Leveraging a Vision Transformer Model to Improve Diagnostic Accuracy of Cardiac Amyloidosis With Cardiac Magnetic Resonance.

Background: Cardiac magnetic resonance (CMR) imaging is an important diagnostic tool for diagnosis of cardiac amyloidosis (CA). However, discrimination of CA from other etiologies of myocardial disease can be challenging.

Objectives: The aim of this study was to develop and rigorously validate a deep learning (DL) algorithm to aid in the discrimination of CA using cine and late gadolinium enhancement CMR imaging.

Microsurgeon Development, Attrition, and Hope for the Future: A Qualitative Analysis.

Background:  The field of microsurgery continues to grow, yet barriers to practice still exist. This qualitative study aims to elucidate factors both strengthening and threatening this subspecialty through structured interviews with fellowship-trained microsurgeons.

Methods:  An interview guide was designed, and structured interviews were conducted with practicing fellowship-trained microsurgeon members of the American Society of Reconstructive Microsurgeons between August 2021 and May 2022.

Avoiding Patient Abandonment: A Pathway to Ethical Resolution in Situations of Untenable Patient-Surgeon Relationships.

Background: A trusting partnership between patient and surgeon lies at the core of a successful therapeutic relationship. However, there are conditions that can jeopardize this partnership and create an ethical dilemma for the surgeon, who is guided by a moral obligation to care for the patient without causing unnecessary harm. We present a discussion of several pathways to achieve ethical resolution to therapeutic relationships that have grown untenable with a focus on patients with comorbid psychiatric illness.

Reconstruction after Mohs Surgery for Digit Melanoma: Description of Techniques and Postoperative Limb Function.

Introduction: Mohs surgery and reconstruction has enabled tissue-preserving resection of cutaneous malignancies. The goal of our case series evaluation is to present reconstructive techniques and functional outcomes in patients undergoing digit-sparing treatment for primary melanoma.

Materials And Methods: A chart review was performed to identify consecutive patients undergoing Mohs surgery and reconstruction for melanoma of the digits.

Free flap reconstruction of elbow soft tissue defects: Lessons learned from 15 years of experience.

Background: The elbow is a complex joint that is vital for proper function of the upper extremity. Reconstruction of soft tissue defects over the joint space remains challenging, and outcomes following free tissue transfer remain underreported in the literature. The purpose of this analysis was to evaluate the rate of limb salvage, joint function, and clinical complications following microvascular free flap coverage of the elbow.

[Hypercalcaemia: intensive care or general ward].

Hypercalcaemia is a life-threatening electrolyte imbalance, which not only occurs in the context of an endocrinological disease but is also frequently associated with a tumour. Its severity is determined by the level of deviation from normal, acuity of occurrence, and severity of the symptoms. These are unspecific, can affect any organ system and ultimately result in a life-threatening hypercalcaemic crisis characterised by cardiac arrhythmia, metabolic acidosis, exsiccosis, fever, psychotic states and, ultimately, coma.

A comparison between patients with various etiologies of cirrhosis and examination of cardiac risk factors limiting survival to liver transplantation.

Background & Aims: Objectives of this retrospective cohort study were to assess differences in patient survival between etiologies of cirrhosis while on the waitlist for liver transplantation (LT), and to identify cardiac risk factors that predict survival failure while on the waitlist for LT.

Methods: This single-center retrospective cohort design included adult patients who were listed for LT at a tertiary academic hospital with a high-volume liver transplant center.

Results: Of the 653 patients listed for LT during the study period, 507 (77.

Oral Sodium to Preserve Renal Efficiency in Acute Heart Failure: A Randomized, Placebo-Controlled, Double-Blind Study.

Background: Evidence for modulating the sodium chloride (NaCl) intake of patients hospitalized with acute heart failure (AHF) is inconclusive. Salt restriction may not benefit; hypertonic saline may aid diuresis.

Objective: To compare the safety and efficacy of oral NaCl during intravenous (IV) diuretic therapy in renal function and weight.

Targeted muscle reinnervation and regenerative peripheral nerve interfaces for pain prophylaxis and treatment: A systematic review.

Objective: Nerve pain frequently develops following amputations and peripheral nerve injuries. Two innovative surgical techniques, targeted muscle reinnervation (TMR) and regenerative peripheral nerve interfaces (RPNI), are rapidly gaining popularity as alternatives to traditional nerve management, but their effectiveness is unclear.

Literature Survey: A review of literature pertaining to TMR and RPNI pain results was conducted.

Cardiac risk factors limiting survival to liver transplantation in patients with nonalcoholic fatty liver disease.

