Prenatal exposure to diethylstilbestrol has multigenerational effects on folliculogenesis.

Diethylstilbestrol (DES) is an estrogenic endocrine disrupting chemical (EDC) that was prescribed to millions of pregnant women worldwide, leading to increased rates of infertility in the exposed offspring. We have previously demonstrated that this reduced fertility persists for multiple generations in the mouse. However, how altered ovarian function contributes to this infertility is unknown.

LEVONORGESTREL INTRAUTERINE DEVICE PLACEMENT IN UTERINE ANOMALIES: A CASE SERIES.

Background: Levonorgestrel intrauterine devices (IUDs) provide effective contraception and medical benefits. They are safe for even severely medically complex patients. The CDC Medical Eligibility Criteria (MEC) states IUDs are category 4 for people with uterine cavity distortions, however there are previous case reports of their successful use in this population.

LI-RADS in 2024: recent updates, planned refinements, and future directions.

Initially released in 2011, liver imaging reporting and data (LI-RADS) CT/MRI diagnostic algorithm categorizes hepatic observations on an ordinal scale based on the probability of hepatocellular carcinoma, malignancy, or benignity, and guides reproducible interpretation, clear communication, and standardized terminology for liver imaging. LI-RADS has significantly expanded in scope in the past decade, with the inclusion of algorithms that address screening and surveillance, diagnosis with contrast enhanced ultrasound (CEUS), and treatment response assessment with both CEUS and CT/MRI. LI-RADS algorithms undergo periodic refinements based on accumulating scientific evidence, user feedback, and technological advancements.

Performing liver imaging at a high level: quality and adequacy in LI-RADS.

Imaging is critical to HCC management, including surveillance, diagnosis, staging, and treatment response assessment, which requires it be performed consistently at a high level. The Liver Imaging Reporting and Data System (LI-RADS) was developed to standardize the acquisition, interpretation, and reporting of liver imaging, but until now, has not addressed the essential component of exam quality and adequacy. In this manuscript, we discuss the concepts of quality and adequacy and their clinical significance in the setting of HCC diagnostic imaging and treatment response assessment.

LI-RADS: Current Status and Future Directions.

The Liver Imaging Reporting and Data System (LI-RADS) is a comprehensive system that uses standardized terminology, technique, interpretation, and reporting of imaging studies for hepatocellular carcinoma surveillance, diagnosis, and locoregional treatment response assessment. Since its initial release in 2011, LI-RADS has evolved and expanded in scope. In this article, we discuss recent updates intended to address clinical needs and mitigate current challenges.

Barcoding of viable peripheral blood mononuclear cells with selenium and tellurium isotopes for mass cytometry experiments.

Barcoding viable cells combined with pooled sample staining is an effective technique that eliminates batch effects from serial cell staining and facilitates uninterrupted data acquisition. We describe three novel and isotopically pure selenium-containing compounds (SeMals) that are useful cellular labeling tools. The maleimide-functionalized selenophenes (SeMal, SeMal, and SeMal) covalently react with cellular sulfhydryl groups and uniquely label cell samples.

Cushing's Myopathy in Dogs: Prevalence, Clinical Abnormalities, and Response to Treatment.

A distinct myotonia is a muscle disorder that may occur secondary to excess corticosteroids (hyperadrenocorticism, HAC, or Cushing's disease) and is associated with electrodiagnostic abnormalities on electromyography (EMG). Clinically these disorders cause muscle stiffness, weakness, atrophy, and/or contractures, which can severely limit the quality of life of those affected. To date, there are very few published data regarding the onset, development, and treatment of hyperadrenocorticism-associated myotonia/pseudomyotonia.

Diagnostic Performance of a Next-Generation Virtual/Augmented Reality Headset: A Pilot Study of Diverticulitis on CT.

Next-generation virtual/augmented reality (VR/AR) headsets may rival the desktop computer systems that are approved for clinical interpretation of radiologic images, but require validation for high-resolution low-luminance diagnoses like diverticulitis. The primary aim of this study is to compare diagnostic performance for detecting diverticulitis on CT between radiologists using a headset versus a desktop. The secondary aim is to survey participating radiologists about the usage of both devices.

ACR Appropriateness Criteria® Nonvariceal Upper Gastrointestinal Bleeding: 2024 Update.

This document summarizes the relevant literature for the selection of the initial imaging in five clinical scenarios in patients with suspected or known nonvariceal upper gastrointestinal bleeding (UGIB). These clinical scenarios include suspected nonvariceal UGIB without endoscopy performed; endoscopically confirmed nonvariceal UGIB with clear source but treatment not possible or continued bleeding after endoscopic treatment; endoscopically confirmed nonvariceal UGIB without a confirmed source; suspected nonvariceal UGIB with negative endoscopy; and postsurgical or post-traumatic nonvariceal UGIB when endoscopy is contraindicated. The appropriateness of imaging modalities as they apply to each clinical scenario is rated as usually appropriate, may be appropriate, and usually not appropriate to assist the selection of the most appropriate imaging modality in the corresponding clinical scenarios of nonvariceal UGIB.

