Protocol for metadata and image collection at diabetic foot ulcer clinics: enabling research in wound analytics and deep learning.

Background: The escalating impact of diabetes and its complications, including diabetic foot ulcers (DFUs), presents global challenges in quality of life, economics, and resources, affecting around half a billion people. DFU healing is hindered by hyperglycemia-related issues and diverse diabetes-related physiological changes, necessitating ongoing personalized care. Artificial intelligence and clinical research strive to address these challenges by facilitating early detection and efficient treatments despite resource constraints.

The Arctic Ocean's Beaufort Gyre.

The Arctic Ocean's Beaufort Gyre is a dominant feature of the Arctic system, a prominent indicator of climate change, and possibly a control factor for high-latitude climate. The state of knowledge of the wind-driven Beaufort Gyre is reviewed here, including its forcing, relationship to sea-ice cover, source waters, circulation, and energetics. Recent decades have seen pronounced change in all elements of the Beaufort Gyre system.

A 42-year-old man with nodular skin lesions.

Nodular skin lesions are infrequently reported among patients with syphilis. We describe a 42-year-old man with secondary syphilis who presented with a nodular cutaneous eruption involving his neck, upper chest, back, arms, and legs. Because there was uncertainty regarding the diagnosis at presentation, the patient underwent a punch biopsy of one of the lesions.

Polar Ocean Observations: A Critical Gap in the Observing System and Its Effect on Environmental Predictions From Hours to a Season.

There is a growing need for operational oceanographic predictions in both the Arctic and Antarctic polar regions. In the former, this is driven by a declining ice cover accompanied by an increase in maritime traffic and exploitation of marine resources. Oceanographic predictions in the Antarctic are also important, both to support Antarctic operations and also to help elucidate processes governing sea ice and ice shelf stability.

Evaluation of anticoagulation and nonsurgical major bleeding in recipients of continuous-flow left ventricular assist devices.

Continuous-flow left ventricular assist device (LVAD) placement has become a standard of care in advanced heart failure treatment. Bleeding is the most frequently reported adverse event after LVAD implantation and may be increased by antithrombotic agents used for prevention of pump thrombosis. This retrospective cohort included 85 adult patients implanted with a Heartmate II LVAD.

Warming of the interior Arctic Ocean linked to sea ice losses at the basin margins.

Arctic Ocean measurements reveal a near doubling of ocean heat content relative to the freezing temperature in the Beaufort Gyre halocline over the past three decades (1987-2017). This warming is linked to anomalous solar heating of surface waters in the northern Chukchi Sea, a main entryway for halocline waters to join the interior Beaufort Gyre. Summer solar heat absorption by the surface waters has increased fivefold over the same time period, chiefly because of reduced sea ice coverage.

Acitretin Use in Dermatology.

Background: Acitretin has been used for the treatment of severe psoriasis for over 20 years.

Objective: The current project was conceived to optimise patient care by recognising the role acitretin can play in the treatment of patients with psoriasis and those with other disorders of keratinisation.

Methods: A literature review was conducted to explore the role of acitretin and to assess its value for dermatologic disorders other than severe psoriasis.

Assessment of Bleeding and Thrombosis Based on Aspirin Responsiveness after Continuous-Flow Left Ventricular Assist Device Placement.

Pump thrombosis (PT) is a severe complication of left ventricular assist device (LVAD) support. This study evaluated PT and bleeding after LVAD placement in patients responsive to a standard aspirin dose of 81 mg using platelet inhibition monitoring compared with initial nonresponders who were then titrated upward to achieve therapeutic response. Patients ≥ 18 years of age with initial placement of HeartMate II LVAD at our institution and at least one VerifyNow Aspirin test performed during initial hospitalization were included.

Development of a Clinical Pathway for Atopic Dermatitis Patients: A Case-Based Approach.

Background: Atopic dermatitis (AD) is a common chronic skin condition, associated with significant patient morbidity. There are a myriad of excellent evidenced based guidelines to guide clinicians by an extensive review of all the available treatments. However, while well written and complete these papers may not always allow easy transition to clinical application.

Canadian Clinical Practice Guidelines for Rosacea.

Rosacea is a chronic facial inflammatory dermatosis characterized by background facial erythema and flushing and may be accompanied by inflammatory papules and pustules, cutaneous fibrosis and hyperplasia known as phyma, and ocular involvement. These features can have adverse impact on quality of life, and ocular involvement can lead to visual dysfunction. The past decade has witnessed increased research into pathogenic pathways involved in rosacea and the introduction of novel treatment innovations.

The effect of ultrafiltration with cardiopulmonary bypass on the removal of dabigatran from the circulation of adult pigs.

Objective: Dabigatran etexilate is a direct thrombin inhibitor approved for use in patients with non-valvular atrial fibrillation. There is no currently available pharmacological therapy to reverse this renally cleared anticoagulant. Dabigatran has a low level of plasma protein binding and has been considered dialyzable.

Risk of Serious Infection With Biologic and Systemic Treatment of Psoriasis: Results From the Psoriasis Longitudinal Assessment and Registry (PSOLAR).

Importance: The efficacy of treatment for psoriasis must be balanced against potential adverse events.

Objective: To determine the effect of treatment on the risk of serious infections in patients with psoriasis.

Design, Setting, And Participants: A multicenter, longitudinal, disease-based registry (Psoriasis Longitudinal Assessment and Registry [PSOLAR]) at dermatology centers.

Comparison of David V valve-sparing root replacement and bioprosthetic valve conduit for aortic root aneurysm.

Objective: Valve sparing root replacement (VSRR) is an attractive option for the management of aortic root aneurysms with a normal native aortic valve. Therefore, we reviewed our experience with a modification of the David V VSRR and compared it with stented pericardial bioprosthetic valve conduit (BVC) root replacement in an age-matched cohort of older patients.

Methods: A total of 48 VSRRs were performed at our institution, excluding those on bicuspid aortic valves.

Salvage periaortic pericardial baffle equalizes mortality in bleeding patients undergoing aortic surgery.

Objective: Bleeding is a potentially serious complication of aortic surgery. We report our experience with the use of a periaortic bovine pericardial baffle to control intractable intraoperative bleeding.

Methods: All patients who underwent aortic root, ascending, or arch replacements between January 2002 and April 2013 were reviewed.

Topical psoriasis therapy in the age of biologics: evidence-based treatment recommendations.

Background: Although the range of therapeutic options has expanded dramatically in recent years, topical agents remain ubiquitous and indispensable tools for treating psoriasis at all levels of severity. The 2009 Canadian psoriasis guidelines considered evidence supporting various monotherapies and combination regimens.

Objective: Here we review all approved topical agents, including corticosteroids, calcineurin inhibitors, vitamin D analogues, and retinoids, used in psoriasis and develop additional treatment recommendations, using the Scottish Intercollegiate Guidelines Network (SIGN) system to evaluate strength of evidence, as in the original guidelines.