Background: Nonalcoholic fatty liver disease (NAFLD) describes the hepatic manifestations of metabolic syndrome, which is estimated to affect 25% of adults, and currently represents the second most common indication for liver transplant in the United States. Studies have shown that patients with NAFLD are at an increased risk for heart failure, arrhythmia, and coronary artery disease (CAD), which may impact outcomes of liver transplantation. However, it remains unclear whether the presence of cardiac disease affects survival prior to liver transplant.

Identifying US Plastic Surgery Training Programs that Effectively Establish Gender and Ethnically Diverse Faculty.

Background: Successful strategies to improve the representation of female and ethnically underrepresented in medicine (UIM) physicians among US plastic and reconstructive surgery (PRS) faculty have not been adequately explored. Accordingly, we aimed to identify programs that have had success, and in parallel gather PRS program directors' and chiefs/chairs' perspectives on diversity recruitment intentionality and strategies.

Methods: We conducted a cross-sectional analysis of the demographic composition of female and UIM faculty of PRS residency training programs.

Management of Artery-Only Digit Replantation: A Systematic Review of the Literature.

Background: Artery-only replantation may be necessary in circumstances when venous repair cannot be performed due to their size or vessel injury. Venous congestion of the replanted part is inevitable. A systematic review was performed to identify techniques for mitigating congestion and analyze the outcomes of those techniques.

Does Dedicated Research Time During Residency Predict Resident Academic Productivity and a Future Academic Career?

Objective: Dedicated research time is a component of certain plastic surgery programs, and yet, there is limited research examining its impact on academic productivity and career outcomes. This study aimed to assess the effect of dedicated research time on the academic productivity of residents and the likelihood of pursuing an academic career.

Methods: We conducted a cross-sectional study that examined bibliometric indices of integrated plastic surgery residency graduates from 2010 to 2020.

Proteolysis of fibrillin-2 microfibrils is essential for normal skeletal development.

The embryonic extracellular matrix (ECM) undergoes transition to mature ECM as development progresses, yet few mechanisms ensuring ECM proteostasis during this period are known. Fibrillin microfibrils are macromolecular ECM complexes serving structural and regulatory roles. In mice, and encoding the major microfibrillar components, are strongly expressed during embryogenesis, but fibrillin-1 is the major component observed in adult tissue microfibrils.

Plastic Surgery Program Leadership Perspectives on Doximity Residency Navigator Rankings: Do We Need a Better Guide for Prospective Applicants?

Introduction: Doximity has become integrated into the residency application process without any clear merit, comparing programs based on reputation and research. Our study aims to gather program directors' and Chiefs/Chairs' perspectives on the Doximity ranking system and to assess what a better system might entail.

Methods: A 16-question survey was sent to 177 program directors and Chief/Chairs of plastic surgery residency programs.

The Abdominal Hernia-Q: a critical analysis of the components that impact quality-of-life.

Purpose: Ventral hernias (VH) are a common surgical problem associated with significant morbidity. While assessment tools have examined quality-of-life (QoL), the relative change in specific domains of hernia-related QoL measures from pre- to post-operative period has yet to be comprehensively examined. Using the Abdominal Hernia-Q (AHQ), this study aims to assess the impact of ventral hernia repair (VHR) on key components of QoL.

Three near fatal or fatal complications during implantation of tunnelled hemodialysis catheters : Learning from experts.

Tunnelled hemodialysis catheters are well accepted and widely used devices to provide vascular access for dialysis in patients when an arteriovenous shunt is not feasible or dysfunctional. In the literature complications after implantation are well documented but fatal or near-fatal events during implantation are seldom reported. In this article 3 such cases from a single tertiary center over a period of more than 10 years are presented and discussed.

Learner Drawing and Sculpting in Surgical Education: A Systematic Review.

Background: Historically, surgery was developed through the visual work of artist-scientists, yet visual art in modern surgical education is rare. The aim of this review is to evaluate the existing literature of learner creation of visual art as an educational tool in surgery and to discuss its potential in augmenting surgical learning.

Method: A systematic review of surgical educational interventions involving learner drawing, painting, and sculpting was conducted in 2020.

Does E-learning Improve Plastic Surgery Education?: A Systematic Review of Asynchronous Resources.

Purpose: E-learning is rapidly growing in medical education, overcoming physical, geographic, and time-related barriers to students. This article critically evaluates the existing research on e-learning in plastic surgery.

Methods: A systematic review of e-learning in plastic surgery was conducted using the PubMed/MEDLINE, Scopus, and Embase databases.