Inhibition of adenylyl cyclase 8 prevents the upregulation of Orai1 channel, which improves cardiac function after myocardial infarction.

The upregulation of Orai1 and subsequent store-operated Ca2+ entry (SOCE) has been associated with adverse cardiac remodeling and heart failure (HF). However, the mechanism underlying Orai1 upregulation and its role in myocardial infarction remains unclear. Our study investigated the role of Orai1 in activating adenylyl cyclase 8 (AC8) and cyclic AMP (cAMP) response element-binding protein (CREB), as well as its contribution to cardiac dysfunction induced by ischemia and reperfusion (I/R). We found that I/R evoked an increase in the expression of Orai1 and AC8 in rats' hearts, resulting in a substantial rise in diastolic Ca2+ concentration ([Ca2+]i), and reduced ventricular contractions. The expression of Orai1 and AC8 was also increased in ventricular biopsies of post-ischemic HF patients. Mechanistically, we demonstrate that I/R activation of Orai1 stimulated AC8, which produced cAMP and phosphorylated CREB. Subsequently, p-CREB activated the ORAI1 promoter, resulting in Orai1 upregulation and SOCE exacerbation. Intramyocardial administration of AAV9 carrying AC8 short hairpin RNA decreased the expression of AC8, Orai1 and CREB, which restored diastolic [Ca2+]i and improved cardiac contraction. Therefore, our data suggests that the axis composed by Orai1/AC8/CREB plays a critical role in I/R-induced cardiac dysfunction, representing a potential new therapeutic target to limit the progression of the disease toward HF.

Design and evaluation of a mobile-based intervention for Maya adults during the COVID-19 pandemic

Introduction: The COVID-19 pandemic has had a direct impact on mental health. Inter national organisations have emphasised the vulnerability of indigenous people. Digital Mental Health approaches deliver online therapy as an evidence-based, effective, and accessible treat ment option for common mental health problems. However, the evidence regarding these ap proaches is limited in indigenous populations. The objective of this study is to describe the design, development, and evaluation of the efficacy of a self-applied online intervention regarding the psychological symptoms of depression, anxiety, and fear of COVID-19 in a sample of the Maya population. Method: A prospective longitudinal quantitative study was designed, where a single group was measured before and after receiving the online intervention. This study took place from April to September 2021 and consisted of six sessions delivered via WhatsApp in Spanish and Mayan. Results: The initial assessment was implemented with 82 participants who were evaluated using the Patient Health Questionnaire, Scale for Generalised Anxiety Disorder and the Fear of COVID-19 Scale; 18 participants remained in the intervention for the post-as sessment. Statistical differences were observed in PRE and POST measures of depression and anxiety, but not in fear of COVID-19. Conclusions: This study produced positive results for the first online mental health intervention implemented in the Latin American indigenous pop ulation. Future studies might consider developing similar interventions for other indigenous communities in Latin America.

Introducción: La pandemia de COVID-19 tuvo impacto directo en la salud mental. Organizaciones internacionales han enfatizado la vulnerabilidad de los pueblos indígenas. Los enfoques de salud mental digital brindan terapia en línea como una opción de tratamiento basada en evidencia, efectiva y accesible; sin embargo, los datos son limitados en población indígena. El objetivo de este estudio fue describir el diseño, desarrollo y evaluación de la eficacia de una intervención en línea autoaplicada sobre síntomas psicológicos de depresión, ansiedad y miedo al COVID-19 en una muestra de población maya. Método: Se diseñó un es tudio cuantitativo longitudinal prospectivo, donde se midió a un solo grupo antes y después de recibir la intervención en línea, implementada de abril a septiembre de 2021, que constó de seis sesiones impartidas vía WhatsApp, en español y maya. Resultados: La evaluación inicial se implementó con 82 participantes que fueron evaluados mediante el Cuestionario de Salud del Paciente, Escala para el Trastorno de Ansiedad Generalizada y Escala de Miedo al COVID-19; 18 participantes permanecieron para la evaluación posterior. Se observaron di ferencias estadísticas en las medidas pre- y post- de depresión y ansiedad, pero no miedo al COVID-19. Conclusiones: Este estudio arrojó resultados positivos de la primera intervención de salud mental en línea implementada en la población indígena latinoamericana. Estudios futuros podrían considerar el desarrollo de intervenciones similares para otras comunidades indígenas en América Latina.

Measurement scales of mental health related to climate change: a scoping review protocol using artificial intelligence.

