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2%) and foot/toes (93.8%) cases since 2014, and ankle arthroscopy has increased 20.7%. Disparities in total cases between 10th and 90th percentile programs have shown a nonsignificant decrease over time, with significant differences between leg/ankle arthrodesis (8-fold), leg/ankle arthroscopy (13-fold), and foot/toe arthrodesis (3.5-fold) in 2019.

The mean volume of foot and ankle case exposures among graduating residents has continued to rise since the implementation of case minimums in 2013 but disparities in volume are present, most notably concerning arthrodesis and arthroscopy. Recognition and future attention toward addressing this variability can be meaningful in promoting a more comprehensive, standardized orthopaedics education.

Level III Retrospective comparative study.

Level III Retrospective comparative study.The coronavirus disease (COVID-19) caused by SARS-CoV-2 is a big challenge and burning issue to the scientific community and doctors worldwide. Globally, COVID-19 has created a health disaster and adversely affects the economic growth. Although some vaccines have already emerged, no therapeutic medication has yet been approved by FDA for the treatment of COVID-19 patients. Traditionally, we have been using different medicinal plants like neem, tulsi, tea, and many spices like garlic, ginger, turmeric, black seed, onion, etc. for the treatment of flu-like diseases. In this paper, we are highlighting the recent research progress in the identification of natural products from the Indian medicinal plants and spices that have potential inhibition properties against SARS-CoV-2. This study will provide an initiative to stimulate further research by providing useful guidance to the medicinal chemists for designing new protease inhibitors effective against SARS-CoV-2 in future.The synthesis of unsymmetrical urea generally requires toxic reagent, solvent and harsh reaction condition. Herein, we introduce Cu-catalyzed greener and safer unsymmetrical urea derivatives synthesis in ethyl acetate. This method minimized utilization of toxic reagent. A variety of indole, amines, and azides with bis-indole successfully employed leading to high yields and gram scale synthesis of isolated urea.Type 2 diabetes mellitus remains global health challenge with involvement of both insulin resistance and dysfunctional insulin secretion from the pancreatic β-cell. Currently, peroxisome proliferator-activated receptor gamma (PPARγ) has been established to play a significant role in glucose homeostasis and insulin sensitization contributing to the pathogenesis of type 2 diabetes mellitus. Hence, this study used in-silico analysis to predict PPARγ antagonists from the natural compounds. ADMET screening, structure-based virtual screening and MM/GBSA calculations of phytochemicals from HPLC analysis of A. precatorius seeds were performed against PPARγ using Maestro Schrodinger suite, followed by the MD simulation of top hit compounds and reference ligand using GROMACS. The quantum chemical calculations of the compounds were performed using Spartan 14 computational chemistry software. The five compounds showed varying degree of binding affinity against PPARγ, the post-docking analysis confirmed strong interaction-acceptor. This study revealed that bioactive compounds especially chlorogenic acid and quercetin identified from A. precatorius seeds demonstrated good modulatory potential against PPARγ compared to acarbose. Therefore, these compounds require further experimental validation for the discovery of new antagonist of PPARγ for developing new anti-diabetes therapy.Communicated by Ramaswamy H. Sarma.

Sigmoid volvulus is a potentially devastating and life-threatening condition associated with sigmoid colon redundancy. Many of the classical radiological signs are considered to represent the two adjacent loops of bowel in a mesentero-axial volvulus. However, limited case reports and series have reported on an organo-axial subtype of sigmoid volvulus. This clinical entity is not widely understood. In this study, we assess the radiological and clinical features of mesentero-axial and organo-axial sigmoid volvulus.

After institutional board approval (CH62/6/2016-228), all computed tomography (CT) studies from 2011 to 2017 reported as sigmoid volvulus at a single institution were reviewed. The cases were reviewed by three radiologists retrospectively and the course of the bowel followed with a focus on assessing its rotational axis. In each case, the sigmoid volvulus was independently subclassified as mesentero-axial or organo-axial volvulus based on the axis of rotation of the volvulus. In addition, X-ray sus.The Ultra-Orthodox community in Israel, characterized by close-knit ties and strong community values, has been particularly vulnerable to COVID-19, both epidemiologically and socially. Accordingly, the current study examined whether the connection between the sense of community and life satisfaction in this population is mediated by meaning in life (MIL). Three hundred and fifty-eight Ultra-Orthodox participants (age range 30-70; M = 49.50, SD = 10.24) filled out scales assessing MIL, sense of community, and satisfaction with life (SWL), as well as sociodemographic and COVID-19-related scales. Sense of community was linked with increased MIL and life satisfaction. Moreover, the connection between sense of community and life satisfaction was mediated by MIL. This study highlights the roles of sense of community and MIL for Ultra-Orthodox individuals and emphasizes the importance of both concepts for maintaining SWL during COVID-19. Practical implications for Ultra-Orthodox communities are suggested.

Raman spectroscopy (RS) provides an automated approach for assisting Mohs micrographic surgery for skin cancer diagnosis; however, the specificity of RS is limited by the high spectral similarity between tumors and normal tissues structures. Reflectance confocal microscopy (RCM) provides morphological and cytological details by which many features of epidermis and hair follicles can be readily identified. Combining RS with deep-learning-aided RCM has the potential to improve the diagnostic accuracy of RS in an automated fashion, without requiring additional input from the clinician.

