Stanford University School of Medicine is the medical school of Stanford University and is located in Stanford, California. It traces its roots to the Medical Department of the University of the Pacific, founded in San Francisco in 1858. This medical institution, then called Cooper Medical College, was acquired by Stanford in 1908. The medical school moved to the Stanford campus near Palo Alto, California, in 1959.The School of Medicine, along with Stanford Health Care and Lucile Packard Children's Hospital, is part of Stanford Medicine. Stanford Health Care was ranked the fourth best hospital in California (behind UCLA Medical Center, Cedars-Sinai Medical Center, and UCSF Medical Center, respectively).
Early successes achieved with the CD19-targeted chimeric antigen receptor (CAR) T cell product tisagenlecleucel for the treatment of paediatric B cell acute lymphoblastic leukaemia (B-ALL) led to a historic first FDA approval of a gene therapy. Widespread CAR T cell commercialization followed, along with expansion to other indications and earlier disease settings owing to clear survival benefits. However, commercial development of additional cell therapies for paediatric malignancies has stagnated, despite several products being brought to market as treatments for various haematological malignancies in adults. In contrast to the consistent efficacy achieved across B cell malignancies, CAR T cell approaches have yet to demonstrate durable activity in patients with acute myeloid leukaemia (AML), T cell acute lymphoblastic leukaemia, solid tumours and/or central nervous system cancers, with both biological factors and broader issues of development and access constraining the field. Herein, we showcase the foundational leaps achieved through the initial trials and commercialization of CAR T cell products and contextualize how these early experiences have moulded the field. We review currently approved and investigational CAR T cell therapies for paediatric and young-adult patients, including key considerations regarding safety, access and future directions. We also discuss additional immunotherapy options that guide clinical decision-making regarding optimal utilization of CAR T cells. Although clearly tolerable and efficacious, the CD19-targeted CAR T cell strategy requires ongoing refinement, and research efforts are now geared towards fully exploiting CAR T cells and other immunotherapies to improve survival with broadened access across disease states. This Review outlines the fundamental role of chimeric antigen receptor (CAR) T cell therapy for children, adolescents and young adults (CAYAs) with relapsed and/or refractory B cell acute lymphoblastic leukaemia, emphasizing the crucial need to further exploit CAR T cells and other immunotherapies to improve survival with broadened access across disease states. Opportunities and challenges for expanding CAR T cell therapy to other haematological and non-haematological malignancies in CAYAs are also discussed.
This study examines the standardization of venture capital (VC) contracts since the release of the National Venture Capital Association (NVCA) model charter in 2003. Using nearly 5,000 charters issued in connection with a startup’s Series A financing, the paper finds a significant increase in the model’s adoption from less than 3% of charters in 2004 to nearly 85% by 2022. Adoption of the Delaware-oriented charter has also been accompanied by the growing dominance of Delaware incorporation, with Delaware charters growing from 54% of sample charters in 2004 to 100% in 2022. High adoption rates among the six most active law firms servicing U.S. startups largely explain the success of the standardization project.While cosine similarity analysis reveals charters are overall more similar in 2022 than in 2004, the capital structures of Series A startups have also become substantially more complex. Series A charters authorizing only a single class of common stock and a single series of “Series A” preferred stock constituted 86% of charters in 2004 but constituted just 5% of 2022 charters, while 30% of 2022 charters had either 2 classes of common stock or 3 or more series of preferred stock. The additional complexity arises almost entirely from multiple securities reflecting prior seed stage financing. In contrast, efforts to add founder-friendly capital securities—such as dual class common stock and founder preferred stock—have made only modest inroads. Overall, the story of VC contracting over the past two decades is largely one of standardization, albeit with growing complexity around startup capital structures due to the increasing importance of seed stage capital and changing expectations regarding what constitutes a “Series A” startup.
This article compares emerging developments in artificial intelligence (AI) reimbursement in radiology between the United States (U.S.) and the European Union (E.U.), focusing on evolving policy proposals, regulatory frameworks, and funding disparities. While radiology accounts for over 75 % of all FDA-cleared clinical AI tools in the U.S., adoption remains limited due to multiple factors including the absence of standardized reimbursement pathways. The 2025 Health Tech Investment Act (S. 1399) bill seeks to address this by introducing a dedicated Medicare payment pathway for FDA-approved AI devices, offering transitional reimbursement for five years. In contrast, the E.U. emphasizes stringent regulation through the Medical Device Regulation (MDR) and the recently proposed AI Act but lacks a unified reimbursement strategy; adoption remains largely dependent on hospital budgets or national innovation funds. By 2025, the U.S. had authorized nearly 777 AI-enabled radiology devices, compared to approximately 200 CE-marked counterparts in Europe. U.S. investment in health AI ($11 billion in 2024) substantially surpasses Europe’s ($8 billion across all AI sectors), fueling a stronger pipeline of radiology AI startups and tools. European radiologists face financial barriers, limiting the clinical integration of AI and exacerbating workforce strain. Emerging policy directions in the in the U.S. and E.U. suggest differing approaches to radiology AI, with the U.S. pursuing proposals for reimbursement reform and the E.U. advancing regulatory oversight. Emerging global trends, particularly China’s rapid regulatory and insurance-driven AI adoption, highlight the growing importance of cross-regional policy dialogue.
Ascites can develop in the setting of a variety of pathologies. The approach to treatment depends on accurate determination of the underlying cause, for which fluid analysis plays a central role. In particular, the serum-ascites albumin gradient serves as a primary diagnostic test for differentiating among causes, with certain additional fluid tests performed based on clinical suspicion. Treatment options range from nonspecific fluid removal, including large-volume paracentesis and placement of tunneled peritoneal catheters, to targeted therapies (e.g., diuretics, TIPS placement, and lymphangiography). Societal guidelines exist for the approach to cirrhotic ascites, but the management of ascites due to other less common causes remains less well defined. The goal of this AJR Expert Panel Narrative Review is to provide guidance for the diagnosis and management of ascites, based on available evidence and our clinical experience.
