This article presents the bioclimatic conditions prevailing in the north-eastern part of the Labrador Peninsula during 1884-89, determined based on meteorological data from six measurement stations: Rama, Hebron, Okak, Nain, Zoar and Hopedale. Weather observations were made by the Moravian Brethren in consultation with the German Maritime Observatory (Ger. Deutsche Seewarte), which provided them with reliable meteorological instruments and instructions for conducting the observations. Measurements of air temperature, atmospheric pressure, and wind direction and strength were taken three times daily at 08:00, 14:00 and 20:00 LT. These data have been digitized and made available by the German Meteorological Service (Deutscher Wetterdienst [DWD]). Based on available meteorological data, bioclimatic analyses were performed using two indices: Wind Chill Temperature (WCT) and Insulation Predicted (Iclp). The annual courses of average 14:00 LT values of air temperature, wind speed, WCT and Iclp were examined. The annual courses of bioclimatic indices parameters were determined, as were the frequency of individual frostbite risk categories and of predicted clothing thermal insulation. The results from stations in the historical period were compared against each other and, for the Nain station, historical period results were compared against contemporary results (years 1991-2020). The analyses show that, the average air temperature and wind speed in the years 1884-89 were, respectively, 2.5 °C and 0.6 ms[-1] lower than in 1991-2020. The WCT and Iclp bioclimatic indices, were prevailingly less favourable in the historical period than in the comparative period by 1.9 °C and 0.1 clo, respectively.

Lysozyme-loaded antibacterial wound dressings hold great promise for wound healing. Herein, we propose a simple yet powerful method of loading antibacterial lysozyme into calcium alginate (CaAlg) hydrogel films for wound healing. This method presents a controlled strategy to modulate the surface roughness of CaAlg hydrogel films by tailoring their thickness, thereby enhancing the lysozyme loading efficiency on the film surface. We fabricated CaAlg hydrogel films with gradient thicknesses by adjusting the copper wire diameters. Morphological characterization confirmed that the surface of the thin CaAlg film is rougher than that of the thick ones. This enhanced surface roughness conferred a larger specific surface area, which effectively promoted the adsorption of lysozyme and, thus, improved the enzyme loading capacity. The release of lysozyme after adsorption and the interactions between lysozyme and alginate were also investigated, and the results showed that approximately 7.5 mg/g lysozyme can be released from the film. Therefore, the lysozyme-loaded CaAlg film (CaAlg-lysozyme) exhibited excellent antibacterial properties. In vivo results showed that the CaAlg-lysozyme film could promote wound healing. The percentages of wound healing of the untreated group, gauze, and CaAlg-lysozyme film were 65.36, 77.78, and 91.43% on day 10, respectively, indicating the great potential of CaAlg-lysozyme film as a practical wound dressing.

In the present case report, the authors describe the deaths of two individuals-an 85-year-old female and her 56-year-old son - both discovered within a shared household, exhibiting advanced postmortem changes. The fatalities occurred in a confined apartment environment. The decedents had been residing under conditions of extreme environmental neglect, characterized by prolonged accumulation of domestic waste and an almost complete absence of interaction with the external community. Postmortem examinations revealed morphological indicators consistent with hypothermia, including pale postmortem lividity, frostbite lesions, and Visnevsky's spots within the gastric mucosa. The terminal causes of death in both cases were determined to be combined cardiovascular and respiratory failure secondary to hypothermia. Relevant comorbidities were identified: in the female, predominantly chronic cardiac and hepatic pathology; in the male, marked malnutrition. In both individuals, ethanol was detected in postmortem blood specimens at concentrations consistent with endogenous production during the late stages of decomposition. In both cases, different degrees of development of hypothermia-related Visnevsky spots were observed, which the authors explain by different reserve capacities of the organism.

Severe frostbite is a dynamic microvascular injury that can progress to delayed tissue loss despite appropriate initial care. Contemporary management emphasizes rapid rewarming, antithromboxane therapy, clinical grading, selective thrombolysis, and prostacyclin-based treatment. Iloprost is the prostacyclin analogue most often described, but access may be delayed in some Canadian settings. We developed and implemented a monitored intravenous epoprostenol pathway for Cauchy grade 2 to 4 frostbite and retrospectively evaluated 23 patients treated between December 2017 and November 2025. The pathway incorporated rapid rewarming, grading, topical and systemic antithromboxane therapy, eligibility criteria, dose titration, physiologic monitoring, dose modification, multidisciplinary care, and follow-up. Overall, 153 of 216 affected digits were preserved. Preservation varied by severity: 62 of 65 grade 2 digits, 74 of 100 grade 3 digits, and 7 of 41 grade 4 digits were preserved. Twelve patients avoided amputation altogether. Mean treatment duration was 3.8 days, and most patients reached 8 ng/kg/min at least once. Documented adverse effects or dose-limiting symptoms occurred in nine patients and were managed with dose reduction or temporary interruption. Available records did not identify thrombolytic therapy, permanent discontinuation for adverse reaction or grade 2 reassessment, or serious drug-attributed adverse events. Protocol-guided intravenous epoprostenol was feasible and generally well tolerated. Findings should be interpreted as descriptive and hypothesis-generating rather than evidence of treatment efficacy.

Hypothermia is classically defined as a reduction in the body's core temperature below 95.0°F (35.0 °C). Most reported cases of hypothermia are due to environmental exposure to low ambient temperatures (accidental hypothermia). Other causes of hypothermia include sepsis, severe hypothyroidism (myxedema coma), acute spinal cord injury, diabetic ketoacidosis, multisystem trauma, and prolonged cardiac arrest. Frostbite, chillblain and trench foot all have specific therapies to prevent limb loss. There have been significant advances in these therapeutic options over the past decade which are detailed in this issue.