The aim of this study is to improve the specificity of RS for detecting basal cell carcinoma (BCC) using an artificial neural network trained on RCM images to identify false positive normal skin structures (hair follicles and epidermis).

Our approach was to build a two-step classification model. In the first step, a Raman biophysical model that was used in prior work classified BCC tumors from normal tissue structures with high sensitivity. In the second step, 191 RCM images were collected from the same site as the Raman data and served as inputs for two ResNet50 networks. The networks selected the hair structure and epidermis images, respectively, within all images corresponding to the positive predictions of the Raman biophysical model with high specificity. The specificity of the BCC biophysical model was improved by moving the Raman spectra corresponding to these selected images from false positive to true negative.

Deep-learning trained on RCM images removed 52% of false positive predictions from the Raman biophysical model result while maintaining a sensitivity of 100%. The specificity was improved from 84.2% using Raman spectra alone to 92.4% by integrating Raman spectra with RCM images.

Combining RS with deep-learning-aided RCM imaging is a promising tool for guiding tumor resection surgery.

Combining RS with deep-learning-aided RCM imaging is a promising tool for guiding tumor resection surgery.γ-glutamyl carboxylase (GGCX), also known as vitamin K-dependent glutamyl carboxylase, catalyzes the posttranslational modification of specific glutamate residues in vitamin K-dependent proteins (VKDPs), and participates multiple biological functions including blood coagulation, bone metabolism, vascular calcification, and cell proliferation. It has been reported originally that GGCX pathogenic variation causes blood coagulation deficiency, which is called as vitamin K-dependent coagulation factor deficiency 1 (VKCFD1). Recently, it has been found that GGCX gene variation results in multiple clinical phenotypes, including dermatological, ophthalmological, skeletal or cardiac abnormalities. Among them, dermatological phenotype is the most common, which is known as pseudoxanthoma elasticum-like syndrome. This paper has reviewed the GGCX pathogenic variation associated phenotypes, in order to increase the recognition of GGCX-related genetic diseases and to help its diagnosis and treatment.

To assess the association of DNA double-strand break repair genes XRCC5 and LIG4 with glioma.

126 patients with glioma (case group) and 120 healthy volunteers (control group) were enrolled. The polymorphisms of XRCC5 loci rs828704 and rs9288516, LIG4 loci rs3093737, rs3093739 and rs10131 were detected, and their association with the susceptibility to glioma was analyzed.

Hardy-Weinberg test showed that XRCC5 loci rs828704 and rs9288516, LIG4 loci rs3093737, rs3093739 and rs10131 were in equilibrium in both groups (P>0.05). The frequency of A allele of XRCC5 gene rs9288516 locus and T allele of LIG4 gene rs10131 locus in the case group was higher than that in the control group (P<0.05). XRCC5 rs9288516 and LIG4 rs10131 were associated with the susceptibility to glioma under both recessive and additive models (P<0.05), while LIG4 rs3093739 was associated with susceptibility to glioma under the recessive model (P<0.05).

XRCC5 rs9288516 and LIG4 rs10131 are associated with the susceptibility to glioma. Above finding may provide a reference for the prevention and treatment of glioma.

XRCC5 rs9288516 and LIG4 rs10131 are associated with the susceptibility to glioma. Above finding may provide a reference for the prevention and treatment of glioma.

To investigate the molecular mechanism of B antigen weaken expression in 4 cases of ABO blood group samples.

ABO blood group phenotypes were detected by micro-column gel method and saline test tube method. Exon 1-7 and promoter region of the ABO gene were amplified by polymerase chain reaction (PCR) and PCR products were directly sequenced.

Mixed agglutination occurs between RBC and B antibody in all the 4 samples. Three patients were identified as ABweak phenotype, and the mother of the patient ID 2 was identified as Bweak. Direct sequencing and pedigree analysis showed that there were -35 to -18 del GGCGGAAGGCGGAGGCCG mutation in the B allele of 3 samples and C>T mutation in -119 base site of one sample in promoter regions.

The promoter of ABO gene plays an important role in the normal expression of ABO blood group, and the mutation of the promoter can lead to the decreased expression of ABO blood group antigen. In this study, a new abnormal mutation (C>T of -119 base site) in the promoter was found, which should be concerned.

T of -119 base site) in the promoter was found, which should be concerned.

To investigate the genetic cause for an infant with mental retardation through molecular cytogenetic analysis.

Conventional G-banding analysis of peripheral blood for the family was first conducted. Chromosomal microarray analysis (CMA) was performed to further ascertain the size and origin of the abnormal chromosome fragments of the patient.

We identified a Chinese infant who carries an unbalanced, maternally inherited karyotype 48, XY, +der(X) (Yqter→Yq11.221∷Xp22.31→Xqter), +21 in which karyotype and CMA analyses disclosed Xp22.31→Xqter duplication of 147.3 Mb and Yq11.221→Yq11.23 duplication of 12.7 Mb.

Accompany with cytogenetic analysis, CMA can accurately identify the origin and size of the abnormal chromosomes, contributing to the precisely genetic analysis.

Accompany with cytogenetic analysis, CMA can accurately identify the origin and size of the abnormal chromosomes, contributing to the precisely genetic analysis.