Citations

Abstract We present a high-fidelity, patient-specific computational framework for simulating cardiovascular hemodynamics in left ventricular assist device (LVAD) patients, with the ability to evaluate the impact of mitral and aortic valve repair. The method couples three-dimensional computational fluid dynamics (CFD) with a zero-dimensional lumped-parameter network representing the full cardiovascular system. Valve dynamics are governed by pressure–flow physics with patient-specific regurgitant areas, enabling the investigation of valve insufficiency and surgical repair. The model incorporates dynamic contrast-enhanced CT imaging, echocardiography, and catheter-based measurements. We demonstrate the utility of this framework using a clinical case involving a patient on long-term LVAD support with mitral regurgitation and aortic insufficiency. The coupled model resolves detailed pressure and velocity fields in the left heart, LVAD cannulae, and aortic root, while maintaining system-wide physiological consistency. Importantly, the framework also quantifies right ventricular loading and function, allowing assessment of how left-sided valve interventions propagate through the cardiopulmonary circulation. Using this pipeline, we simulate mitral and aortic valve repair by modulating valve closure mechanics and regurgitant area, revealing changes in both local and global hemodynamics. This modeling platform provides a powerful means to study the interplay between mechanical circulatory support, native valve physiology, and right heart function. It enables rigorous, patient-specific evaluation of surgical interventions in LVAD patients and delivers quantitative insight into clinically important metrics—such as aortic pulsatility, RV afterload, and chamber-level flow patterns—that are challenging to capture with current imaging modalities.

ABSTRACT Consumer health informatics is becoming increasingly important in a world where more than 5 billion people rely on the internet and social media for health information. eHealthyinfo is a physician‐initiated and reviewed artificial intelligence (AI) applied digital health information website, aiming to be essential in advancing health literacy and promoting preventive health behaviors. To assess the effectiveness of its digital content, we conducted a mixed‐methods evaluation of 13 wellness and nutrition videos randomly selected from eHealthyinfo, representing 30% of its relevant content. Two independent reviewers used the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT‐A/V) and the modified version of the CDC Clear Communication Index (CCI) to evaluate each video. Website log data were also analyzed to assess levels of user engagement. The average PEMAT scores were 89.5% for understandability and 100% for actionability, while the average CCI score was 94.4%, indicating the content was understandable, actionable, and clear. Weblog analysis revealed 16,000 active users, with an average engagement time of 41 seconds per user and a 27% average bounce rate for the examined year. eHealthyinfo demonstrates a strong potential as a digital health education tool, with high‐quality, user‐friendly content.

Objective: To systematically review the existent literature on radiosurgery for treatment of sporadic facial nerve schwannomas (FNS). Databases reviewed: PubMed, SCOPUS, EMBASE, and Web of Science databases. Methods: Systematic review was performed per PRISMA criteria of studies published from 1990 through 2024 on patients diagnosed with sporadic FNS who were treated with radiosurgery. Outcomes included change in facial nerve function, change in hearing class, and radiosurgical treatment failure defined by need for reintervention. Study quality was assessed using the LEGENDS rubric for mixed modality studies. Results: In total, 35 studies encompassing 364 patients were included for data abstraction. Gamma Knife was the most common modality reported. Longitudinal patient-level data on facial nerve function were available for 101 patients, with 8% of patients experiencing worsening facial nerve function and 92% of patients having either stable nerve function or improvement in facial nerve function following treatment over a median follow-up of 36 months. Longitudinal patient-level hearing data were available for 53 patients, including 35 patients with serviceable hearing (AAO-HNS class A or B) at baseline; only 2 patients developed nonserviceable hearing (AAO-HNS class C or D) following treatment over a median follow-up of 36 months. Clinical tumor control data were available for 295 patients, of whom 11 required salvage treatment over a mean follow-up of 49 months. Conclusions: This systematic review demonstrates a relatively low risk of worsening facial nerve function and a high rate of clinical tumor control following radiosurgery for sporadic FNS.

