ADL scores, worst self-rated health, and an increased number of depressive symptoms were associated with increased SMCs. However, the interaction test (p < 0.001) confirmed that increased age was associated with decreased SMCs only among women, and that better objective memory performance was associated with decreased SMCs only among men. CONCLUSIONS: SMCs are common in the Brazilian older population and are associated with health and sociodemographic factors, with different patterns between men and women. There is a need for future studies looking at the cognitive trajectory and dementia risk in older adults with subjective cognitive complaints.

Dissipative optomechanics in high-frequency nanomechanical resonators.

The coherent transduction of information between microwave and optical domains is a fundamental building block for future quantum networks. A promising way to bridge these widely different frequencies is using high-frequency nanomechanical resonators interacting with low-loss optical modes. State-of-the-art optomechanical devices rely on purely dispersive interactions that are enhanced by a large photon population in the cavity. Additionally, one could use dissipative optomechanics, where photons can be scattered directly from a waveguide into a resonator hence increasing the degree of control of the acousto-optic interplay. Hitherto, such dissipative optomechanical interaction was only demonstrated at low mechanical frequencies, precluding prominent applications such as the quantum state transfer between photonic and phononic domains. Here, we show the first dissipative optomechanical system operating in the sideband-resolved regime, where the mechanical frequency is larger than the optical linewidth. Exploring this unprecedented regime, we demonstrate the impact of dissipative optomechanical coupling in reshaping both mechanical and optical spectra. Our figures represent a two-order-of-magnitude leap in the mechanical frequency and a tenfold increase in the dissipative optomechanical coupling rate compared to previous works. Further advances could enable the individual addressing of mechanical modes and help mitigate optical nonlinearities and absorption in optomechanical devices.

More than trees: Stand management can be used to improve ecosystem diversity, structure and functioning 20 years after forest restoration in drylands.

In Mediterranean drylands, extensive areas have been restored by reforestation over the past decades to improve diversity, soil fertility, and tree natural regeneration, contributing to halting desertification and land degradation. However, evaluating reforestation success usually relies on tree survival, while holistic and long-term evaluations of reforestation success based on ecosystem diversity, structure and functioning are scarce. In this work, we provide the first assessment that combines the evaluation of planted trees and indicators of ecosystem diversity, structure, and functioning in established reforestations with three native Mediterranean species along a climatic gradient. We sampled 43 20-year-old stands with umbrella pine, holm oak and cork oak in Portugal, and tested the effects of tree species composition, stand management (i.e., differences in tree density and shrub cover), and edaphoclimatic conditions, on the size of planted trees, species diversity, structural complexity and indicators of ecosystem functioning related to productivity, soil nutrients and tree natural regeneration. Our results show that, after 20 years of reforestation, stand management was an essential driver of plant diversity and ecosystem functioning. Higher tree density, particularly of oaks, and higher shrub cover improved plant diversity, ecosystem productivity, and oak regeneration. The latter was also improved by structural complexity. Tree composition effects highlighted the importance of pine management to avoid competition. Since we evaluated these reforestations along a climatic gradient, we also conclude that climate influenced pine and holm oak size, ecosystem productivity, and soil C/N. Our research, by being based on assessing the long-term reforestation success in a more holistic way, highlighted the importance of stand management for improving ecosystem diversity and functioning in these restored systems. Practices such as increasing tree density up to ~800 trees/ha and allowing a shrub cover of ca. 30 %, may improve the ecological condition of future and currently reforested areas across the Mediterranean region.

The magnetic signal from trunk bark of urban trees catches the variation in particulate matter exposure within and across six European cities.

Biomagnetic monitoring increasingly is applied to assess particulate matter (PM) concentrations, mainly using plant leaves sampled in small geographical area and from a limited number of species. Here, the potential of magnetic analysis of urban tree trunk bark to discriminate between PM exposure levels was evaluated and bark magnetic variation was investigated at different spatial scales. Trunk bark was sampled from 684 urban trees of 39 genera in 173 urban green areas across six European cities. Samples were analysed magnetically for the Saturation isothermal remanent magnetisation (SIRM). The bark SIRM reflected well the PM exposure level at city and local scale, as the bark SIRM (i) differed between the cities in accordance with the mean atmospheric PM concentrations and (ii) increased with the cover of roads and industrial area around the trees. Furthermore, with increasing tree circumferences, the SIRM values increased, as a reflection of a tree age effect related to PM accumulation over time. Moreover, bark SIRM was higher at the side of the trunk facing the prevailing wind direction. Significant relationships between SIRM of different genera validate the possibility to combine bark SIRM from different genera to improve sampling resolution and coverage in biomagnetic studies. Thus, the SIRM signal of trunk bark from urban trees is a reliable proxy for atmospheric coarse to fine PM exposure in areas dominated by one PM source, as long as variation caused by genus, circumference and trunk side is taken into account.

