Citations

INTRODUCTION: The goal of this study was to identify nationwide access to transient elastography (TE), magnetic resonance elastography (MRE), and gastroenterologists. METHODS: We used public data from each test's manufacturer's website to identify the number of TE and MRE units in the United States. We used public data from the Health Resources and Services Administration to identify the number of gastroenterologists in the United States. RESULTS: Overall, 82.4% of US counties do not contain TE or MRE, and 69.2% do not contain a gastroenterologist. Two-thirds (67.4%) of US counties do not contain either elastography or a gastroenterologist. DISCUSSION: There is limited access to TE, MRE, and gastroenterologists in the United States.

Abstract Patient preferences for communication of breast imaging results are heterogeneous and depend on the clinical context and perceived severity of findings. The 21st Century Cures Act, which mandates immediate electronic release of most medical records, has fundamentally altered result reporting and patient communication in breast imaging. Although this policy enhances transparency and timely access to information, it may conflict with established preferences for how patients receive screening mammography results, diagnostic evaluations, breast biopsy results, and breast cancer risk assessment information. Prior studies—largely conducted before widespread patient portal use—demonstrated that breast imaging patients consistently prioritize timely communication, while preferred delivery methods vary based on result acuity and emotional impact. However, much of this literature pre-dates implementation of the 21st Century Cures Act and widespread use of patient portals. This review examines the current literature to summarize evidence-based patient preferences for breast imaging result communication. As adoption of immediate result release continues to evolve across institutions, understanding contemporary patient preferences is essential to guiding radiologists in optimizing patient-centered communication strategies to inform best practices in breast imaging.

ABSTRACT C3 glomerulonephritis (C3GN) is a rare kidney disease driven by dysregulation of the alternative complement pathway. We report two challenging cases of patients with C3GN in whom various immunosuppressant therapies have failed to achieve complete remission, prompting treatment with eculizumab, an anti-C5 humanized monoclonal antibody that inhibits the terminal complement pathway. Although transient improvement in kidney function was observed, both patients eventually experienced worsening renal parameters, with increasing proteinuria and hematuria, culminating in progression to end-stage kidney disease. Repeated kidney biopsies following eculizumab therapy demonstrated persistent, granular mesangial and capillary wall C3 (3+) staining on immunofluorescence studies, indicating ongoing complement activation upstream of the C5 blockade and the perpetuation of C3 deposits in the glomeruli. These cases underscore the limited efficacy of terminal complement inhibition in halting disease progression in C3GN.

Background With improved cardiac surgical outcomes, attention has shifted to patient-centred outcomes, including cosmetic appearances of surgical scars. Minimally invasive cardiac surgery (MICS) is often promoted for its cosmetic benefits, yet empirical evidence remains limited. This study aimed to systematically evaluate scar-specific outcomes comparing MICS to conventional full median sternotomy (FMS) in adult cardiac surgery. Methods A systematic review and meta-analysis was conducted following PRISMA guidelines. PubMed, Embase, Central, and Scopus were searched from inception to August 2025. Studies comparing MICS to FMS, reporting scar-related patient-reported outcomes, wound complications, or cosmetic satisfaction, were included. The primary outcome was scar assessment using validated instruments. Random-effects models calculated standardised mean differences (SMD) and risk ratios (RR) with 95% confidence intervals. Results Twenty-two studies comprising 3131 patients (1459 MICS, 1672 FMS) met inclusion criteria. MICS demonstrated significantly better scar assessment scores (SMD −0.74, 95% CI −1.27 to −0.22; p < 0.01; I 2 = 88%, six studies), higher patient satisfaction rates (RR 1.42, 95% CI 1.21–1.66; p < 0.001; I 2 = 84%, 12 studies), and reduced wound complications (RR 0.31, 95% CI 0.20–0.47; p < 0.001; I 2 = 0%, nine studies). Only six studies reported validated scar assessment scores, highlighting limited integration of these measures. Substantial heterogeneity was observed due to diverse assessment tools and surgical techniques. Conclusions MICS can offer significant advantages in scar-specific outcomes compared to FMS in carefully selected patient populations. Cosmetic outcomes should be interpreted within the context of overall effectiveness and may support shared decision making only when clinical outcomes between surgical approaches are comparable. The lack of standardised scar assessment protocols and limited reporting of cosmetic outcomes represent critical gaps. Future research should prioritise standardised scar evaluation tools and expand cosmetic outcome reporting across all cardiac surgical procedures.

Abstract Myocarditis and valvulitis are inflammatory diseases affecting myocardium and heart valves. Myocarditis, a viral‐induced disease of myocardium, may lead to dilated cardiomyopathy and loss of heart function, and valvulitis leads to deformed heart valves and altered blood flow in rheumatic heart disease. Animal models recapitulating these diseases are important for understanding the human conditions. Cardiac myosin is a major autoantigen in heart tissue, and antibodies and T cells to cardiac myosin are evident in inflammatory heart diseases. This article is a practical guide to the induction and evaluation of experimental autoimmune myocarditis (EAM) in several mouse strains and the Lewis rat. Purification protocols for cardiac myosin and protocols for the induction of EAM by cardiac myosin and its myocarditis‐producing peptides, as well as coxsackievirus B3 (CVB3), are defined. Protocols for assessment of myocarditis and valvulitis in humans and animal models provide methods to define functional autoantibodies targeting cardiac myosin, β‐adrenergic, and muscarinic receptors, and their deposition in tissues. © 2026 Wiley Periodicals LLC. Basic Protocol 1 : Induction of EAM in mice by active immunization with cardiac myosin Alternate Protocol : Induction of EAM in mice by adoptive transfer of cardiac‐myosin‐stimulated T cells Basic Protocol 2 : Induction of EAM in rats by active immunization with cardiac myosin Support Protocol 1 : Purification of cardiac myosin Support Protocol 2 : Preparation of antigen/adjuvant emulsion by agitation for EAM induction in mice and rats Support Protocol 3 : Collection and histopathological assessment of mouse or rat hearts Support Protocol 4 : Immunostaining of rat heart tissue or cells for deposited antibody Basic Protocol 3 : Induction of myocarditis in mice by inoculation with coxsackievirus B3 (CVB3) from infectious cDNA clones Basic Protocol 4 : Induction of myocarditis and dilated cardiomyopathy in mice by inoculation with heart‐passaged coxsackievirus B3 (CVB3) Basic Protocol 5 : Induction of autoimmune valvular heart disease by inoculation with recombinant streptococcal M protein Basic Protocol 6 : Protein kinase A (PKA) assay of serum antibody signaling of the β‐adrenergic receptor with subsequent activation of PKA Basic Protocol 7 : Measurement of serum antibody titers against human cardiac myosin, human adrenergic β 1 and β 2 receptors, and muscarinic 2 receptor Basic Protocol 8 : Detection of antibodies against human cardiac myosin peptides in human serum

Rural populations are underrepresented in cognitive impairment research and have limited resources for education about brain and cognitive health, Alzheimer's disease and related dementias, or caregiving. As our Outreach, Recruitment, and Engagement team aimed to expand activities into more rural communities, we also wanted to better understand the characteristics of the communities surrounding our center and gain insight into the social exposome of the areas. The goal of the manuscript is to reflect on our experience and share measures that were useful in this effort, which can be further enriched and adjusted by other outreach teams.