Pilot Trial of a Smartphone-Based Intervention to Reduce Alcohol Consumption among Veterans with HIV.

Veterans engage in disproportionate levels of alcohol use, which can impact treatment outcomes among veterans with HIV. The TRAC (Tracking and Reducing Alcohol Consumption) intervention, which combines smartphones, mobile breathalyzers, and motivational interviewing (MI), was developed to help reduce alcohol use among this population. This study reports results of an 8-week pilot trial of TRAC among veterans with HIV (N = 10). Participants attended weekly MI sessions conducted via videoconferencing or phone and completed twice-daily self-monitoring of alcohol consumption using breathalyzers and surveys. They also completed pre- and post-intervention questionnaires and a qualitative interview. Analyses explored adherence to self-monitoring tasks, perceptions of the intervention, and preliminary effects of TRAC on alcohol use and readiness to change drinking behavior. Participants completed 76% of breathalyzer readings and 73% of surveys and completed more daytime than evening monitoring tasks. AUDIT hazardous drinking scores significantly decreased between baseline and post-test. Qualitative interviews revealed positive attitudes toward the technologies and MI sessions. Overall, this pilot demonstrated that the TRAC intervention has potential to reduce alcohol use among veterans with HIV, though additional effort is needed to improve adherence to mobile monitoring. Results were used to refine the intervention in preparation for a randomized controlled trial.

Tumor Suppressor p53 Down-Regulates Programmed Cell Death Protein 4 (PDCD4) Expression.

The programmed cell death protein 4 (PDCD4), a well-known tumor suppressor, inhibits translation initiation and cap-dependent translation by inhibiting the helicase activity of EIF4A. The EIF4A tends to target mRNAs with a structured 5'-UTR. In addition, PDCD4 can also prevent tumorigenesis by inhibiting tumor promoter-induced neoplastic transformation, and studies indicate that PDCD4 binding to certain mRNAs inhibits those mRNAs' translation. A previous study demonstrated that PDCD4 inhibits the translation of p53 mRNA and that treatment with DNA-damaging agents down-regulates PDCD4 expression but activates p53 expression. The study further demonstrated that treatment with DNA-damaging agents resulted in the downregulation of PDCD4 expression and an increase in p53 expression, suggesting a potential mechanism by which p53 regulates the expression of PDCD4. However, whether p53 directly regulates PDCD4 remains unknown. Herein, we demonstrate for the first time that p53 regulates PDCD4 expression. Firstly, we found that overexpression of p53 in p53-null cells (H1299 and Saos2 cells) decreased the PDCD4 protein level. Secondly, p53 decreased PDCD4 promoter activity in gene reporter assays. Moreover, we demonstrated that mutations in p53 (R273H: contact hotspot mutation, and R175H: conformational hotspot mutation) abolished p53-mediated PDCD4 repression. Furthermore, mutations in the DNA-binding domain, but not in the C-terminal regulatory domain, of p53 disrupted p53-mediated PDCD4 repression. Finally, the C-terminal regulatory domain truncation study showed that the region between aa374 and aa370 is critical for p53-mediated PDCD4 repression. Taken together, our results suggest that p53 functions as a novel regulator of PDCD4, and the relationship between p53 and PDCD4 may be involved in tumor development and progression.

The feasibility of using smartphones and mobile breathalyzers to monitor alcohol consumption among people living with HIV/AIDS.

BACKGROUND: For people living with HIV/AIDS (PLWHA), alcohol consumption is associated with poor treatment outcomes and medication adherence. This pilot study examined the feasibility of using smartphones and mobile Bluetooth breathalyzers for monitoring alcohol consumption among PLWHA (N = 17). METHODS: For 2 weeks, participants responded to twice-daily text message prompts by completing a breathalyzer reading and a mobile survey about their alcohol use. They also completed baseline questionnaires assessing alcohol consumption and hazardous drinking behaviors. RESULTS: Participants completed an average of 22 of 28 breathalyzer readings and 17 of 28 mobile surveys, and were more likely to complete daytime (vs. evening) monitoring tasks. Results suggested that self-reported frequency of binge drinking at baseline was related to an increased number of days with alcohol consumption according to breathalyzer and mobile surveys, as well as a higher average blood alcohol content. Qualitative interviews found generally positive attitudes toward the technologies, but some participants reported experiencing technical difficulties. CONCLUSIONS: Overall, this preliminary research suggests that smartphone monitoring of alcohol consumption among PLWHA may reflect cross-sectional self-reported alcohol consumption behaviors, but could use improvements to increase adherence to monitoring tasks.