Prevalence of Dementia and Cognitive Impairment No Dementia in a Large and Diverse Nationally Representative Sample: The ELSI-Brazil Study.

BACKGROUND: Approximately 77% of older adults with dementia in Brazil have not been diagnosed, indicating a major public health issue. Previous epidemiological dementia studies in Brazil were based on data from 1 geopolitical region. METHODS: We aimed to estimate the general and subgroup-specific (age, education, and sex) prevalence of dementia and cognitive impairment no dementia (CIND) classification using data from 5 249 participants aged 60 years and older from the ELSI-Brazil, a large nationally representative sample. Participants were classified as having normal cognitive function, CIND, or dementia based on a combination of the individual's cognitive and functional status. RESULTS: We found a general prevalence of 5.8% (95% CI = 4.7-7.2) for dementia and 8.1% (95% CI = 6.8-9.5) for CIND. Dementia prevalence ranged from 3.2% (60-64 years old) to 42.8% (≥90 years old) by age, and from 2.1% (college level or higher) to 16.5% (illiterates) by education. Females had a higher dementia prevalence (6.8%) than males (4.6%). CIND prevalence was similar across age, sex, and education. CONCLUSIONS: The estimated dementia prevalence is lower than that in previous Brazilian epidemiological studies, but is in line with other Latin American studies. Only 1.2% of the ELSI-Brazil participants reported having a previous diagnosis of dementia, revealing that underdiagnosis is rampant and a common reality. Based on our results and national statistics projections, we estimate that in 2019, there were 1 757 480 people aged 60 years and older living with dementia in Brazil and, at least, another 2 271 314 having to deal with some form of cognitive impairment.

Modelling the response of urban lichens to broad-scale changes in air pollution and climate.

To create more resilient cities, it is important that we understand the effects of the global change drivers in cities. Biodiversity-based ecological indicators (EIs) can be used for this, as biodiversity is the basis of ecosystem structure, composition, and function. In previous studies, lichens have been used as EIs to monitor the effects of global change drivers in an urban context, but only in single-city studies. Thus, we currently do not understand how lichens are affected by drivers that work on a broader scale. Therefore, our aim was to quantify the variance in lichen biodiversity-based metrics (taxonomic and trait-based) that can be explained by environmental drivers working on a broad spatial scale, in an urban context where local drivers are superimposed. To this end, we performed an unprecedented effort to sample epiphytic lichens in 219 green spaces across a continental gradient from Portugal to Estonia. Twenty-six broad-scale drivers were retrieved, including air pollution and bio-climatic variables, and their dimensionality reduced by means of a principal component analysis (PCA). Thirty-eight lichen metrics were then modelled against the scores of the first two axes of each PCA, and their variance partitioned into pollution and climate components. For the first time, we determined that 15% of the metric variance was explained by broad-scale drivers, with broad-scale air pollution showing more importance than climate across the majority of metrics. Taxonomic metrics were better explained by air pollution, as expected, while climate did not surpass air pollution in any of the trait-based metric groups. Consequently, 85% of the metric variance was shown to occur at the local scale. This suggests that further work is necessary to decipher the effects of climate change. Furthermore, although drivers working within cities are prevailing, both spatial scales must be considered simultaneously if we are to use lichens as EIs in cities at continental to global scales.

Phyllosphere bacterial communities in urban green areas throughout Europe relate to urban intensity.

The phyllosphere harbours a diverse and specific bacterial community, which influences plant health and ecosystem functioning. In this study, we investigated the impact of urban green areas connectivity and size on the composition and diversity of phyllosphere bacterial communities. Hereto, we evaluated the diversity and composition of phyllosphere bacterial communities of 233 Platanus x acerifolia and Acer pseudoplatanus trees in 77 urban green areas throughout 6 European cities. The community composition and diversity significantly differed between cities but only to a limited extent between tree species. We could show that urban intensity correlated significantly with the community composition of phyllosphere bacteria. In particular, a significant correlation was found between the relative abundances for 29 out of the 50 most abundant families and the urban intensity: the abundances of classic phyllosphere families, such as Acetobacteraceae, Planctomycetes, and Beijerinkiaceae, decreased with urban intensity (i.e. more abundant in areas with more green, lower air pollution, and lower temperature), while those related to human activities, such as Enterobacteriaceae and Bacillaceae, increased with urban intensity. The results of this study suggest that phyllosphere bacterial communities in European cities are associated with urban intensity and that effect is mediated by several combined stress factors.

Wild bee larval food composition in five European cities.

