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Background and Aims: Diagnosis of metabolic dysfunction‐associated steatohepatitis (MASH) requires histology. In this study, a magnetic resonance imaging (MRI) score was developed and validated to identify MASH in patients with metabolic dysfunction‐associated steatotic liver disease (MASLD). Secondarily, a screening strategy for MASH diagnosis was investigated. Methods: This prospective multicentre study included 317 patients with biopsy‐proven MASLD and contemporaneous MRI. The discovery cohort (Spain, Portugal) included 194 patients. NAFLD activity score (NAS) and fibrosis were assessed with the NASH‐CRN histologic system. MASH was defined by the presence of steatosis, lobular inflammation, and ballooning, with NAS ≥4 with or without fibrosis. An MRI‐based composite biomarker of Proton Density Fat Fraction and waist circumference (MR–MASH score) was developed. Findings were afterwards validated in an independent cohort (United States, Spain) with different MRI protocols. Results: In the derivation cohort, 51% (n = 99) had MASH. The MR–MASH score identified MASH with an AUC =.88 (95% CI.83–.93) and strongly correlated with NAS (r =.69). The MRI score lower cut‐off corresponded to 88% sensitivity with 86% NPV, while the upper cut‐off corresponded to 92% specificity with 87% PPV. MR–MASH was validated with an AUC =.86 (95% CI.77–.92), 91% sensitivity (lower cut‐off) and 87% specificity (upper cut‐off). A two‐step screening strategy with sequential MR–MASH examination performed in patients with indeterminate‐high FIB‐4 or transient elastography showed an 83–84% PPV to identify MASH. The AUC of MR–MASH was significantly higher than that of the FAST score (p <.001). Conclusions: The MR–MASH score has clinical utility in the identification and management of patients with MASH at risk of progression. [ABSTRACT FROM AUTHOR]

The ISOTYPE (International System of Typographic Picture Education) pictograms, a system that emerged as a response to a society driven by science and industrialization, as well as imbued with the belief that the modern spirit had what it takes to pursue the universal theories: The will to do a "utopia" universal communication. Otto Neurath (1882- 1945), developed the isotype in the early 20s of twentieth century, with the help of Gerd Arntz (1900-1988) and Marie Neurath (1898-1986). The frame used simplified forms to transmit social and economic information to the general public and applied in museums, books, posters, and educational material. Neurath hoped to create a global standard for education and unite humanity through an ordered, and universally readable language of vision. Their core principles: reduction, to determine the individual style signs; consistency, to give the whole an appearance of a coherent system. The reduction suggests that the "image has a natural, scientific relationship to its object" (Lupton 1989, 54), and formal consistency is linked to mass production, enabling the user to create a habit of how the information is presented. However, isotype did not advance "because of the difficulties related to the sheer size and complexity of the iconic representation" (Rajamanickam, 2005, 7) and tend to ignore the socio-economic and cultural contexts. The creation of language should rely on the context. And considering the context, currently, many of the 17 million Europeans who suffer from food allergies could benefit from a more direct information system in the identification of the fourteen allergens regulated by the Parliament and Council Regulation (EU) nº 1169/2011 in food products' packages. This study is aimed at creating pictograms representing these fourteen allergens along visual and tactile lines, through relief printing. Based on an Inclusive Design approach, the project is meant to overcome restrictions such as sight impairment or illiteracy. Making use of User Centered Design (UCD) methodology, and with the support of the SAED (Disabled Students Support Services of the University of Porto) and GAENEE-UP (Support Office for Students with Special Educational Needs of the University of Porto), it employed field observation processes, in which potential users recorded their tactile perception of the basic elements of visual communication. The result is the creation of a universal code, which is meant to satisfy the expectations and needs of potential users, namely people with impaired sight with a framework that systematize guidelines to support the development of new relief pictograms in the food allergies context. This project was developed with the purpose of creating a unique and universal code that could help two special groups of disabled people: Those,,both adults and children, that suffer from food allergies and the visually impaired. The leading goal was the creation of relief signs that represent the fourteen allergens regulated by the European Union, under the Parliament and Council (EU) Regulation nº 1169/2011, as well as the development of a guideline framework to support future relief pictograms' designs. In this paper we explain the process of creating those, presenting some of the results, semiotic and technical requirements that underlie the framework that systematize the relief pictograms guidelines to visual impaired users. [ABSTRACT FROM AUTHOR]

A 59-year-old woman underwent an abdominal and pelvic computed tomography (CT) scan to rule out non-obstructive urolithiasis. The patient was asymptomatic, with the exception of occasional bilateral low back pain. A physical examination did not reveal any notable findings. The CT scan revealed the presence of an incidental solid left adrenal lesion, which displaced the body of the pancreas and the left kidney. The lesion measured 7 cm × 6.5 cm and exhibited a rounded morphology with well-defined margins. It showed progressive and heterogeneous contrast uptake. Additionally, magnetic resonance imaging (MRI) was performed, confirming the presence of an adrenal lesion with intense and heterogeneous hypersignal on T2. The lesion also demonstrated heterogeneous and persistent enhancement in a dynamic study. Furthermore, there were some indistinct and non-specific hypointense areas identified on both T1 and T2 sequences. The lesion exhibited moderately restricted diffusion. Although the imaging features were non-specific, there were no indications of invasion or distant metastasis, which made a benign large adrenal mass the most likely diagnosis. Non-functioning pheochromocytoma, lipid-poor adrenal adenoma, as well as metastasis or primary adrenal carcinoma, were considered differential diagnoses. The patient underwent an elective adrenalectomy, during which the identified lesion was completely resected. The patient's postoperative recovery was uneventful, and she was discharged three days after the procedure. Subsequent histopathological evaluation revealed an oncocytic neoplasm of the adrenal cortex - specifically, an oncocytoma., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Giesteira et al.)