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Introduction: Behavioral Activation (BA) is a short-term cognitive behavioral therapy modality that stimulates activities that increase patients' reinforcement experiences. Recent research verified the effect of brief BA. However, despite the short intervention time per session, BA is difficult to implement during hospitalization due to its long implementation period., Objectives: To evaluate the clinical effectiveness of a brief BA program for people with depression in an inpatient setting., Methods: This study employed a single-group pre-post design. Fifteen patients who met the inclusion criteria participated in the trial after providing oral and written informed consent. In addition to their usual care, participants received four weekly sessions administered by a nurse. The primary outcome measures included the Beck Depression Inventory (BDI-II), which indicated patients' subjective depression severity. Clinical outcomes were measured at preintervention, immediate postintervention, and one-month postintervention., Results: Fourteen participants completed the BA program and were receptive to treatment. For the primary endpoint, BDI-II, there was an improvement in scores (25.60 to 22.73 to 22.06) between the baseline, postintervention, and 1-month postassessment, but not a significant change. For EQ VAS score, there was no significant change, but there was an improvement in EQ VAS score (51.53 to 52.20 to 55.13) between the baseline, postintervention, and 1-month postassessment. The mean total Global Assessment of Functioning score increased from 40.20 to 57.00 across the pre- and postassessment points ( p  < .0001)., Conclusion: The study comprised a brief BA intervention, with results suggesting that participants could complete the program without feeling burdened. Although there was no significant improvement in the general outcome, depression levels, and other outcomes improved. Thus, while there is a need to rethink BA intervention, this program may be a practical approach to improving depression and other outcomes., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

It is known that some endangered species have persisted for thousands of years despite their very small effective population sizes and low levels of genetic polymorphisms. To understand the genetic mechanisms of long-term persistence in threatened species, we determined the whole genome sequences of akame (Lates japonicus), which has survived for a long time with extremely low genetic variations. Genome-wide heterozygosity in akame was estimated to be 3.3 to 3.4 × 10-4/bp, one of the smallest values in teleost fishes. Analysis of demographic history revealed that the effective population size in akame was around 1,000 from 30,000 years ago to the recent past. The relatively high ratio of nonsynonymous to synonymous heterozygosity in akame indicated an increased genetic load. However, a detailed analysis of genetic diversity in the akame genome revealed that multiple genomic regions, including genes involved in immunity, synaptic development, and olfactory sensory systems, have retained relatively high nucleotide polymorphisms. This implies that the akame genome has preserved the functional genetic variations by balancing selection, to avoid a reduction in viability and loss of adaptive potential. Analysis of synonymous and nonsynonymous nucleotide substitution rates has detected signs of positive selection in many akame genes, suggesting adaptive evolution to temperate waters after the speciation of akame and its close relative, barramundi (Lates calcarifer). Our results indicate that the functional genetic diversity likely contributed to the long-term persistence of this species by avoiding the harmful effects of the population size reduction., Competing Interests: Conflict of Interest The authors declare that there is no conflict of interest., (© The Author(s) 2024. Published by Oxford University Press on behalf of Society for Molecular Biology and Evolution.)

Background: Cognitive therapy for social anxiety disorder (CT-SAD) has extensive empirical support and is recommended in several national guidelines. However, ensuring access to evidence-based psychological therapies such as CT-SAD remains a global challenge. An internet-delivered version of this treatment protocol (iCT-SAD) has recently been developed in the UK as a way to overcome this challenge, demonstrating comparable outcomes to face-to-face CT-SAD whilst requiring less therapist time per client. Initial findings also suggest its cross-cultural transferability, but the previous studies in other cultural settings used the English language programme and only included English-fluent participants as a second language. It is not yet known what outcomes can be achieved once the programme has been translated and adapted for a different cultural context. Therefore, this trial aims to evaluate the clinical efficacy of Japanese iCT-SAD when combined with treatment as usual (TAU) in clients with SAD., Methods: This two-arm, parallel-group, superiority randomised controlled trial will recruit 60 Japanese participants with SAD, randomly assigning them to either Japanese iCT-SAD + TAU or TAU alone at a ratio of 1:1. The primary outcome measure is the self-report Liebowitz Social Anxiety Scale, and secondary.outcomes include other measures of social anxiety symptoms and processes, general mood and functioning, and response to treatment. We will also assess treatment acceptability and gather participant feedback. Assessments will take place at baseline (week 0), mid-treatment (week 8), and post-treatment (week 15), with a further 3-month follow-up (week 27) for the iCT-SAD + TAU arm. The primary analyses will be conducted on an intent-to-treat basis, comparing the primary and secondary outcome measures between groups using linear mixed-effect models, along with additional mediation analysis., Discussion: Investigating the efficacy of translated and culturally adapted iCT-SAD in different cultural contexts is an important step in evaluating the global reach of internet interventions. This trial will provide valuable insights into the effects of iCT-SAD combined with usual care, and how this treatment could be delivered in routine clinical settings in Japan., Trial Registration: International Standard Randomized Controlled Trials (ISRCTN), ISRCTN82859645, registered on January 19, 2024. UMIN Clinical Trials Registry (UMIN-CTR), UMIN000052702, registered on November 6, 2023., (© 2024. The Author(s).)