Urbanization poses threats and opportunities for the biodiversity of wild bees. At the same time, cities can harbor diverse wild bee assemblages, partly due to the unique plant assemblages that provide resources. While bee dietary preferences have been investigated in various studies, bee dietary studies have been conducted mostly in nonurban ecosystems and data based on plant visitation observations or palynological techniques. This data set describes the larval food preferences of four wild bee species (i.e., Chelostoma florisomne, Hylaeus communis, Osmia bicornis, and O. cornuta) common in urban areas in five different European cities (i.e., Antwerp, Belgium; Paris, France; Poznan, Poland; Tartu, Estonia; and Zurich, Switzerland). In addition, the data set describes the larval food preferences of individuals from three wild bee genera (i.e., Chelostoma sp., Hylaeus sp., and Osmia sp.) that could not be identified to the species level. These data were obtained from a Europe-level study aimed at understanding the effects of urbanization on biodiversity across different cities and cityscapes and a Swiss project aimed at understanding the effects of urban ecosystems in wild bee feeding behavior. Wild bees were sampled using standardized trap nests at 80 sites (32 in Zurich and 12 in each of the remaining cities), selected following a double gradient of available habitat at local and landscape scales. Larval pollen was obtained from the bee nests and identified using DNA metabarcoding. The data provide the plant composition at the species or genus level preferred by each bee. These unique data can be used for a wide array of research questions, including urban ecology (e.g., diversity of food sources along urban gradients), bee ecology (characterization of bee feeding preferences), or comparative studies on the urban evolution of behavioral traits between urban and nonurban sites. In addition, the data can be used to inform urban planning and conservation strategies, particularly concerning flower resources (e.g., importance of exotic species and, thus, management activities). This data set can be freely used for noncommercial purposes, and this data paper should be cited if the data is used; we request that collaboration with the data set contact person to be considered if this data set represents an important part of the data analyzed in a study.

Local-scale factors matter for tree cover modelling in Mediterranean drylands.

Forests contribute directly to ecosystem structure and functioning, maintaining biodiversity, acting as a climate regulator and reducing desertification. To better manage forests, it is essential to have high-resolution forest models and appropriate spatial-explicit variables able to explain tree cover at different scales, including the management scale. Most tree cover models rely only on broad-scale variables (>500 m), such as macroclimate, while only few studies include also local-scale variables (<500 m). This study aimed to identify the importance of local-scale factors relative to broad-scale factors and identify the environmental variables at different scales that explain tree cover in oak woodlands in Mediterranean drylands. Sixty sites previously identified as being covered with Holm oak or Cork oak were stratified by precipitation. Normalized Difference Vegetation Index, used here as a surrogate of tree cover, was modelled using simultaneously broad-scale factors (macroclimate) and local-scale factors (microclimatic and edaphic conditions). The percentage of variance explained by local- and broad-scale factors and the effect size of each environmental variable on tree cover was determined for the study site. It was found that local-scale factors and their interaction with broad-scale factors explained more variance than broad-scale factors alone. The most important local-scale factors explaining tree cover were elevation, potential solar radiation, used as a surrogate of microclimatic conditions, and wetness evaluated terrain used as an indicator of water flow accumulation. The main broad-scale factors were related to temperature and precipitation. The effect of some local-scale variables in tree cover seems to increase in areas where water as a limiting factor is more important. This study demonstrates the critical importance of including local-scale factors in multi-scale modelling of tree cover to obtain better predictions. These models will support well-suited forest management decisions, such as reforestation and afforestation plans to reverse evergreen oaks decline in Mediterranean drylands.

Harvesting circuits for triboelectric nanogenerators for wearable applications.

Internet of Things (IoT) and recently Internet of Nano Things (IoNT) bear the promise of new devices able to communicate and assist our daily lives toward wearable technologies which demand a versatile integration such as in wireless body networks (WBN), sensing, and health monitorization. These must comply with stringent constraints on energy usage. Dimensions and complexity intensify the need for small and maintenance-free power sources. Environment energy harvesting and storage is an important approach to sustain operation for a long time. Triboelectric nanogenerators (TENGs) arise as a strong and promising solution to power the new field of outcoming self-sustainable devices, implantable, and wearable devices. They can transform mechanical energy in different modes, have simple structures, and use vulgar and sustainable materials. This paper makes a review about TENGs technology, construction, materials, operation, and focus on strategies for harvesting circuits. Main challenges like efficiency, reliability, energy storage, and sustainability are discussed.

Photobiomodulation as a treatment for dermatitis caused by chemoradiotherapy for squamous cell anal carcinoma: case report and literature review.

