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To improve understanding of anterior cruciate ligament (ACL) injuries, this study investigated the effect of menstrual cycle (MC) phase on ACL injury risk factors in elite female team sport athletes with and without urinary incontinence (UI). Additionally, associations between endogenous sex hormones, MC-related symptoms, and these risk factors were investigated. Ten elite female athletes (24.2 ± 3.6 years, BMI 23.2 ± 1.3 kg/m2, 10.9 ± 1.8 training hours/week) completed three testing sessions across three MC phases, determined using the three-step method. Assessments included static and dynamic postural control and hip strength. Mixed-model ANOVA and canonical correlation analyses evaluated the effects of MC phase, UI, hormones, and performance. A significant interaction between MC phase and UI was observed for single-leg sway area with eyes closed (p = 0.036), and UI was associated with a higher hip adduction:abduction ratio (p = 0.037). No further significant interaction between UI and MC phase was observed. Moreover, hormones explained 16.5% of the variance in risk factors, while subjective symptoms explained 24.5%. Lower progesterone was associated with higher symptoms, lower estradiol and progesterone with reduced strength and poorer postural control, and higher testosterone with greater strength. Although limited by its pilot design, menstrual symptoms, more than MC phases, may influence performance and injury risk, supporting the potential value of systematic symptoms monitoring.

Implantation of left ventricular assist devices conventionally requires a sternotomy and cardiopulmonary bypass. An experimental accessory was designed to redirect the device's outflow graft through the left ventricle into the ascending aorta. This design allows for implantation via left thoracotomy only but resulted in significant pressure loss both in vitro and in vivo. We evaluated the reasons for the pressure loss of the experimental accessory by quantifying pressure distribution and flow profiles using computational fluid dynamics simulation tools. A computational fluid dynamics model based on the accessory's geometry was used to simulate nominal blood flow through the model. Quantities of interest included pressure and flow velocity. Pressure differences between the pump inlet and outlet were calculated at different rotational speeds (4000, 5200, 6400 rpm) and pump flow rates (1, 5, 8.4 L/min). Results were compared with simulations of a generic left ventricular assist device to determine the accessory's impact. Natural pump characteristics were observed, as increased rotational speed caused an increase in pressure head with a constant flow rate. For all cases, a greater decrease in pressure head was seen between 5 and 8.4 L/min than between 1 and 5 L/min. Curvature intensity and channel bifurcation in the outflow were the main contributors to downstream pressure loss. The next iteration of the left ventricular assist device accessory should focus on minimizing curvatures and avoiding bifurcations in the outflow. Further development may allow for less invasive left ventricular assist device implantation with negligible alterations in pump performance.