The importance of nurses integrating effective psychological techniques into their clinical practice is widely recognized. Nevertheless, further evidence from real-world settings is needed to establish nurse-led cognitive behavioural therapy (CBT) as an effective approach in clinical practice. This study aimed to examine the clinical effectiveness and predictors of individual CBT for mental disorders delivered by nurses in various routine clinical settings. This pragmatic retrospective cohort study collected data from participants who received nurse-led individual CBT at four institutions from different prefectures in Japan between April 2015 and March 2023. During the study period, 280 clients were referred to nurses for CBT, 240 of whom received nurse-led individual CBT of at least one session. The common primary diagnoses among participants were major depressive disorder (33.8%), social phobia (12.9%), and obsessive-compulsive disorder (10.0%). Of these, 23 participants were ongoing cases at the end of the observation period, and 217 who had completed the course of therapy or discontinued/dropped out from the therapy were included in the analysis (173 completed and 44 discontinued/dropped out (i.e., dropout rate = 20.3%)). Based on the clinical significance definition (primary outcome), 62.4% of the participants who completed the therapy were judged to demonstrate positive clinical significance (recovered or improved), with only a few participants (6.9%) demonstrating deterioration. Significant improvements were observed before and after nurse-led individual CBT across all secondary outcomes, including depression and anxiety symptoms, health-related quality of life, and functional disability (all ps ≤ 0.001). Univariate logistic regression revealed that clients with higher baseline severity of depression and anxiety symptoms were less likely to achieve positive clinical significance following nurse-led individual CBT. The real-world evidence gained through this study will encourage frontline nurses and motivate institutional/organizational leaders and policymakers to employ nurse-led individual CBT, especially for depression and anxiety-related disorders.

Strengths-Based Nursing and Healthcare (SBNH) has garnered attention in the field of psychiatric nursing in Japan, yet its adoption in other nursing sectors remains limited. Japan is currently facing the formidable challenge of a rapidly aging population and growing demand for healthcare and welfare services. To address these issues, a shift from hospital-based care to comprehensive community care is underway, underscoring the importance of nurses in community settings, where focusing on client strengths is essential. Therefore, this paper aims to present research and practical examples to advocate for the broader dissemination of SBNH in Japan., (Copyright © 2024 Longwoods Publishing.)

Introduction: The Nepean Beliefs Scale by Brakoulias et al. is an interview-based multidimensional instrument that measures pathological beliefs in various psychiatric disorders. This study examined the reliability and validity of Nepean Beliefs Scale (NBS) for delusions and overvalued ideas in patients with chronic-phase schizophrenia. Methods: Multiple raters at two healthcare settings examined the beliefs of 28 individuals with schizophrenia using the NBS. Concurrently, PANSS, PDI-21, BCIS, PHQ-9 and GAD-7 were administered., Results: The NBS had high reliability and correlation with relevant scales., Discussion: The NBS was found to have sufficient reliability and validity for assessing the pathological beliefs of patients with chronic schizophrenia. Although NBS is an easy-to-instruct instrument, it should be noted that appropriate explanations and examples should be added to instructions to obtain reliable responses from patients with chronic schizophrenia., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Ishigaki, Shimada, Tanoue, Yoshinaga, Nishiguchi, Ishikawa and Hosono.)