In-field dermatitis is a severe and common adverse effect of radiation therapy, that can cause significant pain and treatment interruptions in patients with squamous cell anal carcinoma (SCAC) being treated with radical chemoradiation protocols. There are no established therapies for the treatment of radiation induced dermatitis. Photobiomodulation (PBM) is an effective and low-cost treatment for radiation induced mucositis, but have recently been explored to treat in-field dermatitis. We present a case report of the successful use of PBM for the treatment of dermatitis in the anal area in a patient with SCAC treated with concomitant chemoradiation with curative intent and follow with a literature review of the recent advances and possibilities of the use of PBM as a promising strategy. PBM therapy proved to be efficient in the radiodermatitis treatment, both in relieving the symptoms and controlling dermatitis, in addition to improving the patient's quality of life.

3D Antenna Characterization for WPT Applications.

The main goal of this paper is to present a three-dimensional (3D) antenna array to improve the performance of wireless power transmission (WPT) systems, as well as its characterization with over-the-air (OTA) multi-sine techniques. The 3D antenna consists of 15 antenna elements attached to an alternative 3D structure, allowing energy to be transmitted to all azimuth directions at different elevation angles without moving. The OTA multi-sine characterization technique was first utilized to identify issues in antenna arrays. However, in this work, the technique is used to identify which elements of the 3D antenna should operate to transmit the energy in a specific direction. Besides, the 3D antenna design description and its characterization are performed to authenticate its operation. Since 3D antennas are an advantage in WPT applications, the antenna is evaluated in a real WPT scenario to power an RF-DC converter, and experimental results are presented.

A dataset of the flowering plants (Angiospermae) in urban green areas in five European cities.

This article summarizes the data of a survey of flowering plants in 80 sites in five European cities and urban agglomerations (Antwerp, Belgium; greater Paris, France; Poznan, Poland; Tartu, Estonia; and Zurich, Switzerland). Sampling sites were selected based on a double orthogonal gradient of size and connectivity and were urban green areas (e.g. parks, cemeteries). To characterize the flowering plants, two sampling methodologies were applied between April and July 2018. First, a floristic inventory of the occurrence of all flowering plants in the five cities. Second, flower counts in sampling plots of standardized size (1 m2) only in Zurich. We sampled 2146 plant species (contained in 824 genera and 137 families) and across the five cities. For each plant species, we provide its origin status (i.e. whether the plants are native from Europe or not) and 11 functional traits potentially important for plant-pollinator interactions. For each study site, we provide the number of species, genera, and families recorded, the Shannon diversity as well as the proportion of exotic species, herbs, shrubs and trees. In addition, we provide information on the patch size, connectivity, and urban intensity, using four remote sensing-based proxies measured at 100- and 800-m radii.

Missed Tillaux Fracture and Syndesmosis Injury in Adult: Arthroscopic Assisted Reduction and Fixation.

Tillaux fractures are fractures of the lateral margin of the distal tibia, usually reported in children between 12 and 14 years old. As intraarticular fractures, they require anatomic reduction and fixation to avoid posttraumatic complications. Since the injury mechanism is external rotation of the foot on the leg, these injuries are commonly associated with other fractures or ligamentous lesions. Currently, arthroscopy is being increasingly used to assist and improve surgical treatment of ankle fractures. The authors describe a 12-month follow-up of a rare case of a missed Tillaux fracture associated with syndesmosis injury in a 76-year-old polytrauma patient, successfully treated by arthroscopically-assisted reduction and internal fixation.

Missed Tillaux Fracture and Syndesmosis Injury in Adult: Arthroscopic Assisted Reduction and Fixation / Fratura de Tillaux não percebida e lesão por sindesmose em adultos: Redução e fixação artroscópica assistida

Abstract Tillaux fractures are fractures of the lateral margin of the distal tibia, usually reported in children between 12 and 14 years old. As intraarticular fractures, they require anatomic reduction and fixation to avoid posttraumatic complications. Since the injury mechanism is external rotation of the foot on the leg, these injuries are commonly associated with other fractures or ligamentous lesions. Currently, arthroscopy is being increasingly used to assist and improve surgical treatment of ankle fractures. The authors describe a 12-month follow-up of a rare case of a missed Tillaux fracture associated with syndesmosis injury in a 76-year-old polytrauma patient, successfully treated by arthroscopically-assisted reduction and internal fixation.

Resumo As fraturas de Tillaux são fraturas da margem lateral da tíbia distal, geralmente relatadas em crianças entre 12 e 14 anos. Como fraturas intra-articulares, requerem redução e fixação anatômica para evitar complicações pós-traumáticas. Como o mecanismo de lesão é a rotação externa do pé na perna, essas lesões são comumente associadas a outras fraturas ou lesões ligamentares. Atualmente, a artroscopia está sendo cada vez mais utilizada para auxiliar e melhorar o tratamento cirúrgico das fraturas do tornozelo. Os autores descrevem um acompanhamento de 12 meses de um caso raro de uma fratura não percebida de Tillaux associada a lesão por sindesmose em um paciente de politrauma com 76 anos de idade, tratado com sucesso por redução e fixação interna assistida por artroscopia.