INTRODUCTION: Human actions have influenced climate changes around the globe, causing extreme weather phenomena and impacting communities worldwide. Climate change has caused, directly or indirectly, health effects such as injury and physical injuries, which impact morbidity and mortality. Similarly, there is evidence that exposure to climatic catastrophes has serious repercussions on psychological well-being, and rising temperatures and drought have detrimental effects on mental health.Despite the recent effort of researchers to develop specific instruments to assess the effects of climate change on mental health, the evidence on measures of its impact is still scarce, and the constructs are heterogeneous. The aim of this scoping review is to describe the instruments developed and validated to assess the impact of mental health related to climate change. METHODS AND ANALYSIS: This review is registered at Open Science Framework (https://osf.io/zdmbk). This scoping review will follow the reporting elements chosen for systematic review and meta-analysis (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). We proposed a PO question, as it places no restrictions on the participants (P), and the outcome (O) are measurement instruments on mental health related to climate change. A search will be conducted in different databases (PubMed, Scopus, Web of Science, PsycINFO). We will use an open-source artificial intelligence screening tool (ASReview LAB) for the title and abstract review. The full-text review will be performed by three researchers. If there is a disagreement between two independent reviewers, a third reviewer will take the final decision. We will use the COnsensus-based Standards for the selection of health Measurement INstruments tool to assess the risk of bias for each included study. The review will be conducted starting in September 2023. ETHICS AND DISSEMINATION: The planned scoping review does not require ethical approval since it will not involve an ethical risk to the participants. The results obtained from this study will be presented at conferences, congresses and scientific publications.

Online transdiagnostic intervention for emotional, trauma- and stressor-related disorders in the Mexican population: A randomized pilot and feasibility trial.

•Mexican individuals received via telehealth the unified protocol for anxiety, depression, and trauma related disorders.•Online unified protocol reduced depression, anxiety, emotional issues, uncertainty intolerance, and psychological distress.•The transdiagnostic unified protocol is well-suited to train therapists for emotional, trauma, and stressor-related disorders.

Suicide risk and associated factors in healthcare workers seeking psychological support during COVID-19: a cross-sectional study.

Healthcare workers have been one of the groups most severely affected by the COVID-19 pandemic, leaving them with serious psychological effects. Some of these effects have not been treated promptly, leading to further psychological symptoms. The objective of this study was to evaluate suicide risk in healthcare workers seeking psychological help during the COVID-19 pandemic, and factors associated with this risk on participants that were searching for treatment during the COVID-19 pandemic. This is a cross-sectional study analyzing data from 626 Mexican healthcare workers seeking psychological help due to the COVID-19 pandemic through the www.personalcovid.com platform. Before they entered treatment, the Plutchik Suicide Risk Scale, the Depression Scale of the Center for Epidemiologic Studies, the Pittsburgh Sleep Quality Index, and the Professional Quality of Life Measure, were administered. Results: 49.4% (n = 308) presented suicide risk. The most severely affected groups were nurses (62%, n = 98) and physicians (52.7%, n = 96). Predictors of suicide risk in healthcare workers were secondary traumatic stress, high depressive affect, low positive affect, emotional insecurity and interpersonal problems, and medication use. Conclusions: The suicidal risk detected was high, found mostly in nurses and doctors. This study suggests the presence of psychological effects on healthcare workers, despite the time that has elapsed since the onset of the pandemic.

The Efficacy and Usability of an Unguided Web-Based Grief Intervention for Adults Who Lost a Loved One During the COVID-19 Pandemic: Randomized Controlled Trial.

BACKGROUND: The death of a loved one was a challenge many people faced during the COVID-19 pandemic within the context of extraordinary circumstances and great uncertainty. Grief is an unavoidable part of life, and for most people, feelings of grief decrease naturally over time. However, for some people, grieving can become a particularly painful process with clinical symptoms that may require professional help to resolve. To provide psychological support to people who had lost a loved one during the COVID-19 pandemic, an unguided web-based psychological intervention was developed. OBJECTIVE: The main objective of this study was to evaluate the efficacy of the web-based treatment, Grief COVID (Duelo COVID in Spanish; ITLAB), in reducing clinical symptoms of complicated grief, depression, posttraumatic stress, hopelessness, anxiety, and suicidal risk in adults. The secondary aim was to validate the usability of the self-applied intervention system. METHODS: We used a randomized controlled trial with an intervention group (IG) and a waitlist control group (CG). The groups were assessed 3 times (before beginning the intervention, upon completing the intervention, and 3 months after the intervention). The intervention was delivered on the web in an asynchronous format through the Duelo COVID web page. Participants created an account that could be used on their computers, smartphones, or tablets. The evaluation process was automated as part of the intervention. RESULTS: A total of 114 participants were randomly assigned to the IG or CG and met criteria for inclusion in the study (n=45, 39.5% completed the intervention and n=69, 60.5% completed the waitlist period). Most participants (103/114, 90.4%) were women. The results indicated that the treatment significantly reduced baseline clinical symptoms in the IG for all variables (P<.001 to P=.006), with larger effect sizes for depression, hopelessness, grief, anxiety, and risk of suicide (all effect sizes ≥0.5). The follow-up evaluation showed that symptom reduction was maintained at 3 months after the intervention. The results from the CG showed that participants experienced significantly decreased levels of hopelessness after completing the time on the waitlist (P<.001), but their suicidal risk scores increased. Regarding the usability of the self-applied intervention system, the results indicated a high level of satisfaction with the Grief COVID. CONCLUSIONS: The self-applied web-based intervention Grief COVID was effective in reducing symptoms of anxiety, depression, hopelessness, risk of suicide risk, posttraumatic stress disorder, and complicated grief disorder. Grief COVID was evaluated by the participants, who reported that the system was easy to use. These results affirm the importance of developing additional web-based psychological tools to help reduce clinical symptoms in people experiencing grief because of the loss of a loved one during a pandemic. TRIAL REGISTRATION: ClinicalTrials.gov NCT04638842; https://clinicaltrials.gov/ct2/show/NCT04638842.

