Minimal Effect of Culturally Informed Marketing Messages on Engagement With a Digital Anxiety Intervention Among Latinx Individuals

This study evaluated the effectiveness of different culturally informed marketing messages to encourage enrollment in a fully remote digital mental health intervention (DMHI) for anxiety. Spanish-speaking Latinx individuals (N=1200) with a history of anxiety were randomly assigned to receive a standard recruitment message via email, or one of three messages with an added culturally informed message feature: added positive user testimonials; noted goal of using the DMHI to support the individual’s relationships; or reference to somatic symptoms of anxiety (e.g., dizziness, rapid heart beat) instead of referencing “anxiety.” Participants could then click a link in the email to visit the DMHI website, enroll, and start the first session. We examined the effects of message features, language of the marketing materials (Spanish vs. English), and participant language (Spanish/English bilingual vs. monolingual Spanish) on rates of site clicks, enrollment, and starting the first session. Across messages, 8.3% of patients clicked a link to visit the DMHI website, but none of the message features, nor message language or participant language, were significantly associated with rates of site clicks, enrollment, or starting the first session. Results suggest that culturally informed, email-based recruitment messages may not be sufficient on their own to promote DMHI engagement among Spanish-speaking Latinx individuals

Pilot Feasibility and Acceptability of a Spanish Translation of Web-Based Cognitive Bias Modification for Interpretation Among Spanish-Speaking Latinx Individuals With Anxiety

Digital mental health interventions may be a critical tool to help fill the substantial need for low-cost, effective mental health supports among Spanish-speaking Latinx individuals. In this study, feedback from focus groups with Spanish-speaking Latinx adults with anxiety was used to develop a two-session, Spanish-translated web-based interpretation bias modification intervention with surface-level cultural adaptations (called MindTrails-Spanish). A pilot trial was then conducted to evaluate the feasibility (i.e., rates of adherence and clinical deterioration), acceptability, and preliminary effectiveness of MindTrails-Spanish in an online sample of Spanish-speaking, Latinx adults with a history of anxiety. Bilingual English/Spanish-speaking adults were randomized to receive an invitation for either the standard English version of MindTrails (MindTrails-English) or the Spanish version of MindTrails (MindTrails-Spanish-Bilingual). Separately, monolingual Spanish-speaking adults were allocated to receive an invitation for the Spanish version (MindTrails-Spanish-Monolingual). Enrolled participants (N=21) were asked to complete one MindTrails session per week for two weeks, and assessment measures at pre- and post-intervention to assess changes in positive interpretation bias, negative interpretation bias, anxiety symptoms (using two separate measures), and perceptions of MindTrails. Results were compared to a priori benchmarks of clinically meaningful outcomes. All three conditions met benchmarks for feasibility and primary acceptability indicators. The MindTrails-Spanish-Bilingual condition met benchmarks for improvements in all four intervention outcomes, whereas the MindTrails-Spanish-Monolingual condition met benchmarks for two (negative interpretation bias and one of the two anxiety measures). Qualitative feedback from participants highlighted their positive experiences with the program and provided actionable suggestions for ways to improve the program’s accessibility and cultural relevance. Findings support the feasibility and acceptability of MindTrails-Spanish with Spanish-speaking Latinx adults. A larger randomized controlled trial is needed to investigate whether Spanish translation and cultural adaptation can improve adherence and intervention outcomes in this population

Fate of bone marrow stromal cells in a syngenic model of bone formation.

International audienceBone marrow stromal cells (BMSCs) have been demonstrated to induce bone formation when associated to osteoconductive biomaterials and implanted in vivo. Nevertheless, their role in bone reconstruction is not fully understood and rare studies have been conducted to follow their destiny after implantation in syngenic models. The aim of the present work was to use sensitive and quantitative methods to track donor and recipient cells after implantation of BMSCs in a syngenic model of ectopic bone formation. Using polymerase chain reaction (PCR) amplification of the Sex determining Region Y (Sry) gene and in situ hybridization of the Y chromosome in parallel to histological analysis, we have quantified within the implants the survival of the donor cells and the colonization by the recipient cells. The putative migration of the BMSCs in peripheral organs was also analyzed. We show here that grafted cells do not survive more than 3 weeks after implantation and might migrate in peripheral lymphoid organs. These cells are responsible for the attraction of host cells within the implants, leading to the centripetal colonization of the biomaterial by new bone

Behavioral Engagement and Psychosocial Outcomes in Web-Based Interpretation Bias Training for Anxiety

Digital mental health interventions (DMHIs) have the potential to expand treatment access for anxiety but often have low user engagement. The present study analyzed the relationship between indicators of behavioral engagement and psychosocial outcomes in a free web-based cognitive bias modification for interpretation (CBM-I) program. CBM-I is designed to shift interpretation biases common in anxiety by providing practice thinking about emotionally ambiguous situations in less threatening ways. Using data from 697 anxious community adults undergoing five weekly sessions of CBM-I in a clinical trial, we extracted use markers based on task completion rate and time spent on training and assessment tasks. After an exploratory cluster analysis of these markers yielded two engagement groups (reflecting more versus less time spent across tasks), we used multilevel models to test for group differences in interpretation bias and anxiety outcomes. Unexpectedly, engagement group did not significantly predict differential change in positive interpretation bias or anxiety. Further, participants who spent less time improved in negative interpretation bias (on one of two measures) significantly more during treatment than those who spent more time. However, participants who spent less time had a significant loss in treatment gains for negative bias (on both measures) by 2-month follow-up. Findings highlight the challenge of interpreting time spent as a marker of engagement and the need to consider cognitive and affective markers of engagement in addition to behavioral markers. Further understanding engagement patterns holds promise for improving DMHIs for anxiety

Human Primary Osteocyte Differentiation in a Three-Dimensional Culture System.