Background: Internet-delivered cognitive therapy for social anxiety disorder (iCT-SAD), which is a therapist-guided modular web-based treatment, has shown strong efficacy and acceptability in English-language randomized controlled trials in the United Kingdom and Hong Kong. However, it is not yet known whether iCT-SAD can retain its efficacy following linguistic translation and cultural adaptation of treatment contents and implementation in other countries such as Japan., Objective: This study aimed to examine the preliminary efficacy and acceptability of the translated and culturally adapted iCT-SAD in Japanese clinical settings., Methods: This multicenter, single-arm trial recruited 15 participants with social anxiety disorder. At the time of recruitment, participants were receiving usual psychiatric care but had not shown improvement in their social anxiety and required additional treatment. iCT-SAD was provided in combination with usual psychiatric care for 14 weeks (treatment phase) and for a subsequent 3-month follow-up phase that included up to 3 booster sessions. The primary outcome measure was the self-report version of the Liebowitz Social Anxiety Scale. The secondary outcome measures examined social anxiety-related psychological processes, taijin kyofusho (the fear of offending others), depression, generalized anxiety, and general functioning. The assessment points for the outcome measures were baseline (week 0), midtreatment (week 8), posttreatment (week 15; primary assessment point), and follow-up (week 26). Acceptability was measured using the dropout rate from the treatment, the level of engagement with the program (the rate of module completion), and participants' feedback about their experience with the iCT-SAD., Results: Evaluation of the outcome measures data showed that iCT-SAD led to significant improvements in social anxiety symptoms during the treatment phase (P<.001; Cohen d=3.66), and these improvements were maintained during the follow-up phase. Similar results were observed for the secondary outcome measures. At the end of the treatment phase, 80% (12/15) of participants demonstrated reliable improvement, and 60% (9/15) of participants demonstrated remission from social anxiety. Moreover, 7% (1/15) of participants dropped out during treatment, and 7% (1/15) of participants declined to undergo the follow-up phase after completing the treatment. No serious adverse events occurred. On average, participants completed 94% of the modules released to them. Participant feedback was positive and highlighted areas of strength in treatment, and it included further suggestions to improve suitability for Japanese settings., Conclusions: Translated and culturally adapted iCT-SAD demonstrated promising initial efficacy and acceptability for Japanese clients with social anxiety disorder. A randomized controlled trial is required to examine this more robustly., (©Naoki Yoshinaga, Graham R Thew, Yuta Hayashi, Jun Matsuoka, Hiroki Tanoue, Rieko Takanashi, Mutsumi Araki, Yoshihiro Kanai, Alisha Smith, Sophie H L Grant, David M Clark. Originally published in JMIR Formative Research (https://formative.jmir.org), 05.05.2023.)

Background: Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) and mild encephalopathy associated with excitotoxicity (MEEX) are the most frequent acute encephalopathies in pediatric patients in Japan. AESD typically presents with biphasic seizures and delayed reduced diffusion in the subcortical area, called bright tree appearance (BTA), on radiological examination. In patients with AESD, arterial spin labeling (ASL) shows decreased cerebral blood flow (CBF) in the hyperacute stage and increased CBF in the acute stage, suggesting the usefulness of ASL for the early diagnosis of AESD. Additionally, proton magnetic resonance spectroscopy (MRS) shows elevated glutamate (Glu) and glutamine (Gln) in AESD. MEEX is a group of mild encephalopathies with transient elevation of Gln on MRS similar to that in AESD; however, MEEX does not include any clinical biphasic course or abnormalities, including BTA on diffusion-weighted imaging. Although the usefulness of ASL for AESD has been reported, there are no reports for patients with MEEX. In this study, we report our experience with a 4-year-old girl diagnosed with MEEX who showed unique findings on ASL., Case Presentation: The patient was a 4-year-old girl admitted to the emergency room with febrile status epilepticus. Considering the possibility of AESD, vitamin therapy was initiated. ASL-MR imaging (MRI) of the brain performed on the second day showed increased blood flow in the frontal, temporal, and occipital regions with spared central sulcus, which indicated AESD with central sparing. The patient was diagnosed with AESD, and the treatment included pulse steroid therapy and immunoglobulin therapy from day 3. The patient remained mildly unconscious but gradually became conscious by day 7 with no seizures. Brain MRI performed on day 8 did not show any characteristic AESD findings, such as BTA. Furthermore, MRS showed elevated Gln, which, along with the clinical course, led to the diagnosis of MEEX. The patient was discharged on day 16 without obvious sequelae., Conclusions: ASL may be useful in the early diagnosis of MEEX as well as AESD, facilitating early intervention., (© 2022. The Author(s).)

