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i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource. This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and Associate Division Director for Ambulatory Operations The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma. STATEMENT OF NEED Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL. Target Audience Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL). Learning Objectives 1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL 2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults 3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection

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Title: Sense of Taste Presenter: Dr. Faiza, Assistant Professor of Physiology Qualifications: MBBS (Best Graduate, AIMC Lahore) FCPS Physiology ICMT, CHPE, DHPE (STMU) MPH (GC University, Faisalabad) MBA (Virtual University of Pakistan) Learning Objectives: Describe the structure and function of taste buds. Describe the relationship between the taste threshold and taste index of common substances. Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation. Recognize different abnormalities of taste perception and their causes. Key Topics: Significance of Taste Sensation: Differentiation between pleasant and harmful food Influence on behavior Selection of food based on metabolic needs Receptors of Taste: Taste buds on the tongue Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper) Primary and Secondary Taste Sensations: Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami Chemical basis and signal transduction mechanisms for each taste Taste Threshold and Index: Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine) Taste index relationship: Inversely proportional to taste threshold Taste Blindness: Inability to taste certain substances, particularly thiourea compounds Example: Phenylthiocarbamide Structure and Function of Taste Buds: Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers Location of Taste Buds: Found in papillae of the tongue (Fungiform, Circumvallate, Foliate) Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus Mechanism of Taste Stimulation: Interaction of taste substances with receptors on microvilli Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes Taste Sensitivity and Adaptation: Decrease in sensitivity with age Rapid adaptation of taste sensation Role of Saliva in Taste: Dissolution of tastants to reach receptors Washing away the stimulus Taste Preferences and Aversions: Mechanisms behind taste preference and aversion Influence of receptors and neural pathways Impact of Sensory Nerve Damage: Degeneration of taste buds if the sensory nerve fiber is cut Abnormalities of Taste Detection: Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia) Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels Neurotransmitters and Taste Threshold: Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity Supertasters: 25% of the population with heightened sensitivity to taste, especially bitterness Increased number of fungiform papillae

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