International audienceAbstract Introduction: Investigations on primary osteocytes, which compose over 90-95% of bone cells, embedded throughout the mineralized matrix, is a major challenge due to their difficult accessibility and the very rare models available in vitro. We engineered a three-dimensional (3D) culture method of primary human osteoblast differentiation into osteocytes. These 3D-differentiated osteocytes were compared with 2D-cultured cells and with human microdissected cortical osteocytes obtained from bone cryosections. Materials and Methods: Human primary osteoblasts were seeded either within the interspace of calibrated biphasic calcium phosphate particles or on plastic culture dishes and cultured for four weeks in the absence of differentiation factors. Osteocyte differentiation was assessed by histological and immunohistological analysis after paraffin embedding of culture after various times as well as by quantitative RT-PCR analysis of a panel of osteoblast and osteocyte markers after nucleic acid extraction. Results: Histological analysis revealed, after only one week, the presence of an osteoid matrix including many lacunae in which the cells were individually embedded, exhibiting characteristics of osteocyte-like cells. Real time PCR expression of a set of bone-related genes confirmed their osteocyte phenotype. Comparison with plastic-cultured cells and mature osteocytes microdissected from human cortical bone allowed to assess their maturation stage as osteoid-osteocytes. Conclusions: This model of primary osteocyte differentiation is a new tool to gain insights into the biology of osteocytes. It should be a suitable method to study the osteoblast-osteocyte differentiation pathway, the osteocyte interaction with the other bone cells and orchestration of bone remodeling transmitted by mechanical loading and shear stress. It should be used in important cancer research areas such as the crosstalk of osteocytes with tumor cells in bone metastasis since it has been recently shown that gene expression in osteocytes is strongly affected by cancer cells of different origin. It could be also a very efficient tool for drug testing and bone tissue engineering applications

Online Cognitive Bias Modification for Interpretation to Reduce Anxious Thinking During COVID-19

Anxiety disorders are highly prevalent, and rates increased during the COVID-19 pandemic. However, most individuals with elevated anxiety do not access treatment due to barriers such as stigma, cost, and availability. Digital mental health programs, such as cognitive bias modification for interpretation (CBM-I), hold promise as a tool to increase access to care. Before widely disseminating CBM-I, we must rigorously test its effectiveness and determine whom it is best positioned to benefit. The present study compared CBM-I against a psychoeducation active comparison condition offered through the public website MindTrails, and also tested whether baseline anxiety tied to COVID-19 influenced the rate of change in anxiety and interpretation bias during and after each intervention. Adults with moderate-to-severe anxiety symptoms were randomly assigned to complete five sessions of either CBM-I or psychoeducation as part of a larger trial, and 608 enrolled in the present study after the first session. As predicted (https://osf.io/2dyzr), CBM-I was superior to psychoeducation at reducing anxiety symptoms (on our primary but not secondary measure: d = -0.31), reducing negative interpretation bias (d range = -0.34 to -0.43), and increasing positive interpretation bias (d = 0.79) by the end of treatment. Results also indicated that individuals higher (vs. lower) in baseline COVID-19 anxiety had stronger decreases in anxiety symptoms while receiving CBM-I but weaker decreases in anxiety symptoms (on the secondary anxiety measure) while receiving psychoeducation. These findings suggest that CBM-I may be a useful anxiety-reduction tool for individuals experiencing higher anxiety tied to uncertain events such as COVID-19

Biphasic Calcium Phosphate Microparticles for Bone Formation: Benefits of Combination with Blood Clot.

International audienceParticulate forms of biphasic calcium phosphate (BCP) biomaterials below 500 mum are promising bone substitutes that provide with interconnected open porosity allowing free circulation of fluids and cells. Dispersion of the particles in the surrounding tissues at the time of implantation is a major drawback preventing from an easy use. We have asked whether blood clot could be a convenient natural hydrogel for handling BCP microparticles, and we hypothesized that blood clot might also confer osteoinductive properties to these particles. We show here that blood clotted around BCP microparticles constitutes a cohesive, moldable, and adaptable biomaterial that can be easily implanted in subcutaneous sites but also inserted and maintained in segmental bone defects, conversely to BCP microparticles alone. Moreover, implantation in bony and ectopic sites revealed that this composite biomaterial has osteogenic properties. It is able to repair a 6-mm critical femoral defect in rat and induced woven bone formation after subcutaneous implantation. Parameters such as particle size and loading into the clot are critical for its osteogenic properties. In conclusion, this blood/BCP microparticle composite is a moldable and osteoinductive biomaterial that could be used for bone defect filling in dental and orthopedic surgery