An internet-based self-applied rat phobia treatment using a Virtual Therapy Assistant: Study protocol for a randomized controlled trial.

Specific phobias are a common anxiety disorder that deteriorates the lives of people who suffer from them. To reduce the symptoms produced by this mental disorder exposure therapies have been used. However, low- and middle-income countries, including Mexico, have the lowest rate of treatment due to multiple barriers that prevent addressing mental health problems. Self-applied treatments have been explored in previous studies, nevertheless, high dropout rates are a common problem in this kind of treatment. An alternative is using immersive self-applied treatments that could help increase adherence to the treatment. This article aims to present a study protocol to explore the feasibility of an Internet self-applied exposure treatment for rat phobias, using four types of immersive multimedia elements: images, videos, video games, and 360° videos. Also, the satisfaction and perception of a Virtual Therapy Assistant (VTA) that provides information and support to the user are described. The study protocol will compare two groups of participants, one on the waiting list, and the other will receive the self-applied treatment for rat phobia supported by the VTA. For this study, 45 participants will be recruited and the evaluation measures will be taken at four different times: baseline, post-treatment, and follow-ups at 3 and 6 months. The levels of anxiety and avoidance of the user manifested during the exposure to the multimedia elements, the improvement of the user's clinical symptoms, the level of satisfaction, the perception of effectiveness, and ease of use of the self-applied system will be evaluated. This study is expected to support the viability of self-applied treatment for rat phobias and the use of a VTA, showing the impact on treatment adherence. To the best of our knowledge, this is the first study to explore an exposure treatment for rats using different multimedia elements with the support of a VTA. The work will serve as a basis for the development of new virtual assistants that help in the treatment of other types of specific phobias. This research has been registered in Clinical Trials NCT (NCT05081323).

Nutritional education knowledge of teachers and nutritionists in four European countries / Conocimientos sobre educación nutricional de profesores y nutricionistas de cuatro países europeos

Objective: the aim of this study was to examine the perception of professionals from four European countries in charge of teaching Nutrition Education (NE) to children in primary schools or hospitals. Methods: this was achieved through an exploratory study that initiated with two focus groups, one with 5 elementary school teachers and another with 14 nutritionists. From the results of it an online survey was designed and distributed internationally to elementary schools and professional clinics in Spain, Italy, Norway, and Austria. The participants were 75 elementary school teachers and 98 nutritionists. It was measured the level of knowledge of teachers and nutritionists to teach NE, and the level of nutritional knowledge of the children in their respective country. Descriptive statistics were conducted, one-factor ANOVAs to analyze the effect of nationality, and when a significant interaction was found, a post-hoc analysis using Bonferroni adjustment was applied. Results: the results indicated that forty-one percent of the participants considered they have “adequate” theoretical knowledge to teach NE. Only 27 % considered they had “adequate” pedagogical training. A significant effect was found: F(3,168) = 17.37, p < 0.001, η2p = 0.24. Regarding the levels of NE knowledge of children, from lowest to highest, there were Spain, Italy, Austria, and Norway. Also, it was observed that professionals and children from Spain and Italy were more affected with less knowledge and training regarding NE. Conclusions: these results could help governments and educational organizations of the affected countries to take decisions to tackle this problematic. (AU)

Objetivo: el objetivo de este estudio fue examinar la percepción de los profesionales de cuatro países europeos encargados de enseñar educación nutricional (EN) a niños de escuelas primarias u hospitales. Métodos: esto se logró a través de un estudio exploratorio que se inició con dos grupos focales, uno con 5 maestros de primaria y otro con 14 nutricionistas. A partir de los resultados del mismo se diseñó una encuesta en línea y se distribuyó internacionalmente a escuelas primarias y clínicas de profesionales en España, Italia, Noruega, y Austria. Los participantes fueron 75 maestros de primaria y 98 nutricionistas. Se midió el nivel de conocimientos de los maestros y nutricionistas para enseñar EN, y el nivel de conocimientos nutricionales de los niños de su respectivo país. Se hicieron análisis descriptivos, ANOVA de un factor para analizar el efecto de la nacionalidad, y cuando se encontró una interacción significativa se aplicó un análisis post-hoc mediante ajuste de Bonferroni. Resultados: los resultados indicaron que el cuarenta y uno por ciento de los participantes consideró tener conocimientos teóricos “adecuados” para enseñar NE. Solo el 27 % consideró tener una formación pedagógica “adecuada”. Se encontró un efecto significativo: F(3,168) = 17.37, p < 0,001, η2p = 0,24. Con respecto a los niveles de conocimiento de NE de los niños en los distintos países, de menor a mayor se clasificaron España, Italia, Austria y Noruega. Asimismo, se observó que los profesionales y los niños de España e Italia se vieron más afectados con menos conocimiento y formación en EN. Conclusiones: estos resultados podrían ayudar a los gobiernos y organizaciones educativas de los países afectados a tomar decisiones para abordar esta problemática. (AU)

