Browse Articles

Moiré band structure engineering using a twisted boron nitride substrate

How I treat ETP-ALL in children

Abstract Early T-cell precursor acute lymphoblastic leukemia (ETP-ALL) is a unique subtype of immature T-cell ALL that was initially associated with a dramatically inferior prognosis compared with non-ETP T-cell ALL (Not-ETP) when it was first described in 2009. Analyses of larger patient cohorts treated with more contemporary regimens, however, have shown minimal survival differences between ETP and Not-ETP. In this manuscript, we use representative cases to explore therapeutic advances and address common clinical questions regarding the management of children, adolescents, and young adults with ETP-ALL. We describe our recommended treatment approach for a child or adolescent with newly diagnosed ETP-ALL, with an emphasis on the prognostic significance of induction failure and detectable minimal residual disease and the role of hematopoietic stem cell transplant in first remission. We discuss the interplay between the ETP immunophenotype and genomic markers of immaturity in T-cell ALL. Finally, we review novel therapeutic approaches that should be considered when managing relapsed or refractory ETP-ALL.

An exploration of the influencing factors of privacy fatigue among mobile social media users from the configuration perspective

Non-contact lensless holographic reconstruction of diffractive intraocular lenses profiles

Ripening associated antioxidant and phytochemical changes in mango (Mangifera indica) cultivar Dusehri

Spatial transcriptomics of healthy and fibrotic human liver at single-cell resolution

How I treat infant acute lymphoblastic leukemia

Abstract Infant acute lymphoblastic leukemia (ALL) is an aggressive malignancy that has historically been associated with a very poor prognosis. Despite large cooperative international trials and incremental increases in intensity of therapy, there has been no significant improvement in outcome over the last 3 decades. Using representative cases, we highlight the key differences between KMT2A-rearranged and KMT2A–germ line infant ALL, and how advances in molecular diagnostics are unpicking KMT2A–germ line genetics and guiding treatment reduction. We focus on KM2TA-rearranged infant B-cell ALL for which the last few years have seen the emergence of novel therapies that both are more effective and less toxic than conventional chemotherapy. Of these, there is promising early data on the efficacy and tolerability of the bispecific T-cell engager monoclonal antibody, blinatumomab, as well as the use of autologous and allogeneic chimeric antigen receptor T-cell therapy. We discuss how we can improve risk stratification and incorporate these new agents to replace the most toxic elements of currently deployed intensive chemotherapy schedules with their associated unacceptable toxicity.

Development of nanofiber facial mask inspired by the multi-function of dried ginger (Zingiberis Rhizoma) essential oil

Expression pattern of cancer-associated cellular senescence genes in clear cell renal cell carcinoma distinguishes tumor subclasses with clinical implications

Association between the systemic immunity-inflammation index and stroke: a population-based study from NHANES (2015–2020)

Interplay between disorder and topology in Thouless pumping on a superconducting quantum processor

How I treat older patients with Ph/BCR-ABL–negative acute lymphoblastic leukemia

Abstract Despite advancements in new treatments, management of older patients with acute lymphoblastic leukemia (ALL) remains an unmet medical need. With increasing age, patients with ALL have a significantly lower complete remission rate, higher early mortality and relapse rate, and poorer survival than younger patients. This is attributed to a higher prevalence of adverse prognostic factors among older individuals and reduced tolerance to chemotherapy. Progress has been made in tailoring moderately intensive chemotherapy protocols for Philadelphia chromosome (Ph)/BCR::ABL–negative ALL in older patients, and recent phase 2 studies have explored integrating immunotherapy into initial treatment with very promising results. However, establishing new standard regimens for this age group remains and improving general management strategy is a pending task.

Geospatial distribution of unimproved water source and sanitation facilities in Ethiopia: evidence from the latest demographic and health survey (2019)

A 13-level switched-capacitor-based multilevel inverter with reduced components and inrush current limitation

Discrepancy and agreement between subjective symptoms and visual field impairment in glaucoma patients at a driving assessment clinic

A data-driven group retrosynthesis planning model inspired by neurosymbolic programming

Introduction to a How I Treat series on acute lymphoblastic leukemia

Edited by Associate Editor Hervé Dombret, this How I Treat series highlights the clinical approach to high-risk subgroups of acute lymphoblastic leukemia (ALL). These include adult Philadelphia chromosome (Ph)–positive ALL, Ph-like ALL, infant acute ALL, early T-cell precursor ALL, Ph-negative ALL in older patients, and postimmunotherapy relapsed B-cell ALL. Using illustrative cases, the authors outline the approach to these patients, with recommendations with regard to targeted therapies, novel therapeutic approaches, and the changing role of allogeneic stem cell transplantation.

First report on comprehensive genomic analysis of a multidrug-resistant Enterobacter asburiae isolated from diabetic foot infection from Bangladesh

Narrative mobile video game-based cognitive training to enhance frontal function in patients with mild cognitive impairment

Abstract Although cognitive training has been proposed as a possible therapeutic modality for mild cognitive impairment (MCI), most serious games focus on specific tasks. This study aimed to investigate the feasibility and efficacy of narrative video game-based cognitive intervention for MCI. A four-week (± 1-week) mobile game intervention was given to 17 MCI participants (mean age (SD) = 72.8(4.75)). At baseline and post-intervention, the participants received neuropsychological tests and a depression scale. Frontal function was assessed using the Corsi block-tapping test, Color Word Stroop Test, Controlled Oral Word Association Test, Digit Symbol Coding, and Trail Making Test-Elderly’s Version; depression was assessed using the Geriatric Depression Scale. User’s compliance and gaming experience were also evaluated. MCI patients showed significant improvements in frontal function, particularly in Digit Symbol Coding (mean ± SD, 0.47 ± 0.49, p  = 0.007) and phonemic fluency (mean ± SD, 0.39 ± 0.55, p  = 0.024). Each frontal subtest’s mean z-score was increased (mean ± SD, 0.44 ± 0.38, p  = 0.008). Block span and depression scale remained unchanged. High adherence rates (122.35%) and favorable feedback on the gaming experience indicated that the game intervention’s usability boosted patients’ motivation and engagement. Our findings demonstrate that narrative game-based cognitive intervention was not only beneficial but also enjoyable for elderly MCI.

A novel approach for agricultural carbon emission reduction by integrating fermatean neutrosophic set with WINGS and AHP-EWM