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Objective To evaluate the clinical performance and financial costs of breast-specific gamma imaging (BSGI) as a biopsy-reducing problem-solving strategy in patients with inconclusive diagnostic imaging findings. Methods A retrospective analysis of all patients for whom BSGI was utilized for inconclusive imaging findings following complete diagnostic mammographic and sonographic evaluation between January 2013 and December 2018 was performed. Positive BSGI findings were correlated and biopsied with either US or stereotactic technique with confirmation by clip location and pathology. After a negative BSGI result, patients were followed for a minimum of 24 months or considered lost to follow-up and excluded (22 patients). Results of further imaging studies, biopsies, and pathology results were analyzed. Net savings of avoided biopsies were calculated based on average Medicare charges. Results Four hundred and forty female patients from 30 to 95 years (mean 55 years) of age were included in our study. BSGI demonstrated a negative predictive value (NPV) of 98.4% (314/319) and a positive predictive value for biopsy of 35.5% (43/121). The overall sensitivity was 89.6% (43/48), and the specificity was 80.1% (314/392). In total, 78 false positive but only 5 false negative BSGI findings were identified. Six hundred and twenty-one inconclusive imaging findings were analyzed with BSGI and a total of 309 biopsies were avoided. Estimated net financial savings from avoided biopsies were $646 897. Conclusion In the management of patients with inconclusive imaging findings on mammography or ultrasonography, BSGI is a problem-solving imaging modality with high NPV that helps avoid costs of image-guided biopsies. [ABSTRACT FROM AUTHOR]

This Note examines the current legal landscape around “poppers,” an alkyl nitrite-based inhalant that has a strong association with the LGBTQ+ community as a party and sex drug. Under U.S. law, the sale of poppers for recreational use is clearly illegal, but an unregulated poppers industry has arisen over the last fifty years. Poppers manufacturers have taken advantage of a loophole in the statutory ban by marketing their goods as serving alternative “commercial purposes,” such as room odorizers, leather cleaners, and nail polish removers. Poppers can be bought behind the counter at most sex stores, while governments across the world rarely engage in actual enforcement. To skirt existing government regulations, poppers manufacturers have devised new formulations that are more dangerous. At the same time, the poppers industry has increasingly relied on intellectual property (“IP”) law for protection: U.S. poppers companies like Pac-West have registered around forty poppersrelated trademarks. As courts and the USPTO grapple with issues surrounding the validity of poppers trademarks under the unlawful use doctrine, this Note aims to analyze the implications of the current regime of IP protection for criminally banned poppers. Looking at recent developments in the United Kingdom and Australia, this Note recommends legalization and regulation of poppers, rather than just IP protection, as the best way to encourage innovation and protect consumers. [ABSTRACT FROM AUTHOR]

The article explores the journey of innovation surrounding Truvada, a groundbreaking medication for HIV/AIDS treatment and prevention. It delves into the technical aspects of HIV, antiretroviral technology, and the development of Truvada, highlighting key milestones, innovators, and the collaborative ecosystem that facilitated its creation.