Nutritional education knowledge of teachers and nutritionists in four European countries.

Introduction: Objective: the aim of this study was to examine the perception of professionals from four European countries in charge of teaching Nutrition Education (NE) to children in primary schools or hospitals. Methods: this was achieved through an exploratory study that initiated with two focus groups, one with 5 elementary school teachers and another with 14 nutritionists. From the results of it an online survey was designed and distributed internationally to elementary schools and professional clinics in Spain, Italy, Norway, and Austria. The participants were 75 elementary school teachers and 98 nutritionists. It was measured the level of knowledge of teachers and nutritionists to teach NE, and the level of nutritional knowledge of the children in their respective country. Descriptive statistics were conducted, one-factor ANOVAs to analyze the effect of nationality, and when a significant interaction was found, a post-hoc analysis using Bonferroni adjustment was applied. Results: the results indicated that forty-one percent of the participants considered they have "adequate" theoretical knowledge to teach NE. Only 27 % considered they had "adequate" pedagogical training. A significant effect was found: F(3,168) = 17.37, p < 0.001, η2p = 0.24. Regarding the levels of NE knowledge of children, from lowest to highest, there were Spain, Italy, Austria, and Norway. Also, it was observed that professionals and children from Spain and Italy were more affected with less knowledge and training regarding NE. Conclusions: these results could help governments and educational organizations of the affected countries to take decisions to tackle this problematic.

Introducción: Objetivo: el objetivo de este estudio fue examinar la percepción de los profesionales de cuatro países europeos encargados de enseñar educación nutricional (EN) a niños de escuelas primarias u hospitales. Métodos: esto se logró a través de un estudio exploratorio que se inició con dos grupos focales, uno con 5 maestros de primaria y otro con 14 nutricionistas. A partir de los resultados del mismo se diseñó una encuesta en línea y se distribuyó internacionalmente a escuelas primarias y clínicas de profesionales en España, Italia, Noruega, y Austria. Los participantes fueron 75 maestros de primaria y 98 nutricionistas. Se midió el nivel de conocimientos de los maestros y nutricionistas para enseñar EN, y el nivel de conocimientos nutricionales de los niños de su respectivo país. Se hicieron análisis descriptivos, ANOVA de un factor para analizar el efecto de la nacionalidad, y cuando se encontró una interacción significativa se aplicó un análisis post-hoc mediante ajuste de Bonferroni. Resultados: los resultados indicaron que el cuarenta y uno por ciento de los participantes consideró tener conocimientos teóricos "adecuados" para enseñar NE. Solo el 27 % consideró tener una formación pedagógica "adecuada". Se encontró un efecto significativo: F(3,168) = 17.37, p < 0,001, η2p = 0,24. Con respecto a los niveles de conocimiento de NE de los niños en los distintos países, de menor a mayor se clasificaron España, Italia, Austria y Noruega. Asimismo, se observó que los profesionales y los niños de España e Italia se vieron más afectados con menos conocimiento y formación en EN. Conclusiones: estos resultados podrían ayudar a los gobiernos y organizaciones educativas de los países afectados a tomar decisiones para abordar esta problemática.

E-Health Psychological Intervention for COVID-19 Healthcare Workers: Protocol for its Implementation and Evaluation.

(1) Background: Healthcare workers have been affected by the COVID-19 pandemic. Digital interventions have been carried out that have been effective with this population; however, few have been reported in Latin America. Our aim is to describe the components and methods to evaluate the feasibility and utility of an online multi-component psychological intervention for healthcare workers in Mexico during COVID-19. (2) Methods: This study is a randomized clinical trial with two arms: (1) self-applied intervention and (2) intervention delivered online by therapists. The participants are randomly assigned to one arm, receiving the same treatment contents in both groups. The "Personal COVID" intervention consists of an internet platform containing 9 nuclear and 3 complementary modules. The objectives of the intervention are: (1) to reduce anxiety, depressive symptoms, burnout, and compassion fatigue, and (2) to increase the quality of life, sleep quality, self-care, and their skills to give bad news. The protocol has been registered on ClinicalTrials.gov (identifier: NCT04890665). (3) Discussion: This protocol is designed according to the highest scientific standards following the SPIRIT guidelines. The "Personal COVID" intervention is expected to be of high efficacy in treating the emotional distress of healthcare workers and promoting their health during the COVID-19 pandemic.

