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Judicial Panel on Multidistrict Litigation (JPML) ruled that the cases should proceed as a separate multidistrict litigation (MDL) in federal court in Philadelphia, rather than being folded into an existing MDL involving gastrointestinal side effects linked to the same class of medications

Ligand binding triggers receptor dimerization and recruitment to estrogen response elements on chromatin, modulating transcription of genes involved in calcium homeostasis, lipid metabolism, endothelial nitric-oxide synthase expression, and serotonergic signaling