Xylazine-Associated Necrotic Upper-Extremity Wounds: A Single Hospital System's Experience with 82 Patients and 125 Wounds.

Background: The rise in xylazine-adulterated heroin and fentanyl poses novel challenges to hand surgeons and a rising epidemic of necrotic upper-extremity wounds. While prior case studies have focused on particularly severe and complex xylazine-associated necrotic (XAN) wounds, the aim of this consecutive case series was to characterize the variability of presentations (ranging from mild to severe) at a single institution at the epicenter of the xylazine epidemic.

Methods: Patients presenting to a tertiary referral center for XAN upper-extremity wounds were retrospectively identified from emergency department visits and hospital admissions between January 2021 and December 2023.

Biometrics and Biomarkers in Patients With Psoriasis.

Psoriasis (PsO) is a chronic, systemic, and autoimmune dermatologic condition characterized by dry, scaly, and erythematous plaques on the skin. PsO can present in various forms, including guttate (small, round lesions commonly over the upper trunk and extremities that can be raised and scaly), inverse (smooth plaques of inflamed skin within skin folds of the groin, buttock, and breasts), pustular (white painful pustules within red inflamed blotches widespread over the body), and erythrodermic (red rash present over most of the body). Individuals with PsO can present differently, with unique symptoms and patterns on the skin.

Skin necrosis following digital wart intralesional injection of cantharidin.

A right-hand-dominant female presented 5 weeks following a right middle finger intralesional cantharidin injection for a common wart by a dermatologist. The patient experienced progressive stiffness, blistering, swelling, pain, and ultimately, full-thickness skin necrosis surrounding the injection site. Careful debridement followed by a full-thickness skin graft was performed with no evidence of involvement of the germinal matrix or terminal extensor tendon.

The Performance of a Customized Generative Pre-trained Transformer on the American Society for Surgery of the Hand Self-Assessment Examination.

Introduction:  Multimodal large language models (MLLMs), such as OpenAI's ChatGPT (San Francisco, CA), have the potential to improve medical care delivery and education, although important shortcomings in accuracy and image interpretation have been noted. The aim of this study was to assess the multimodal performance of a ChatGPT model customized with hand surgery-specific knowledge.

Methods: A customized generative pre-trained transformer (GPT) was trained using peer-reviewed literature recommended by the American Society for Surgery of the Hand (ASSH).

Active decompression during automated head-up cardiopulmonary resuscitation.

Background: The combination of active compression-decompression cardiopulmonary resuscitation (ACD-CPR) with an impedance threshold device (ITD) and controlled head-up positioning (AHUP-CPR) is associated with improved outcomes compared with conventional CPR (C-CPR). This study focused on the role of active decompression (AD) during AHUP-CPR.

Methods: Farm pigs (n = 10, ∼40 kg) were anesthetized, intubated and ventilated.

The Performance of ChatGPT on the American Society for Surgery of the Hand Self-Assessment Examination.

Background: This study aims to compare the performance of ChatGPT-3.5 (GPT-3.5) and ChatGPT-4 (GPT-4) on the American Society for Surgery of the Hand (ASSH) Self-Assessment Examination (SAE) to determine their potential as educational tools.

Treatment Options for Failed Back Surgery Syndrome: An Umbrella Systematic Review of Systematic Reviews on the Effectiveness of Therapeutic Interventions.

Background: Failed back surgery syndrome (FBSS) is a common and incapacitating condition affecting patients with previous spine surgery in whom treatment approach can be challenging. This study aimed to summarize existing secondary studies and up-to-date randomized clinical trials (RCTs) that assess the effectiveness of available treatment options for FBSS.

Methods: Systematic searches were carried out in five databases (PubMed, Cochrane, Scielo, Epistemonikos, and Google scholar) for all systematic reviews on the effectiveness of treatment options for FBSS published after 2012.

Initial Experience of Using First-Person Wearable Video Recording Technology During Central Venous Catheter Placement in the Cardiac Operating Room.

Objective: The aim of this study was to use wearable video-recording technology to measure precisely the timing of discrete events during perioperative central venous catheter (CVC) placements.

Design: A single-center, observational, exploratory study on the use of wearable video-recording technology during intraoperative CVC placement.

Setting: The study was conducted at a University Hospital.

Extensor tendon transfer for fracture-related extensor pollicis longus rupture: Long-term outcome case series.

Background: Spontaneous rupture of the extensor pollicis longus (EPL) tendon following both nonoperative and operative treatment of distal radius fractures has been well described.

Purpose: The purpose of this study was to assess long-term outcomes of extensor indicis proprius to EPL tendon transfers for patients following distal radius fracture and EPL tendon repair.

Study Design: Retrospective case series focusing on long-term clinical outcomes.

The association of regional cerebral oximetry and neurologically intact survival in a porcine model of cardiac arrest.

Background: The objective of this study was to determine if regional cerebral oximetry (rSO2) assessed during CPR would be predictive of survival with favorable neurological function in a prolonged model of porcine cardiac arrest. This study also examined the relative predictive value of rSO2 and end-tidal carbon dioxide (ETCO2), separately and together.

Methods: This study is a post-hoc analysis of data from a previously published study that compared conventional CPR (C-CPR) and automated head-up positioning CPR (AHUP-CPR).

Chemical Characterization of 29 Industrial Hempseed ( L.) Varieties.

Hemp is considered one of the potential novel crops for human and animal nutrition. This study aimed to determine the complete chemical composition of 29 different varieties of whole hempseeds. Fatty acid composition, amino acid profile, mineral composition, and cannabinoids content were also evaluated.

Evaluation of behavior in veal calves fed milk containing different levels of hempseed cake (.).