Efficacy of a transdiagnostic guided internet-delivered intervention for emotional, trauma and stress-related disorders in Mexican population: study protocol for a randomized controlled trial.

BACKGROUND: Emotional and stress-related disorders show high incidence, prevalence, morbidity, and comorbidity rates in Mexico. In recent decades, research findings indicate that cognitive behavioral interventions, from a disorder-specific perspective, are the effective front-line treatment for anxiety and depression care. However, these treatments are not often used. Reasons include limited access and low availability to effective interventions and comorbidity between mental disorders. Emotional deregulation of negative affectivity has been found to be a mediating factor in addressing emotional disorders from a transdiagnostic perspective, aimed at two or more specific disorders. In addition, technological advancement has created alternatives for psychological assistance, highlighting the possibilities offered by technologies since Internet-supported intervention programs have been empirically tested for effectiveness, efficiency and efficacy and can be key to ensuring access to those who are inaccessible. The aim of the study is to evaluate the efficacy, moderators of clinical change and acceptability of a transdiagnostic guided Internet-delivered intervention versus a transdiagnostic self-guided Internet-delivered intervention for emotional, trauma and stress-related disorders, and waiting list in community sample. METHODS: A three-armed, parallel group, superiority randomized controlled clinical trial with repeated measurements at four times: pretest, posttest, follow-up at 3, 6 and 12 months. Outcomes assessor, participant, care provider and investigator will be blinded. Participants aged 18 to 70 years will be randomly allocated 1:1:1 to one of three study arms: a) Transdiagnostic guided internet-delivered intervention with synchronous assistance, b) Transdiagnostic self-guided internet-delivered intervention, c) Waiting list group. Based on sample size estimation, a minimum of 207 participants (69 in each intervention group) will be included. DISCUSSION: The study could contribute to improving the efficacy of transdiagnostic internet-delivered interventions to promote the dissemination of evidence-based treatments and eventually, to decrease the high prevalence of emotional and trauma-related disorders in the Mexican population. TRIAL REGISTRATION: ClinicalTrial.gov: NCT05225701 . Registered February 4, 2022.

A Perspective on How User-Centered Design Could Improve the Impact of Self-Applied Psychological Interventions in Low- or Middle-Income Countries in Latin America.

Global technological progress has generated alternatives for psychological assistance, both for the evaluation and for the treatment of different emotional disorders. Evidence suggests that Internet-based treatments are effective for the treatment of anxiety and depression disorders. However, in Latin America online treatments are still scarce compared to developed countries and have similar problems as developed countries, such as high dropout rate. One possible solution to help decrease the dropout rate is to design and develop online interventions based on the needs and characteristics of the users. The user-centered design (UCD) is a fundamental concept to develop successful online interventions. The objective of this article is to provide a perspective overview on how UCD could improve the impact of self-applied psychological interventions in low- or middle-income countries in Latin America; however this proposal can also be applied in low- and middle-income countries in other regions of the world. The literature on UCD has demonstrated its efficacy when properly applied in online interventions; however, it is not common to see how this methodology has been applied in research in online interventions, and regarding Latin America, this is even more scarce with a very limited number of articles implementing the principles of UCD.

Prevalence of Anxiety Symptoms and Associated Clinical and Sociodemographic Factors in Mexican Adults Seeking Psychological Support for Grief During the COVID-19 Pandemic: A Cross-Sectional Study.

The COVID-19 pandemic is one of the greatest challenges in modern history, with more than four million confirmed deaths worldwide. To date, evidence regarding the psychological impact of the COVID-19 pandemic on grievers is scarce for developing countries such as Mexico. This study aimed to assess the levels of anxiety and associated concerns in a sample of Mexican adults bereaved during the COVID-19 outbreak. A cross-sectional study was conducted through the Duelo COVID (COVID Grief) platform, which is a self-guided online treatment. A total of 5,224 participants reported their anxiety, depression, sleep quality, avoidance, and arousal, prolonged grief symptoms, and medication consumption. Independent sample Mann-Whitney U-tests, chi-square tests, and Kruskal-Wallis tests, as well as multinomial logistic regression, were conducted. Results indicated that 90.4% of the participants reported clinical levels of anxiety, depression, and sleep affectations. The people who lost someone during the last 5 months scored higher in normal grief symptoms compared to the people whose loss was 6 months ago or more, and 9.8% of individuals reported the use of prescription medication, with anxiolytics and antidepressants being the most common. Females, younger respondents, unemployed people with a lower educational level, and participants who disclosed a recent suicide attempt were among those who reported medication consumption. Sleep problems were more frequent in older participants.

A Self-Applied Multi-Component Psychological Online Intervention Based on UX, for the Prevention of Complicated Grief Disorder in the Mexican Population During the COVID-19 Outbreak: Protocol of a Randomized Clinical Trial.

