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However, in local tissues, steroid metabolic reprogramming is driven by pro-inflammatory factors such as TNF-: inflammatory cytokines induce the overexpression of aromatase (Aromatase/CYP19A1), accelerating the conversion of the substrate testosterone into estradiol and leading to an excessive local production of E2 (154, 155)

Other compounds Cyanidin-3-O--glucoside (C3G) increases the expression of Gclc in the liver by increasing cAMP levels to activate protein kinase A (PKA) and then increases the phosphorylation of cAMP response element binding protein (CREB) to promote CREB-DNA binding and increase Gclc transcription

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Also, as discussed in the CY 2024 PFS final rule, since Medicare CQMs would be subject to MIPS scoring policies, the application of MIPS benchmarking policies to Medicare CQMs is both logical and necessary for implementation of the new collection type (88 FR 79180)

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