Smartphone overuse, depression & anxiety in medical students during the COVID-19 pandemic

"Introduction Medical students have made particular use of smartphones during the COVID-19 pandemic. Although higher smartphone overuse has been observed, its effect on mental disorders is unclear. This study aimed to assess the association between smartphone overuse and mental disorders in Peruvian medical students during the COVID-19 pandemic. Methods A cross-sectional study was conducted in 370 students aged between 16 and 41 years (median age: 20) in three universities from July to October 2020. A survey including Smartphone Dependence and Addiction Scale, PHQ-9, and GAD-7 was applied. Prevalence ratios were estimated using generalized linear models. Results Smartphone overuse was a common feature among students (n = 291, 79%). Depressive symptoms were present in 290 (78%) students and anxiety symptoms in 255 (69%). Adjusted for confounders, addictive/dependent smartphone use was significantly associated with presence of depressive symptoms (PR = 1.29, 95% CI: 1.20–1.38 for dependent use; PR = 1.30, 95% CI: 1.12–1.50 for addictive use). Also, addictive/dependent smartphone use was significantly associated with presence of anxiety symptoms (PR = 1.59, 95% CI: 1.14–2.23 for dependent use; PR = 1.61, 95% CI: 1.07–2.41 for addictive use). Conclusions Our findings suggest that medical students exposed to smartphone overuse are vulnerable to mental disorders. Overuse may reflect an inappropriate way of finding emotional relief, which may significantly affect quality of life and academic performance. Findings would assist faculties to establish effective measures for prevention of smartphone overuse.

The HERA-B Ring Imaging Cherenkov Counter

The HERA-B RICH uses a radiation path length of 2.8 m in C_4F_10 gas and a large 24 square meters spherical mirror for imaging Cherenkov rings. The photon detector consists of 2240 Hamamatsu multi-anode photomultipliers with about 27000 channels. A 2:1 reducing two-lens telescope in front of each PMT increases the sensitive area at the expense of increased pixel size, resulting in a contribution to the resolution which roughly matches that of dispersion. The counter was completed in January of 1999, and its performance has been steady and reliable over the years it has been in operation. The design performance of the RICH was fully reached: the average number of detected photons in the RICH for a beta=1 particle was found to be 33 with a single hit resolution of 0.7 mrad and 1 mrad in the fine and coarse granularity regions, respectively.Comment: 29 pages, 23 figure

Open and Hidden Charm Production in 920 GeV Proton-Nucleus Collisions

The HERA-B collaboration has studied the production of charmonium and open charm states in collisions of 920 GeV protons with wire targets of different materials. The acceptance of the HERA-B spectrometer covers negative values of xF up to xF=-0.3 and a broad range in transverse momentum from 0.0 to 4.8 GeV/c. The studies presented in this paper include J/psi differential distributions and the suppression of J/psi production in nuclear media. Furthermore, production cross sections and cross section ratios for open charm mesons are discussed.Comment: 5 pages, 9 figures, to be published in the proceedings of the 6th International Conference on Hyperons, Charm & Beauty Hadrons (BEACH04), Chicago, IL, June 27 - July 3, 200

Measurement of the J/Psi Production Cross Section in 920 GeV/c Fixed-Target Proton-Nucleus Interactions

The mid-rapidity (dsigma_(pN)/dy at y=0) and total sigma_(pN) production cross sections of J/Psi mesons are measured in proton-nucleus interactions. Data collected by the HERA-B experiment in interactions of 920 GeV/c protons with carbon, titanium and tungsten targets are used for this analysis. The J/Psi mesons are reconstructed by their decay into lepton pairs. The total production cross section obtained is sigma_(pN)(J/Psi) = 663 +- 74 +- 46 nb/nucleon. In addition, our result is compared with previous measurements

Search for the Flavor-Changing Neutral Current Decay D0→μ+μ−D^0 \to \mu^+\mu^- with the HERA-B Detector

We report on a search for the flavor-changing neutral current decay $D^0 \to \mu^+\mu^-$ using $50 \times 10^6$ events recorded with a dimuon trigger in interactions of 920 GeV protons with nuclei by the HERA-B experiment. We find no evidence for such decays and set a 90% confidence level upper limit on the branching fraction $Br(D^0 \to \mu^+\mu^-) <2.0 \times 10^{-6}$.Comment: 17 pages, 4 figures (of which 1 double), paper to be submitted to Physics Letters

Inclusive V0V^0 Production Cross Sections from 920 GeV Fixed Target Proton-Nucleus Collisions

Inclusive differential cross sections $d\sigma_{pA}/dx_F$ and $d\sigma_{pA}/dp_t^2$ for the production of \kzeros, \lambdazero, and \antilambda particles are measured at HERA in proton-induced reactions on C, Al, Ti, and W targets. The incident beam energy is 920 GeV, corresponding to $\sqrt {s} = 41.6$ GeV in the proton-nucleon system. The ratios of differential cross sections \rklpa and \rllpa are measured to be $6.2\pm 0.5$ and $0.66\pm 0.07$, respectively, for \xf $\approx-0.06$. No significant dependence upon the target material is observed. Within errors, the slopes of the transverse momentum distributions $d\sigma_{pA}/dp_t^2$ also show no significant dependence upon the target material. The dependence of the extrapolated total cross sections $\sigma_{pA}$ on the atomic mass $A$ of the target material is discussed, and the deduced cross sections per nucleon $\sigma_{pN}$ are compared with results obtained at other energies.Comment: 17 pages, 7 figures, 5 table

Pharmacokinetic/pharmacodynamic modelling approaches in paediatric infectious diseases and immunology.