Background: COVID-19 has taken many lives worldwide and due to this, millions of persons are in grief. When the grief process lasts longer than 6 months, the person is in risk of developing Complicated Grief Disorder (CGD). The CGD is related to serious health consequences. To reduce the probability of developing CGD a preventive intervention could be applied. In developing countries like Mexico, the psychological services are scarce, self-applied interventions could provide support to solve this problem and reduce the health impact even after the pandemic has already finished. Aims: To design and implement a self-applied intervention composed of 12 modules focused on the decrease of the risk of developing CGD, and increasing the life quality, and as a secondary objective to reduce the symptomatology of anxiety, depression, and increase of sleep quality. The Intervention Duelo COVID (Grief COVID) follows the principles of User Experience (UX) and is designed according to the needs and desires of a sample of the objective participants, to increase the adherence to the self-applied intervention, considered one of the main weaknesses of online interventions. Methods: A Randomized Controlled Trial will be conducted from the 22nd of December of 2020 to the first of June 2021. The participants will be assigned to an intervention with elements of Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, Mindfulness and Positive Psychology. The control group will be a wait-list condition, that will receive the intervention 1.5-2 months after the pre-measurement were taken. The Power Size Calculation conducted through G*Power indicated the need for a total of 42 participants, which will be divided by 21 participants in each group. The platform will be delivered through responsive design assuring with this that the intervention will adapt to the screen size of cellphones, tablets, and computers. Ethics and Dissemination: The study counts with the approval of the Research Ethics Committee of the Autonomous University of Ciudad Juárez, México, and it is registered in Clinical Trials (NCT04638842). The article is sent and registered in clinical trials before the recruitment started. The results will be reported in future conferences, scientific publications, and media.

miR-30b-5p Downregulation as a Predictive Biomarker of Coronary In-Stent Restenosis.

In-stent restenosis (ISR) is one of the main limitations of percutaneous coronary intervention (PCI) therapy with drug-eluting stents (DES) implantation. The aim of this study was to determine if circulating microRNAs (miRNAs) have diagnostic capability for determining ISR in a cohort of matched patients. Blood samples were collected from 55 patients who underwent previously PCI and were readmitted for a new coronary angiography. Patients were divided into subgroups comprising patients who presented ISR or not (non-ISR). A microarray analysis determined that up to 49 miRNAs were differentially expressed between ISR and non-ISR patients. Of these, 10 miRNAs are related to vascular smooth muscle and endothelial cells proliferation, migration, and differentiation, well-known hallmarks of vascular remodeling. Additionally, we identified that the expression of miR-30b-5p is significantly lower in serum samples of ISR patients, as compared to non-ISR. A further analysis demonstrated that miR-30b-5p provides better values of the receiver operator characteristic curve than other miRNAs and biochemical parameters. Finally, the in-silico analysis suggests that miR-30b-5p is predicted to target 62 genes involved in different signaling pathways involved in vascular remodeling. In conclusion, we determined for the first time that circulating mi-R30b-5p can reliably prognose restenosis in patient with implanted DES, which could be potentially helpful in the establishment of an early diagnosis and therapy of ISR.

Efficacy and acceptability of a web platform to teach nutrition education to children / Eficacia y aceptabilidad de una plataforma web para enseñar educación nutricional a niños

INTRODUCTION: Nutrition Education (NE) has been identified as a key factor to prevent children obesity. Teachers and dietitians are the professionals in charge of transmitting this knowledge to children; however, it has been identified that they do not possess either proper training, or the proper tools to perform this activity. OBJECTIVES: to evaluate the acceptability and usability of a NE Internet platform and its two "Serious Games" (SGs) among a sample of elementary school teachers, dietitians, and education students. In addition, to evaluate the efficacy of this platform to teach NE in a sample of children aged 9 to 12 years. METHODS: a total of 66 NE professionals and 135 children participated. Usability and acceptability questionnaires of the platform and an instrument to measure the acceptability, immersion, and playability of the SGs were administered to the professionals. The children fulfilled a questionnaire on nutritional knowledge. Descriptive statistics analyzed the main responses of the professionals involved, and an ANOVA compared the differences observed. For the children's data a t-test of repeated samples and a repeated-measures ANOVA were performed. RESULTS: dietitians and education students responded with a favorable opinion about the platform; however, the scores given by all professionals to the SGs ranged from low to moderate. Children increased their nutritional knowledge from pre to post evaluation (p < 0.001). This increase was observed in 10-year-old children and in children with 11 to 12 years of age, but not in 9-year-olds. CONCLUSIONS: this platform proved to be an effective tool to increase children's nutritional knowledge. Professionals expressed a medium level in terms of acceptability and usability for this platform, but also effectiveness in providing NE to children

