Effects of internet and smartphone addiction on cognitive control in adolescents and young adults: A systematic review of fMRI studies

BACKGROUND

Internet Addiction (IA) refers to excessive or uncontrolled behaviors related to Internet access, causing impairment or distress. Similarly, Smartphone Addiction (SPA) involves the excessive use of smartphones, disrupting users' daily lives. Cognitive control plays a relevant role in the development of IA and SPA, with executive functions and rewards processing being particularly important.

OBJECTIVE

This study aims to provide a synthesis of scientific evidence on the differential effects of IA and SPA on cognition in young adults and adolescents, using fMRI.

METHODS

Relevant articles published between 2013 and May 2023 were identified following the PRISMA protocol.

RESULTS

Included studies (n = 21) revealed that both behavioral addictions were associated with impairments in cognitive control related to reward processing (ACC, insula, amygdala) and executive function (DLPFC, frontal, parietal lobes) in adolescents and young adults.

CONCLUSION

These findings provide evidence for neuroanatomical similarities between IA and SPA in young adults and adolescents related to executive functions and rewards processing. However, differential effects of SPA and IA on cognitive control were not found in this study. Future research should explore the relationship between these addictions with other cognitive domains to further expand our understanding within this field. While both IA and SPA involve the excessive use of online technology, SPA could involve a higher risk, given that smartphones allow internet connectivity anytime.

Current Landscape of Genome-Wide Association Studies in Acute Myeloid Leukemia: A Review

Acute myeloid leukemia (AML) is a clonal hematopoietic disease that arises from chromosomal and genetic aberrations in myeloid precursor cells. AML is one of the most common types of acute leukemia in adults; however, it is relatively rare overall, comprising about 1% of all cancers. In the last decade or so, numerous genome-wide association studies (GWAS) have been conducted to screen between hundreds of thousands and millions of variants across many human genomes to discover genetic polymorphisms associated with a particular disease or phenotype. In oncology, GWAS has been performed in almost every commonly occurring cancer. Despite the increasing number of studies published regarding other malignancies, there is a paucity of GWAS studies for AML. In this review article, we will summarize the current status of GWAS in AML.

SAMHD1 single nucleotide polymorphisms impact outcome in children with newly diagnosed acute myeloid leukemia

Cytarabine arabinoside (Ara-C) has been the cornerstone of acute myeloid leukemia (AML) chemotherapy for decades. After cellular uptake, it is phosphorylated into its active triphosphate form (Ara-CTP), which primarily exerts its cytotoxic effects by inhibiting DNA synthesis in proliferating cells. Interpatient variation in the enzymes involved in the Ara-C metabolic pathway has been shown to affect intracellular abundance of Ara-CTP and, thus, its therapeutic benefit. Recently, SAMHD1 (SAM and HD domain-containing deoxynucleoside triphosphate triphosphohydrolase 1) has emerged to play a role in Ara-CTP inactivation, development of drug resistance, and, consequently, clinical response in AML. Despite this, the impact of genetic variations in SAMHD1 on outcome in AML has not been investigated in depth. In this study, we evaluated 25 single nucleotide polymorphisms (SNPs) within the SAMHD1 gene for association with clinical outcome in 400 pediatric patients with newly diagnosed AML from 2 clinical trials, AML02 and AML08. Three SNPs, rs1291128, rs1291141, and rs7265241 located in the 3' region of SAMHD1 were significantly associated with at least 1 clinical outcome: minimal residual disease after induction I, event-free survival (EFS), or overall survival (OS) in the 2 cohorts. In an independent cohort of patients from the COG-AAML1031 trial (n = 854), rs7265241 A>G remained significantly associated with EFS and OS. In multivariable analysis, all the SNPs remained independent predictors of clinical outcome. These results highlight the relevance of the SAMHD1 pharmacogenomics in context of response to Ara-C in AML and warrants the need for further validation in expanded patient cohorts.

Rebooting a sports pharmacy advanced pharmacy practice experience: Utilizing medicinal chemistry as a foundational approach to get pharmacists back in the game

BACKGROUND AND PURPOSE

To implement a sports pharmacy advanced pharmacy practice experience (SP-APPE) utilizing medicinal chemistry as a foundational approach.