This study aimed to investigate the clinical effectiveness of nurse-led cognitive/behavioral therapy (CBT) in Japanese routine outpatient care. We retrospectively collected data from 100 cases with mental disorders who had received nurse-led CBT. Results demonstrated that CBT provided by nurses led to significant improvements in quality of life and other clinical outcomes during the intervention period (all p < 0.001). Among participants who received optional follow-up, these improvements were well-maintained. This real-world evidence of nurse-led CBT bridges the research-practice gap, and will encourage frontline nurses and motivate institutional/organizational leaders, academic/professional societies, and policymakers to employ empirically-supported psychotherapeutic techniques in routine nursing care., Competing Interests: Declaration of competing interest None., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective: To retrospectively review the efficacy of combined surgery comprising dorsal laminectomy and dorsal fixation using screws and polymethylmethacrylate as treatment for dogs with degenerative lumbosacral stenosis (DLSS)., Animals: 21 client owned dogs diagnosed with DLSS and treated surgically., Procedures: Based on clinical records, signalments, clinical signs, findings from orthopedic and neurological examinations, imaging findings, and postoperative complications were evaluated at the following time points: preoperatively, postoperatively, and 3, 6, 12, 24, and 36 months after surgery., Results: In all 21 cases, clinical signs were alleviated, proprioceptive deficits were improved from 3 months after surgery, and no recurrence of clinical signs was observed during the observation period. Minor complications were observed in 6 cases (28.6%), including implant failure in 2 (9.5%), delayed healing of surgical wounds in 2 (9.5%), seroma in 1 (4.8%), and swelling of the affected area in 1 (4.8%). There was no case with major complications., Clinical Relevance: Combined surgery comprising dorsal laminectomy and dorsal fixation using screws and polymethylmethacrylate is a useful treatment that can improve long-term clinical signs in dogs with DLSS.

Introduction: Despite the recent global mental health movement of the transition from hospital-centred to integrated community-based services, comprehensive evidence of psychosocial interventions focusing on community-dwelling individuals with schizophrenia is still lacking. To overcome this gap in the current knowledge, we will conduct a systematic review and meta-analysis to assess the efficacy of all types of psychosocial interventions for community-dwelling (non-hospitalised) individuals with schizophrenia when compared with non-active control conditions (eg, treatment as usual)., Methods and Analysis: This study protocol has been developed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. By March 2022, the following sources will have been searched, without restrictions for language or publication period: Embase, PubMed, PsycINFO, CINAHL, the Cochrane Central Register of Controlled Trials, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform. We will also try to identify other potentially eligible studies by searching the reference lists of included studies, other relevant systematic reviews and grey literature. All relevant randomised controlled trials from both high-income and low-income to middle-income countries will be allowed. Two independent reviewers will conduct the selection/screening of studies, data extraction and methodological quality assessment of included studies. The primary outcomes are quality of life and psychiatric hospital admission. Standard pairwise meta-analyses with a random-effects model will be conducted. Subgroup and sensitivity analyses will be performed to assess the robustness of the findings. Risk of bias will be assessed with the Revised Cochrane Risk-of-Bias Tool for Randomised Trials. The Grades of Recommendation Assessment, Development and Evaluation approach will be used to assess the quality of evidence., Ethics and Dissemination: Ethics approval is not required for this study. The study findings will be disseminated through conference presentations as well as peer-reviewed publications., Prospero Registration Number: CRD42021266187., Competing Interests: Competing interests: HI has received consulting fees from Mitsubishi-Tanabe Pharma; honoraria for lectures from Mochida Pharmaceutical, Otsuka Pharmaceutical and Kyowa Pharmaceutical. TG has received honorarium for writing from Igaku-Shoin. AT has received honoraria for lectures from Mitsubishi-Tanabe Pharma, Sumitomo Dainippon Pharma and Otsuka Pharmaceutical. HS has received honoraria for lectures/presentations from Pfizer, Sanofi, Alexion Pharmaceuticals, Novo Nordisk Pharma, Sumitomo Dainippon Pharma, JCR Pharmaceuticals, Miyazaki City and Country Medical Association, Children’s Cancer Association of Japan and Miyazaki Health Promotion Association; payment for expert testimony from Kyushu Conference for School Physical Examination, Miyazaki City and Country Medical Association and Miyazaki Prefectural Health Foundation; he is a leader of Committee for Growth Charts at School of Miyazaki City and Country Medical Association and Specialist Committee on Newborn Screening Tests of Miyazaki Prefectural Health Foundation. YI has received contracts from Tsumura; honoraria for lectures from Otsuka Pharmaceutical, Sumitomo Dainippon Pharma, Meiji Seika Pharma, Tsumura, Yoshitomiyakuhin Corporation, Takeda Pharmaceutical, Eisai, Mochida Pharmaceutical, Kyowa Kirin, MSD and Towa Pharmaceutical. NY has received a book royalty from Medical Friend; honoraria for lectures from Gakken Medical Support, Eisai, Meiji Seika Pharma, Mitsubishi-Tanabe Pharma and Mochida Pharmaceutical; honoraria for writings from Igaku-Shoin, Nikkei Business Publications and Maruzen Publishing; he is a Diplomate of the Academy of Cognitive and Behavioral Therapies, Secretary Board Member of the Japanese Association for Cognitive Therapy and Member of the Japan Clinical Guideline Development Group for Anxiety Disorders and Obsessive-Compulsive Disorder., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)