The present study aimed to evaluate the effect on behavioral patterns of veal calves fed with increasing levels of hempseed cake (HSC) diluted in the milk replacer. In total, 48 Belgian Blue veal calves (12 females and 36 males), with a body weight (BW) of 62.0 kg and age of 42.

Validation of Temperature Sensors to Monitor Thermoplastic Splint Wear in Hand Surgery Patients.

Background: The aim of this study was to validate the use of temperature sensors to accurately measure thermoplastic volar forearm splint wear in a healthy cohort of volunteers using 5- and 15-minute temperature measurement intervals.

Methods: A prospective diagnostic study was performed to evaluate the diagnostic accuracy of temperature sensors in monitoring splint wear in 8 healthy volunteers between December 2022 and June 2023. Temperature sensors were molded into thermoplastic volar forearm splints.

Hemodynamics, survival and neurological function with early versus delayed automated head-up CPR in a porcine model of prolonged cardiac arrest.

Aim: To determine if controlled head and thorax elevation, active compression-decompression cardiopulmonary resuscitation (CPR), and an impedance threshold device combined, termed automated head-up positioning CPR (AHUP-CPR), should be initiated early, as a basic (BLS) intervention, or later, as an advanced (ALS) intervention, in a severe porcine model of cardiac arrest.

Methods: Yorkshire pigs (n = 22) weighing ∼40 kg were anesthetized and ventilated. After 15 minutes of untreated ventricular fibrillation, pigs were randomized to AHUP-CPR for 25 minutes (BLS group) or conventional CPR for 10 minutes, followed by 15 minutes of AHUP-CPR (ALS group).

Role of Preoperative Nerve Conduction Studies for Penetrating Hand Injuries Involving the Median Palmar Cutaneous Nerve.

Penetrating lacerations to the hand are a common cause of nerve injury and can lead to debilitating pain and numbness in the distribution of the nerve affected. Owing to an overlap in the cutaneous innervation from different sensory nerves, clinically identifying the injured nerve can be difficult. We present a novel case of isolated injury to the palmar cutaneous nerve from a penetrating knife injury which was detected using 'comparison waveform' nerve conduction studies.

Virtual Reality-based Methods for Training Novice Electrophysiology Trainees-A Pilot Study.

Developing an accurate and detailed 3-dimensional (3D) mental model of cardiac anatomy is critical for electrophysiology (EP) trainees. Due to its immersive nature, virtual reality (VR) may provide a better learning environment than traditional teaching methods for assimilating 3D cardiac anatomy. The purpose of this pilot study was to evaluate the technical feasibility of an interactive, remote VR-based method for teaching cardiac anatomy to novice EP trainees.

Sex-Dependent Transcriptional Changes in Response to Stress in Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Pilot Project.

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex, multi-symptom illness characterized by debilitating fatigue and post-exertional malaise (PEM). Numerous studies have reported sex differences at the epidemiological, cellular, and molecular levels between male and female ME/CFS patients. To gain further insight into these sex-dependent changes, we evaluated differential gene expression by RNA-sequencing (RNA-Seq) in 33 ME/CFS patients (20 female, 13 male) and 34 matched healthy controls (20 female and 14 male) before, during, and after an exercise challenge intended to provoke PEM.

A role for ultra-high resolution three-dimensional printed human heart models.

Introduction: Echocardiography is essential for diagnosing and assessing the severity of perioperative structural and functional heart disease. Yet, educational opportunities to better understand echocardiography-based cardiac anatomy remain limited by the two-dimensional display, lack of anatomic details, variability of heart models, and costs and global access of training.

Methods: We performed micro computed tomography of human heart specimens not suitable for orthotopic transplantation.

Physical Characterization of Ten Hemp Varieties to Use as Animal Bedding Material.

Hemp ( L.) hurds, the inner bark of the stem, are a poorly appreciated part of the plant that typically represents waste. The aim of this experiment was to describe the physical characteristics, including moisture (M), water absorption (WA), and ammonia absorption (AA), of 10 hemp varieties (Fibranova, Codimono, USO31, CS, Futura 75, Eletta Campana, Carmaleonte, Felina 32, Santhica, and Ferimon) cultivated in Italy.

A Free-Access Online Interactive Simulator to Enhance Perioperative Transesophageal Echocardiography Training Using a High-Fidelity Human Heart 3D Model.

The clinical uses of perioperative transesophageal echocardiography have grown exponentially in recent years for both cardiac and noncardiac surgical patients. Yet, echocardiography is a complex skill that also requires an advanced understanding of human cardiac anatomy. Although simulation has changed the way echocardiography is taught, most available systems are still limited by investment costs, accessibility, and qualities of the input cardiac 3-dimensional models.

Effect of Dietary Hemp Cake Inclusion on the In Vivo and Post Mortem Performances of Holstein Veal Calves.

Fifty-two male Holstein veal calves were divided into two homogeneous groups receiving two isoenergetic and isonitrogenous concentrates without (CTR group) or with 3% of hemp cake (HC group). The trial lasted for 171 days. All the calves were weighed five times during the trial.

Medical decision support system using weakly-labeled lung CT scans.

Purpose: Determination and development of an effective set of models leveraging Artificial Intelligence techniques to generate a system able to support clinical practitioners working with COVID-19 patients. It involves a pipeline including classification, lung and lesion segmentation, as well as lesion quantification of axial lung CT studies.

Approach: A deep neural network architecture based on DenseNet is introduced for the classification of weakly-labeled, variable-sized (and possibly sparse) axial lung CT scans.

A High-Fidelity Three-Dimensional Computational Model of a Patient with Hypertrophic Cardiomyopathy.

• Echocardiography and CMR are used for diagnosis of HCM. • Learning echocardiography requires advanced and repetitive training. • A 3D model can enhance understanding of cardiac anatomy and pathophysiology.