EDUCATIONAL ACTIVITY AND SETTING

A student-pharmacist and medicinal chemistry faculty member collaborated to reboot a SP-APPE. Approached from a medicinal chemistry perspective and tailored to the infrastructure of the university, three fourth-year student-pharmacists piloted the SP-APPE (fall 2017 to fall 2018). Various performance enhancing drugs (PEDs) and supplements were investigated. Student-pharmacists evaluated general knowledge of PEDs along with the perceived value of pharmacists in sports among student-athletes, athletic personnel, and pre-APPE students.

FINDINGS

By demonstrating how legitimate medications were chemically similar to substances banned by sports governing agencies, comparing chemical structures/pharmacophores of PEDs to those of various prescription drugs, and comprehending athletes' misuse of PEDs, student-pharmacists educated student-athletes and athletic personnel on pertinent topics spanning pharmacy and sports (e.g., marijuana, medication sharing, deciphering supplement labels). Laboratory analytical methods that detect PEDs and educational points regarding potential adverse health risks posed by PED usage were also reviewed. Survey participants (approximately 75%, n = 134) perceived pharmacists as valuable to student-athletes and athletic personnel. Student-pharmacists indicated that medicinal chemistry knowledge was strengthened by completing the APPE and relevant to their pharmacy careers.

SUMMARY

Based on medicinal chemistry principles, the SP-APPE provided a venue for student-pharmacists to interact with athletics, assist with drug information education, and identify drugs or supplements as chemically related to those banned by sports governing agencies. Confident in medicinal chemistry concepts, student-pharmacists translated their expertise to benefit the patient/student-athlete.

How to Transition from Single-Gene Pharmacogenetic Testing to Preemptive Panel-Based Testing: A Tutorial

There have been significant advancements in precision medicine and approaches to medication selection based on pharmacogenetic results. With the availability of direct-to-consumer genetic testing and growing awareness of genetic interindividual variability, patient demand for more precise, individually tailored drug regimens is increasing. The University of Florida (UF) Health Precision Medicine Program (PMP) was established in 2011 to improve integration of genomic data into clinical practice. In the ensuing years, the UF Health PMP has successfully implemented several single-gene tests to optimize the precision of medication prescribing across a variety of clinical settings. Most recently, the UF Health PMP launched a custom-designed pharmacogenetic panel, including pharmacogenes relevant to supportive care medications commonly prescribed to patients undergoing chemotherapy treatment, referred to as "GatorPGx." This tutorial provides guidance and information to institutions on how to transition from the implementation of single-gene pharmacogenetic testing to a preemptive panel-based testing approach. Here, we demonstrate application of the preemptive panel in the setting of an adult solid tumor oncology clinic. Importantly, the information included herein can be applied to other clinical practice settings.

Pediatric neurotologic skull base surgery

The objectives of neurotologic skull base surgery are complete resection of the lesion and high-grade function following surgery. There is a perception that these goals are more difficult to achieve in children than in adults. Skull base disease in children and adolescents is rare. Of the 292 skull base tumors treated from 1970 to 1995 by The Otology Group in Nashville, 15 were in patients 21 years of age or younger, with only 5 patients under 10 years old. In this retrospective study, the authors review these 15 cases and compare them to their adult series. The pathology encountered in the 15 young patients with skull base tumors included 8 glomus lesions and 4 schwannomas. In these patients, 13 tumors occurred sporadically, and 2 tumors were related to neurofibromatosis type 2. Advanced-stage disease and malignancy were prevalent in this younger patient group. All patients underwent excision of their skull base tumor, with one procedure considered a subtotal resection. As compared with an adult glomus tumor series, postoperative cranial nerve function and complication rates were generally worse in the young glomus patients. However, postoperative function and complications were consistent with the extensive procedures required for the treatment of advanced disease. Despite the advances that have been made in imaging and treatment modalities, this study illustrates the need for more timely diagnosis in younger patients with skull base tumors.