Selective Androgen Receptor Modulators (SARMs) are not FDA approved, and obtaining SARMs for personal use is illegal. Nevertheless, SARM use is increasingly popular amongst recreational athletes. Recent case reports of drug-induced liver injury (DILI) and tendon rupture raise serious concerns for the safety of recreational SARM users. On 10 November 2022 PubMed, Scopus, Web of Science, and ClinicalTrials.gov were searched for studies that reported safety data of SARMs. A multi-tiered screening approach was utilized, and any study or case report of generally healthy individuals exposed to any SARM was included. Thirty-three studies were included in the review with 15 case reports or case series and 18 clinical trials (total patients N = 2136 patients, exposed to SARM N = 1447). There were case reports of drug-induced liver injury (DILI) (N = 15), Achilles tendon rupture (N = 1), rhabdomyolysis (N = 1), and mild reversible liver enzyme elevation (N = 1). Elevated alanine aminotransferase (ALT) was commonly reported in clinical trials in patients exposed to SARM (mean 7.1% across trials). Two individuals exposed to GSK2881078 in a clinical trial were reported to have rhabdomyolysis. Recreational SARM use should be strongly discouraged, and the risks of DILI, rhabdomyolysis, and tendon rupture should be emphasized. However, despite warnings, if a patient refuses to discontinue SARM use, ALT monitoring or dose reduction may improve early detection and prevention of DILI.

Primary signet ring cell carcinoma (SRCC) of the breast is extremely rare, and the associated patterns of metastatic dissemination poorly described. Here, we report the case of a 61-year-old woman presenting with acute abdominal pain. Esophagogastroduodenoscopy revealed a non-bleeding erosive gastropathy, which was biopsied and found significant for a poorly differentiated, GATA3-positive SRCC. The patient was lost to follow up until re-presenting 6 months later with a perforating duodenal ulcer and umbilical herniation. Biopsies of umbilical hernia sack contents were significant for an estrogen receptor (ER) positive SRCC, and breast examination identified a right breast mass significant for an ER positive lobular carcinoma with signet ring features, thereby affirming the diagnosis of metastatic SRCC of the breast. This case offers insight into an advanced form of a rare clinical entity, and suggests that staining for breast markers such as GATA3 should be considered for all biopsies significant for SRCC.

P re-professional fieldwork helps graduates pursue specialized library careers, addressing the well-documented experience barrier that many graduates lack. Because COVID-19 required remote learning, virtual practicums may continue, offering LIS graduates the chance to learn from experts and develop skills beyond traditional LIS curriculum. 1 Virtual practicum benefits have been addressed in previous literature, 2 but student perspectives are not usually included. In this two-part series, the student and supervisor describe challenges with their virtual practicum experience so others may replicate similar experiences.Part 1 will set the stage for the structure of the practicum, introducing background information about participating institutions, preparation for the experience, student learning objectives, and reporting for course credit. The host institution and practicum site agreed to modify the existing in-person experience into a virtual format because of COVID-19. The virtual activities aligned with the student-defined learning objectives. Structure was essential to the success of this virtual practicum. Expectations were established early on about workload, communication, file management software, and designated virtual meeting spaces. Others who seek to replicate a similar experience may use part 1 of this series as a template for designing a virtual practicum. Part 2 will reflect on the student and supervisor's experiences and lessons learned.

E xisting literature on practicum experiences often focus on one perspective, either the student's or the supervisor's, but rarely in the same piece or related to the same practicum offering. Pre-professional fieldwork helps graduates pursue specialized library careers, addressing the well-documented experience barrier that many graduates lack. Because COVID-19 required remote learning, virtual practicums may continue, offering LIS graduates the chance to learn from experts and develop skills beyond traditional LIS curriculum. 1 For the practicum shared here, the student's institution and practicum host site agreed to modify the existing in-person experience into a virtual format because of COVID-19.Part 1 of our article, published in the May 2023 issue of C&RL News, outlined the logistics and preparation in offering an online practicum and described the student objectives and learning outcomes. In Part 2, we present the student's and supervisor's reflections on communication, work-life balance, managing information overload, and project workload, providing recommendations for others coordinating a virtual practicum. About the institutionThe University of Illinois Chicago (UIC) is a Carnegie Classified Research 1 institution with a health science library supporting research and education at three regional locations (Chicago, Peoria, and Rockford) and three satellite locations (Quad Cities, Urbana, and Springfield). The practicum took place within the Health Sciences Library (LHS) in the Information Services and Research (ISR) Department. LHS supports six health sciencespecific colleges (medicine, nursing, pharmacy, dentistry, public health, and applied health sciences) of the sixteen at the institution. Health science student enrollment in 2020 was approximately 7,500 and full-time health science faculty was about 1,200. 2 The institution is a federally designated Minority Serving Institution, an Asian American Native American Pacific Islander-Serving Institution, and is a Hispanic-Serving Institution. 3 Faculty in ISR are tenure-track and are library liaisons to the health sciences colleges.

Objective: An underexplored area in Library and Information Science (LIS) is the development of educational offerings and partnerships in Health-Related Informatics (HRI) (e.g., bioinformatics, clinical informatics, health informatics). The purpose of this study is to identify which disciplines are collaborating in HRI education and how partnerships developed. Methods: This study was conducted in two parts: a website review and survey. Seventy-seven North American ALA-accredited and iSchool member websites were searched between November 2019-March 2020 for HRI-related educational offerings and which academic units were involved. Two hundred sixteen individuals involved in LIS and/or HRI education were contacted for a 40-question survey that included: their roles and responsibilities regarding HRI education; the alignment of this education with strategic plans or competencies; and how HRI partnerships developed. The survey also asked those who were not currently partnering in HRI education which factors influenced their circumstances. Results: 352 HRI educational offerings existed within ALA-accredited or iSchool programs. A total of 38 (17.5%) responded to the survey. For almost two-thirds of these, there was no indication of partnership in that education (213/352, 60.5%). LIS or iSchool involvement in HRI is just under one-third of all offerings (111/352, 31%). “Health or healthcare” informatics (35) or “biomedical or bioinformatics” were the most common types of HRI offered from the website review and survey. Conclusions: Opportunities exist for LIS programs to form HRI educational partnerships that will provide richer educational offerings for LIS students and health sciences librarians.