Frostbite injuries can have lasting sequelae including amputations, intolerance to cold, chronic pain, paresthesia, and inability to return to work. Despite this morbidity, the treatment of frostbite remains understudied. The FRostbite ObServational Trial (FROST) aims to address this gap through a multicenter evaluation of treatment practices and outcomes. As part of FROST, we reviewed institutional frostbite care protocols from 16 participating sites across North America. Practices were categorized as demonstrating uniform agreement $\Big(\ge$90% mentioned the practice), consensus ($\ge$75%), or majority if ($\ge$50%). Uniform agreement was limited to use of rapid rewarming and thrombolytics, the latter being influenced by site selection criteria for FROST participation. Consensus was achieved in multiple areas (such as urgency of treatment, perfusion assessment, the therapeutic windows for pharmaceutical interventions, and the therapeutic dosing of IV thrombolytics). Protocols varied on grades for thrombolytic treatment initiation, prostacyclin analogue use, post-thrombolytic anticoagulation treatment and duration, the role of physical or occupational therapy, splinting, and appropriate wound care. This manuscript provides a synthesis of protocols and expert opinion for the acute management of frostbite injury. This synthesized protocol may serve as a tool for centers to develop their own standard protocol to facilitate care for frostbite patients. Additionally, current opportunities for frostbite research and improving care are detailed in the manuscript. Education regarding prevention of injury and the need for emergent treatment is needed for both the public and the medical community.

Alpine skiing is associated with characteristic patterns of hand and wrist trauma, which together account for approximately 11% of all injuries in this sport. These injuries typically result from high-velocity falls, pole-related mechanisms, and collisions with infrastructure, including lift pylons and barriers. This review provides an overview of common hand and wrist injuries in alpine skiers, with emphasis on skiing-specific mechanisms, characteristic imaging findings, strengths and limitations of different imaging modalities, as well as clinically relevant implications. Although some of the described injury patterns and imaging considerations may also occur in other skiing disciplines and other sports, this review focuses specifically on alpine skiing. Discussed fractures include those of the fingers, base of the first metacarpal (Bennett and Rolando fractures), scaphoid, and distal radius. Soft-tissue injuries encompass frostbite and skiing-related injuries of ligaments, tendons, and volar plates. In most cases, conventional radiographs are the first-line imaging modality, while CT, MRI, and ultrasound are used selectively depending on the suspected injury pattern, particularly for detailed assessment of fractures, ligament integrity, and tendon injuries. An accurate evaluation of typical imaging patterns is essential for guiding treatment strategies and improving clinical outcomes. Delayed diagnosis may lead to prolonged recovery, chronic instability, post-traumatic osteoarthritis, and other secondary complications.

Frostbite is a serious clinical condition in which delayed treatment usually results in irreversible tissue necrosis. Due to lack of effective therapeutic interventions, we have developed minoxidil-loaded chitosan (CH)-polyethylene glycol (PEG) hydrogel (MH) to treat frostbite injury. RSM-CCD was used to optimize the independent variables in order to maximize the gel fraction, swelling index and in vitro drug permeation studies. The MH formulation was characterized by field emission scanning electron microscopy (FESEM) and atomic force microscopy (AFM). The healing activity was evaluated in L929 cells. The MH formulation was studied in experimentally induced frostbite in a rat model. Further, the efficacy was evaluated for wound closure rate, histopathological analysis, immunohistochemical expression of CD34, and levels of IL-6, IL-10, VEGF, and NO. MH showed a gel fraction (63.21 ± 3.28%), swelling index (479.79 ± 6.12%), and in vitro drug permeation (91.78 ± 10.17%). FESEM and AFM analyses validated its macroscopic properties. In L929 cell lines, MH showed significant cell proliferation, improvement of cell migration from the scratch assay and negligible toxicity. MH is also shown to be hemocompatible and non-irritant. Further, an in vivo study revealed significant improvement in the wound area with re-epithelization, angiogenesis, reduction of inflammation, and significant collagen depositions without the formation of scars. Based on these preclinical observations, it can be concluded that MH has the potential to be a promising therapeutic option for frostbite-induced tissue injury. Further studies, such as long-term stability and detailed molecular mechanisms, will be required for its clinical applicability.

Rapid rewarming is the most conventional and primary treatment for frostbite, yet effective adjunctive strategies remain absent. Conventional wound dressings, such as therapeutic hydrogels, tend to freeze and lack the necessary rewarming ability, rendering them unsuitable for direct application. Herein, we engineered an environmentally tolerant photothermal hydrogel, named 5A-Gel, featuring anti-swelling, anti-pressure, antioxidant, anti-freezing, and anti-drying capacities, for the treatment of frostbite. 5A-Gel was formed via dynamic crosslinking between gelatin and tea polyphenols in a glycerol/water solvent system. The incorporation of glycerol endowed the hydrogel with superior anti-swelling, anti-freezing, and anti-drying performance (remaining flexible at -20 °C and 37 °C for at least 60 days), along with concentration-dependent antioxidant activity due to tea polyphenols. Furthermore, 5A-Gel exhibited excellent photothermal effects, maintaining stable temperature and softness under 808 nm laser irradiation with robust cyclic durability. In addition, 5A-Gel showed slow degradability, excellent hemocompatibility, and favorable in vivo biosafety. Functionally, in a mouse frostbite wound model, photothermal rewarming therapy using 5A-Gel markedly expedited frostbite healing, promoting re-epithelialization, enhancing collagen deposition, alleviating inflammatory response, and stimulating neovascularization. Therefore, the as-prepared 5A-Gel serves as a competent therapeutic platform for in situ frostbite treatment and offers innovative principles for the rational engineering of high-performance hydrogel systems targeting frostbite tissue injuries.