Implementation of a bundle to improve diagnosis in hospitalized patients: lessons learned.

Objectives: The inpatient setting is a challenging clinical environment where systems and situational factors predispose clinicians to making diagnostic errors. Environmental complexities limit trialing of interventions to improve diagnostic error in active inpatient clinical settings. Informed by prior work, we piloted a multi-component intervention designed to reduce diagnostic error to understand its feasibility and uptake.

MASLD: What We Have Learned and Where We Need to Go-A Call to Action.

Since its introduction in 1980, fatty liver disease (now termed [MASLD]) has grown in prevalence significantly, paralleling the rise of obesity worldwide. While MASLD has been the subject of extensive research leading to significant progress in the understanding of its pathophysiology and progression factors, several gaps in knowledge remain. In this pictorial review, the authors present the latest insights into MASLD, covering its recent nomenclature change, spectrum of disease, epidemiology, morbidity, and mortality.

An analysis of the physicochemical properties of oral drugs from 2000 to 2022.

Calculable physicochemical descriptors are a useful guide to assist compound design in medicinal chemistry. It is well established that controlling size, lipophilicity, hydrogen bonding, flexibility and shape, guided by descriptors that approximate to these properties, can greatly increase the chances of successful drug discovery. Many therapeutic targets and new modalities are incompatible with the optimal ranges of these properties and thus there is much interest in approaches to find oral drug candidates outside of this space.

Reproducibility and Repeatability of US Shear-Wave and Transient Elastography in Nonalcoholic Fatty Liver Disease.

Background US shear-wave elastography (SWE) and vibration-controlled transient elastography (VCTE) enable assessment of liver stiffness, an indicator of fibrosis severity. However, limited reproducibility data restrict their use in clinical trials. Purpose To estimate SWE and VCTE measurement variability in nonalcoholic fatty liver disease (NAFLD) within and across systems to support clinical trial diagnostic enrichment and clinical interpretation of longitudinal liver stiffness.

Updated National and State-Specific Prevalence of Congenital Cytomegalovirus Infection, United States, 2018-2022.

Context: Congenital cytomegalovirus (cCMV) infection is the most common infectious cause of birth defects and the leading non-genetic cause of sensorineural hearing loss in the United States. Prior national cCMV infection prevalence estimates were based on one multi-site screening study conducted between 2007 and 2012 and were not adjusted for sociodemographic characteristics, such as maternal race and ethnicity or age.

Objective: This study sought to estimate national and state-specific prevalence of cCMV infection in the United States, adjusted for maternal race and ethnicity and maternal age group, by pooling estimates from published studies.

AACN competency-based essentials revisit: Evidence-based validation of entrustable professional activities in Asia.

Aim: This study intended to validate the competency-based approach through an entrustable professional activity in the nursing undergraduate education arena in Taiwan.

Background: Entrustable professional activity is a recommended strategy to enhance nursing competencies and skills. It has been widely applied to nursing education in Western countries, especially graduate programs.

Scalable Synthesis of an Acid Stable Analogue of Hippuristanol.

Hippuristanol is a marine derived steroidal natural product with promising anticancer activity. However, instability at low pH has precluded its development as an efficient therapy. We addressed this limitation by replacing one of the oxygen atoms of the spiroketal moiety with a carbon atom.

Urinary Retention Evaluation and Catheterization Algorithm for Adult Inpatients.

Importance: Acute urinary retention (UR) is common, yet variations in diagnosis and management can lead to inappropriate catheterization and harm.

Objective: To develop an algorithm for screening and management of UR among adult inpatients.

Design, Setting, And Participants: In this mixed-methods study using the RAND/UCLA Appropriateness Method and qualitative interviews, an 11-member multidisciplinary expert panel of nurses and physicians from across the US used a formal multi-round process from March to May 2015 to rate 107 clinical scenarios involving diagnosis and management of adult UR in postoperative and medical inpatients.

A Geographically Weighted Cost-effectiveness Analysis of Newborn Cytomegalovirus Screening.

Background: Early identification of newborns with congenital cytomegalovirus (CMV) is necessary to provide antiviral therapy and other interventions that can improve outcomes. Prior research demonstrates that universal newborn CMV screening would be the most cost-effective approach to identifying newborns who are infected. CMV is not uniformly prevalent, and it is uncertain whether universal screening would remain cost-effective in lower-prevalence neighborhoods.

Voxel-based tumor dose correlates to complete pathologic necrosis after transarterial radioembolization for hepatocellular carcinoma.

Purpose: The transarterial radioembolization (TARE) dose is traditionally calculated using the single-compartment Medical Internal Radiation Dose (MIRD) formula. This study utilized voxel-based dosimetry to correlate tumor dose with explant pathology in order to identify dose thresholds that predicted response.

Methods: All patients with HCC treated with TARE using yttrium-90 [Y] glass microspheres at a single institution between January 2015 - June 2023 who underwent liver transplantation were eligible.