Latissimus dorsi (LD) and teres major (TMA) injuries are increasingly recognized as significant sources of pain in overhead athletes, particularly pitchers. These injuries are challenging to diagnose clinically, and conventional MRI often lacks sufficient detail to fully evaluate them. Musculoskeletal ultrasound (US) offers dynamic, high‐resolution evaluation and may better characterize these injuries. This pictorial review illustrates the sonographic appearance of common LD and TMA injuries, aiming to enhance diagnostic accuracy, increase clinician familiarity with this region, and support future research in injury classification using ultrasound.

Abstract Lewy pathology can form over decades in patients with Lewy body diseases, but the causal cellular mechanisms associated with this process remain unclear. This project aims to discover proteins that associate with monomeric and/or oligomeric alpha-synuclein during early stages of the aggregation process. To mimic the aggregation processes, cells expressing a synuclein-biotin ligase fusion protein were treated human recombinant pre-formed fibrils and subjected to BioSITe and mass spectrometry. Using a novel split biotin ligase fused to alpha-synuclein facilitated the identification of proteins specifically associated with multimeric alpha-synuclein. A total of 581 proteins were differentiated into potential interactors of monomeric versus multimeric alpha-synuclein in physiological versus aggregated conditions. The data reveal important phosphorylation mechanisms, connections to insulin processing, and a potential interaction with ALS-associated FUS. Interestingly, we identified that loss of specific interactions may contribute to pathology in patients with sporadic onset of Lewy body diseases. Future studies will validate both true interaction of highlighted proteins with alpha-synuclein, and the impact of such proteins on alpha-synuclein aggregation.

Variations in liver allocation systems worldwide are presented, with a specific focus on regional differences and their potential impact on outcomes, with the goal of serving as a reference for future policy development. Summaries of liver allocation across multiple European, Scandinavian, and Asian systems, as well as the combined allocation system of Australia plus Canada, the United States, and the systems in Central America, South America, and the Caribbean are reviewed. A comprehensive comparison of how different regions address MELD exceptions, primarily focusing on hepatocellular carcinoma, along with the most common etiologies of liver disease requiring transplantation is presented. In addition, the adoption of living donation and donation after circulatory death is discussed. The study involves contributions from a diverse group of world experts in liver transplantation and may serve as an essential resource to foster international dialogue as countries strive to optimize organ allocation policies, including MELD exceptions.

Background. Living kidney donation (KD) evaluation particularly focuses on glomerular filtration rate (GFR). Assessing GFR in living kidney donors can be done by estimation (eGFR) or measurement (mGFR). This study aims to evaluate the impact of eGFR equations, focusing on the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) 2021 equation for donor eligibility screening and the reclassification of donors excluded by eGFR criteria to mGFR assessments. Methods. Retrospective, single-center observational study of 2512 kidney donors evaluated between 2011 and 2023, at the Mayo Clinic. We performed analyses and comparisons of 4 eGFR formulae and 2 mGFR methods in terms of performance, eligibility criteria according to Kidney Disease: Improving Global Outcomes guidelines/age-adjusted criteria, eligibility reclassification, and subgroup analyses. Results. The CKD-EPI 2021 resulted in a higher percentage of patients being eligible for KD (81.4%) and achieved the highest P10 (32%–34%) and P30 (87%–88%) across all mGFR methods. When patients were deemed eligible for donation by any eGFR formula, 95% retained this status on reassessment with mGFR. Conversely, when an eGFR formula classified a patient as ineligible, this was revised to be eligible in about 90% of cases on reassessment with mGFR, with a higher reclassification rate observed when the IoCl was used instead of CrCl. Conclusions. The CKD-EPI 2021 performs best for screening potential KD. If a KD is deemed ineligible by CKD-EPI 2021, there is a high likelihood that they will be reclassified as eligible when assessed with mGFR. This study strongly supports using mGFR in donor evaluations, especially when the eGFR does not meet the criteria to ensure equity of access to being a living donor.