A Comprehensive Literature Review of Digital Health Interventions in the Treatment of Substance Use Disorder With Special Focus on Mobile Applications.

COVID-19 quarantine showed an increase in opioid-related deaths partially due to the limited capacity of clinics and treatment centers. Digital health interventions (DHIs) such as telehealth have improved access to treatment, reduced psychosocial barriers, and helped patients with substance use disorder (SUD). An in-depth literature review was conducted to gauge the efficacy and usefulness of DHIs on substance use disorder. PubMed was used with string search terms to identify studies analyzing telehealth for substance use disorders. Studies were eligible and selected if they used health interventions (HIs) and reported outcomes on the efficacy of DHIs, benefits of DHIs, and limitations of DHIs. The Agency of Healthcare Research and Quality (AHRQ) was used to analyze the impact of DHIs on SUD. Lastly, Apple's App Store was used to identify the current DHI available. The analysis indicated that mobile phone apps were the most appropriate sources to use for patients with substance use disorders. The search also found 36 mobile applications available on the market for patients, containing mainly pain medication diaries and trackers. The study did not find any apps for clinical usage that met the standards necessary for adequate healthcare in the opioid crisis, largely due to a lack of clinician involvement in using applications. Developing adequate DHIs has the potential to improve outcomes in patients with SUD and aid in recovery time. The research concluded that physicians looking to develop DHIs should take into consideration the mode of delivery of DHI, the aim to produce specific health outcomes as opposed to multiple outcomes, and clinician involvement in DHI development. DHIs can become a vital tool for medical professionals, especially during the COVID-19 crisis, as the use of healthcare technology has limited in-person contact, maintained current doctor-patient relationships, and allowed for contact tracing of the disease.

Risk of Cardiovascular Disease in Male Farmers Over the Age of 45: A Review of Literature.

The prevalence of heart disease in farmers is well documented, but there is limited research characterizing the diverse risk factors associated specifically with male farmers over the age of 45 in the United States, while also providing a multifactorial strategy to address these concerns. The majority of current research either focuses on the general rural population or does not take into account different demographic variables. Hence, this review looked to address those gaps by focusing on those specific variables. A literature review was generated looking at risk factors associated with cardiovascular disease in farmers using key search terms. Next, an additional search was conducted focusing on treatment plans to address these concerns. The articles were then sorted based on the inclusion and exclusion criteria. The initial articles were sorted by one researcher and then reassessed on two separate occasions. The literature review was performed using these databases: PubMed, CINAHL, Cochrane, and Ovid Medline. A total of 221 articles were generated, of which 12 articles matched the criteria. The articles highlighted important risk factors that were either social or non-social determinants of health that negatively impacted the target population. These were followed up by offering solutions that attempted to provide a holistic approach, including clinical and community-based interventions. Male farmers over the age of 45 years are at an increased risk of being diagnosed with heart disease compared to non-farmers in the same demographic. When attempting to implement interventions, stress management should be incorporated into the treatment plan. In addition, a multifaceted approach targeting clinical and community concerns is recommended.

SAHA and EGCG Promote Apoptosis in Triple-negative Breast Cancer Cells, Possibly Through the Modulation of cIAP2.

BACKGROUND/AIM: Inhibition of apoptosis is one of the hallmarks of cancer, and anti-apoptotic genes are often targets of genetic and epigenetic alterations. Cellular inhibitor of apoptosis 2 (cIAP2) has a role in degrading caspases by linking them to ubiquitin molecules, and is upregulated in triple-negative breast cancer (TNBC). Previous studies have demonstrated that cIAP2 may play a role in the epithelial-to-mesenchymal transition (EMT). MATERIALS AND METHODS: Suberoylanilide hydroxamic acid (SAHA), a histone deacetylase (HDAC) inhibitor, was administered to triple-negative breast cancer (TNBC) cells alone or in combination with epigallocatechin-3-gallate (EGCG), a DNA methyltransferase (DNMT) inhibitor isolated from green tea. RESULTS: The compounds were able to decrease the expression of cIAP2 while increasing the expression of pro-apoptotic caspase 7. There were also changes in histone modifications, suggesting a role of epigenetic mechanisms in these changes in expression of cIAP2. These changes resulted in an increase in apoptosis. SAHA and EGCG were also capable of limiting TNBC cell migration across a fibronectin (FN) matrix. CONCLUSION: SAHA and EGCG reduce the metastatic potential of TNBC by inducing the apoptotic pathway.

Effects of SAHA and EGCG on Growth Potentiation of Triple-Negative Breast Cancer Cells.

Triple-negative breast cancer comprises approximately 15⁻20% of all breast cancers diagnosed and is nearly twice as common in black women than white women in the United States. We evaluated the effects of two epigenetic-modifying compounds on markers of growth potential in several triple-negative breast cancer cell lines. Suberoylanilide hydroxamic acid (SAHA), a histone deacetylase (HDAC) inhibitor currently used in the treatment of cutaneous T cell lymphoma, was administered to triple-negative breast cancer cells alone or in combination with epigallocatechin-3-gallate (EGCG), a DNA methyltransferase (DNMT) inhibitor isolated from green tea. The compounds affected the expression of oncogenic miR-221/222 and tumor suppressors, p27 and PTEN, in addition to estrogen receptor alpha (ERα). E-cadherin expression was increased while N-cadherin was decreased, indicating a more epithelial phenotype. In addition, the activity of DNMTs was diminished with the treatments, and there was a significant enrichment of AcH3 within the promoter of p27 and PTEN, suggesting a role of epigenetic mechanisms for the aforementioned changes. These results translated to reduced migration of the triple-negative breast cancer cells with the treatments. Together, these findings support the role of SAHA and EGCG in limiting growth and proliferation of breast cancer cells.