INTRODUCCIÓN: la educación nutricional (EN) se ha identificado como un factor clave para prevenir la obesidad infantil. Los profesionales encargados de transmitir este conocimiento a los niños son maestros y dietistas; sin embargo, se ha identificado que no cuentan ni con la capacitación, ni con las herramientas adecuadas para realizar esta actividad. OBJETIVOS: evaluar la aceptabilidad y la facilidad de uso de una plataforma de Internet de EN y sus dos "Juegos Favoritos" (JF) en una muestra de maestros de primaria, nutricionistas y estudiantes de educación. Además, evaluar la eficacia de esta plataforma para enseñar EN en una muestra de niños de 9 a 12 años. MÉTODOS: participaron un total de 66 profesionales de EN y 135 niños. Se administraron a los profesionales cuestionarios de usabilidad y aceptabilidad de la plataforma, y un instrumento para medir la aceptabilidad, la inmersión y la jugabilidad de los JF. Los niños completaron un cuestionario sobre conocimiento nutricional. Se analizaron con estadísticas descriptivas las principales respuestas de los profesionales y las diferencias se compararon con un ANOVA. Para los datos de los niños se realizaron una prueba "t" de muestras repetidas y un ANOVA de medidas repetidas. RESULTADOS: los nutricionistas y los estudiantes de educación dieron una opinión favorable sobre la plataforma; sin embargo, las puntuaciones de todos los profesionales acerca de los JF fueron de bajas a medias. Los niños aumentaron su conocimiento nutricional al comparar la evaluación antes y después de la plataforma (p < 0.001). El aumento se observó en los niños de 10 años y en los niños de 11 a 12 años, pero no en los niños de 9 años. CONCLUSIONES: esta plataforma demostró ser una herramienta efectiva para aumentar el conocimiento nutricional de los niños. Los profesionales expresaron un nivel medio en términos de aceptabilidad y usabilidad para esta plataforma, pero también efectividad para impartir EN a los niños

A Self-Administered Multicomponent Web-Based Mental Health Intervention for the Mexican Population During the COVID-19 Pandemic: Protocol for a Randomized Controlled Trial.

BACKGROUND: The COVID-19 pandemic has become a public health emergency of international concern; it has not only threatened people's physical health but has also affected their mental health and psychological well-being. It is necessary to develop and offer strategies to reduce the psychological impact of the outbreak and promote adaptive coping. OBJECTIVE: This study protocol aims to describe a self-administered web-based intervention (Mental Health COVID-19) based on the principles of positive psychology supported by elements of cognitive behavioral therapy and behavioral activation therapy to reduce the symptoms of anxiety and depression and increase positive emotions and sleep quality during and after the COVID-19 outbreak through a telepsychology system. METHODS: A randomized controlled clinical superiority trial with two independent groups will be performed, with intrasubject measures at four evaluation periods: pretest, posttest, 3-month follow-up, and 6-month follow-up. Participants will be randomly assigned to one of two groups: self-administered intervention with assistance via chat or self-administered intervention without assistance via chat. The total required sample size will be 166 participants (83 per group). RESULTS: The clinical trial is ongoing. This protocol was approved by the Research Ethics Board of the Free School of Psychology-University of Behavioral Sciences (Escuela libre de Psicología-Universidad de Ciencias del Comportamiento). The aim is to publish the preliminary results in December 2020. A conservative approach will be adopted, and the size effect will be estimated using the Cohen d index with a significance level (α) of .05 (95% reliability) and a conventional 80% power statistic. CONCLUSIONS: The central mechanism of action will be to investigate the effectiveness of an intervention based on positive psychology through a web platform that can be delivered through computers and tablets, with content that has been rigorously contextualized to the Mexican culture to provide functional strategies to help the target users cope with the COVID-19 pandemic. TRIAL REGISTRATION: ClinicalTrials.gov NCT04468893; https://clinicaltrials.gov/ct2/show/NCT04468893. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/23117.

Efficacy and acceptability of a web platform to teach nutrition education to children.

INTRODUCTION: Introduction: Nutrition Education (NE) has been identified as a key factor to prevent children obesity. Teachers and dietitians are the professionals in charge of transmitting this knowledge to children; however, it has been identified that they do not possess either proper training, or the proper tools to perform this activity. Objectives: to evaluate the acceptability and usability of a NE Internet platform and its two "Serious Games" (SGs) among a sample of elementary school teachers, dietitians, and education students. In addition, to evaluate the efficacy of this platform to teach NE in a sample of children aged 9 to 12 years. Methods: a total of 66 NE professionals and 135 children participated. Usability and acceptability questionnaires of the platform and an instrument to measure the acceptability, immersion, and playability of the SGs were administered to the professionals. The children fulfilled a questionnaire on nutritional knowledge. Descriptive statistics analyzed the main responses of the professionals involved, and an ANOVA compared the differences observed. For the children´s data a t-test of repeated samples and a repeated-measures ANOVA were performed. Results: dietitians and education students responded with a favorable opinion about the platform; however, the scores given by all professionals to the SGs ranged from low to moderate. Children increased their nutritional knowledge from pre to post evaluation (p < 0.001). This increase was observed in 10-year-old children and in children with 11 to 12 years of age, but not in 9-year-olds. Conclusions: this platform proved to be an effective tool to increase children's nutritional knowledge. Professionals expressed a medium level in terms of acceptability and usability for this platform, but also effectiveness in providing NE to children.