Pharmacokinetic/pharmacodynamic (PKPD) modelling is used to describe and quantify dose-concentration-effect relationships. Within paediatric studies in infectious diseases and immunology these methods are often applied to developing guidance on appropriate dosing. In this paper, an introduction to the field of PKPD modelling is given, followed by a review of the PKPD studies that have been undertaken in paediatric infectious diseases and immunology. The main focus is on identifying the methodological approaches used to define the PKPD relationship in these studies. The major findings were that most studies of infectious diseases have developed a PK model and then used simulations to define a dose recommendation based on a pre-defined PD target, which may have been defined in adults or in vitro. For immunological studies much of the modelling has focused on either PK or PD, and since multiple drugs are usually used, delineating the relative contributions of each is challenging. The use of dynamical modelling of in vitro antibacterial studies, and paediatric HIV mechanistic PD models linked with the PK of all drugs, are emerging methods that should enhance PKPD-based recommendations in the future

Time to positivity in blood cultures of adults with Streptococcus pneumoniae bacteremia

BACKGROUND: previous studies have established that bacterial blood concentration is related with clinical outcome. Time to positivity of blood cultures (TTP) has relationship with bacterial blood concentration and could be related with prognosis. As there is scarce information about the usefulness of TTP, we study the relationship of TTP with clinical parameters in patients with Streptococcus pneumoniae bacteremia. METHODS: TTP of all cases of Streptococcus pneumoniae bacteremia, detected between January 1995 and December 2004 using the BacT/Alert automated blood culture system in a teaching community hospital was analyzed. When multiple cultures were positive only the shortest TTP was selected for the analysis. RESULTS: in the study period 105 patients with Streptococcus pneumoniae bacteremia were detected. Median TTP was 14.1 hours (range 1.2 h to 127 h). Immunosuppressed patients (n = 5), patients with confusion (n = 19), severe sepsis or shock at the time of blood culture extraction (n = 12), those with a diagnosis of meningitis (n = 7) and those admitted to the ICU (n = 14) had lower TTP. Patients with TTP in the first quartile were more frequently hospitalized, admitted to the ICU, had meningitis, a non-pneumonic origin of the bacteremia, and a higher number of positive blood cultures than patients with TTP in the fourth quartile. None of the patients with TTP in the 90(th )decile had any of these factors associated with shorter TTP, and eight out of ten patients with TTP in the 10(th )decile had at least one of these factors. The number of positive blood cultures had an inverse correlation with TTP, suggesting a relationship of TTP with bacterial blood concentration. CONCLUSION: Our data support the relationship of TTP with several clinical parameters in patients with Streptococcus pneumoniae bacteremia, and its potential usefulness as a surrogate marker of outcome

Epigenetic prediction of response to anti-PD-1 treatment in non-small-cell lung cancer: a multicenter, retrospective analysis

Background: Anti-programmed death-1 (PD-1) treatment for advanced non-small-cell lung cancer (NSCLC) has improved the survival of patients. However, a substantial percentage of patients do not respond to this treatment. We examined the use of DNA methylation profiles to determine the efficacy of anti-PD-1 treatment in patients recruited with current stage IV NSCLC. Methods: In this multicentre study, we recruited adult patients from 15 hospitals in France, Spain, and Italy who had histologically proven stage IV NSCLC and had been exposed to PD-1 blockade during the course of the disease. The study structure comprised a discovery cohort to assess the correlation between epigenetic features and clinical benefit with PD-1 blockade and two validation cohorts to assess the validity of our assumptions. We first established an epigenomic profile based on a microarray DNA methylation signature (EPIMMUNE) in a discovery set of tumour samples from patients treated with nivolumab or pembrolizumab. The EPIMMUNE signature was validated in an independent set of patients. A derived DNA methylation marker was validated by a single-methylation assay in a validation cohort of patients. The main study outcomes were progression-free survival and overall survival. We used the Kaplan-Meier method to estimate progression-free and overall survival, and calculated the differences between the groups with the log-rank test. We constructed a multivariate Cox model to identify the variables independently associated with progression-free and overall survival. Findings: Between June 23, 2014, and May 18, 2017, we obtained samples from 142 patients: 34 in the discovery cohort, 47 in the EPIMMUNE validation cohort, and 61 in the derived methylation marker cohort (the T-cell differentiation factor forkhead box P1 [FOXP1]). The EPIMMUNE signature in patients with stage IV NSCLC treated with anti-PD-1 agents was associated with improved progression-free survival (hazard ratio [HR] 0·010, 95% CI 3·29 × 10 −4–0·0282; p=0·0067) and overall survival (0·080, 0·017–0·373; p=0·0012). The EPIMMUNE-positive signature was not associated with PD-L1 expression, the presence of CD8+ cells, or mutational load. EPIMMUNE-negative tumours were enriched in tumour-associated macrophages and neutrophils, cancer-associated fibroblasts, and senescent endothelial cells. The EPIMMUNE-positive signature was associated with improved progression-free survival in the EPIMMUNE validation cohort (0·330, 0·149–0·727; p=0·0064). The unmethylated status of FOXP1 was associated with improved progression-free survival (0·415, 0·209–0·802; p=0·0063) and overall survival (0·409, 0·220–0·780; p=0·0094) in the FOXP1 validation cohort. The EPIMMUNE signature and unmethylated FOXP1 were not associated with clinical benefit in lung tumours that did not receive immunotherapy. Interpretation: Our study shows that the epigenetic milieu of NSCLC tumours indicates which patients are most likely to benefit from nivolumab or pembrolizumab treatments. The methylation status of FOXP1 could be associated with validated predictive biomarkers such as PD-L1 staining and mutational load to better select patients who will experience clinical benefit with PD-1 blockade, and its predictive value should be evaluated in prospective studies