INTRODUCCIÓN: Introducción: la Educación Nutricional (EN) se ha identificado como un factor clave para prevenir la obesidad infantil. Los profesionales encargados de transmitir este conocimiento a los niños son maestros y dietistas; sin embargo, se ha identificado que no cuentan ni con la capacitación ni con las herramientas adecuadas para realizar esta actividad. Objetivos: evaluar la aceptabilidad y la facilidad de uso de una plataforma de Internet de EN y sus dos "Juegos Formativos" (JF) en una muestra de maestros de primaria, nutricionistas y estudiantes de educación. Además, evaluar la eficacia de esta plataforma para enseñar EN en una muestra de niños de 9 a 12 años. Métodos: participaron un total de 66 profesionales de EN y 135 niños. Se administraron a los profesionales cuestionarios de usabilidad y aceptabilidad de la plataforma, y un instrumento para medir la aceptabilidad, la inmersión y la jugabilidad de los JF. Los niños completaron un cuestionario sobre conocimiento nutricional. Se analizaron con estadísticas descriptivas las principales respuestas de los profesionales y las diferencias se compararon con un ANOVA. Para los datos de los niños se realizaron una prueba "t" de muestras repetidas y un ANOVA de medidas repetidas. Resultados: los nutricionistas y los estudiantes de educación dieron una opinión favorable sobre la plataforma; sin embargo, las puntuaciones de todos los profesionales acerca de los JF fueron de bajas a medias. Los niños aumentaron su conocimiento nutricional al comparar la evaluación antes y después de la plataforma (p < 0.001). El aumento se observó en los niños de 10 años y en los niños de 11 a 12 años, pero no en los niños de 9 años. Conclusiones: esta plataforma demostró ser una herramienta efectiva para aumentar el conocimiento nutricional de los niños. Los profesionales expresaron un nivel medio en términos de aceptabilidad y usabilidad para esta plataforma, pero también efectividad para impartir EN a los niños.

Effectiveness of behavioral activation for depression treatment in medical students: Study protocol for a quasi-experimental design.

INTRODUCTION: Depression is a frequent mood disorder among medical students that can lead to multiple negative consequences at individual and social level (such as academic achievement and interpersonal conflicts) as well as patient care performance. Therefore, the need of depression decreasing treatments in medical students is important. This study is designed to evaluate the effectiveness of the Behavioral Activation Treatment for Depression in a sample of Mexican medical students. METHODS: This study will be performed under a quasi-experimental design to verify the effectiveness of the Behavioral Activation Treatment for Depression to reduce depressive symptoms in medical students from two public universities in northwestern Mexico. The participants will be assessed with the Center for Epidemiologic Studies Depression Scale, the Depression Anxiety Stress Scales, the Pittsburgh Sleep Quality Index, and the Plutchik Suicide Risk Scale. In addition to the psychometric assessment, there will be an electroencephalogram evaluation using the EMOTIV (v 1.1) device. RESULTS: A pre-post intervention of 10 Behavioral Activation Treatment for Depression sessions will be implemented. The results of the effectiveness of the Behavioral Activation Treatment for Depression will be analyzed in five measures at pre-post intervention and two follow-ups of 3 and 6 months. CONCLUSIONS: This study looks for evidence regarding the efficacy and feasibility of the Behavioral Activation Treatment for Depression in a sample of medical students from two public universities in Mexico with high levels of depression along with stress and anxiety.

Activation of sarcolipin expression and altered calcium cycling in LMNA cardiomyopathy.

Cardiomyopathy caused by A-type lamins gene (LMNA) mutations (LMNA cardiomyopathy) is associated with dysfunction of the heart, often leading to heart failure. LMNA cardiomyopathy is highly penetrant with bad prognosis with no specific therapy available. Searching for alternative ways to halt the progression of LMNA cardiomyopathy, we studied the role of calcium homeostasis in the evolution of this disease. We showed that sarcolipin, an inhibitor of the sarco/endoplasmic reticulum (SR) Ca2+ ATPase (SERCA) was abnormally elevated in the ventricular cardiomyocytes of mutated mice compared with wild type mice, leading to an alteration of calcium handling. This occurs early in the progression of the disease, when the left ventricular function was not altered. We further demonstrated that down regulation of sarcolipin using adeno-associated virus (AAV) 9-mediated RNA interference delays cardiac dysfunction in mouse model of LMNA cardiomyopathy. These results showed a novel role for sarcolipin on calcium homeostasis in heart and open perspectives for future therapeutic interventions to LMNA cardiomyopathy.