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Periosteal expansion osteogenesis (PEO) is a technique for augmenting bone by creating a gradual separation between the bone and periosteum. This study assessed PEO‐induced bone formation around the femurs of rats using a dynamic frame device (DFD), consisting of a shape memory membrane made of polyethylene terephthalate (PET) formed into a tubular shape. The DFDs, consisting of a PET membrane coated with hydroxyapatite (HA)/gelatin on the bone‐contact surface, were inserted between the periosteum and bone of the femurs of rats. In the experimental group, DFDs were suture‐fixed to the femur with 4–0 Vicryl Rapid; in the control group, 4–0 silk thread was used for fixation. Five rats per group were euthanized at intervals of 3, 5, and 8 weeks postoperatively. Bone formation was evaluated via micro‐CT imaging, histomorphometry, and histological analysis. Morphological analysis revealed new bone between the femur and the periosteum, expanded by the DFD, in all groups. The mean values of new bone were 0.30 mm2 proximally, 0.18 mm2 centrally, and 0.82 mm2 distally in the control group, compared to 1.05 mm2 proximally, 0.27 mm2 centrally, and 0.84 mm2 distally in the experimental group. A significant difference in new bone was observed in the proximal region of the experimental group. Histological examination showed that a single layer of newly formed neoplastic bone was noted on the cortical bone surface across all sites. The proximal portion displayed a bone marrow cavity at the center, encircled by a thick bone cortex with a layered structure. New bone formation was notable between existing cortical bone and the periosteum, particularly at both ends of the DFD. The use of PET in PEO was a viable option for achieving ideal bone morphology. [ABSTRACT FROM AUTHOR]

In patients with extensive jaw defects, jaw functions, such as mouth opening and occlusion, should be considered during jaw reconstruction in anticipation of implant placement and prosthetic treatment. Herein, we report a case of temporomandibular joint and mandibular bony reconstruction using custom-made trays and particulate cancellous bone and marrow, followed by implant placement. We succeeded in restoring both temporomandibular joint function and occlusion using the reconstruction plate with the condylar head, a mesh tray, and particulate cancellous bone and marrow in a patient with left mandibular reconstruction plate fracture and bony adhesion of the left TMJ. [ABSTRACT FROM AUTHOR]

Background: Several studies have reported that a switch to the dopamine partial agonist (DPA) aripiprazole (ARP), especially when the switch is abrupt, is likely to fail and sometimes worsen psychosis in schizophrenia patients already under high-dose antipsychotic treatment. Such a switching failure is speculated to be related to be the dopamine supersensitivity state. The risks of switching to the DPA brexpiprazole (BREX) have not been reported. Aims and Methods: We retrospectively analyzed the cases of 106 patients with schizophrenia to identify any factors related to the success or failure of switching to BREX. Results: The comparison between the patients with dopamine supersensitivity psychosis (n = 44) and those without (n = 62) revealed no significant difference in the switching failure judged at the sixth week. A comparison of the patients with successful switching (n = 80) and those who failed (n = 26) revealed that patients with treatment-resistant schizophrenia (TRS) were significantly more likely to fail. A logistic regression analysis also revealed that patients with past failure of switching to ARP are likely to succeed in switching to BREX. The 2-year follow-up of the patients with successful switching to BREX suggested that the patients who were treated with BREX, even temporarily, experienced some improvement in their Global Assessment of Functioning and Clinical Global Impression-Severity scores. Conclusions: Overall, the results indicate that patients with schizophrenia can be switched more safely to BREX compared to ARP. However, the failure of switching to BREX could be higher in patients with TRS, and thus, starting BREX treatment in refractory patients warrants careful monitoring. [ABSTRACT FROM AUTHOR]

Aim: The large number of new long-stay (NLS) patients and high readmission rates in psychiatric hospitals are longstanding concerns in Japan despite reforms to encourage multidisciplinary support of such patients. Staffing shortages of specialists, especially mental health social workers (MHSWs), may be one of the reasons for these problems to remain unsolved., Methods: The authors examined the effectiveness of the MHSW-centered multidisciplinary care model in preventing NLSs and rehospitalization in terms of both patient dynamics and cost by retrospective comparison of before and after program implementation., Results: After our program was introduced, NLS was almost completely prevented. In addition, a significant decrease in readmissions of involuntarily admitted patients was also observed. On the other hand, the resulting decrease in treatment costs and hospital revenues was mismatched by an increase in personnel costs., Conclusion: While MHSW-centered multidisciplinary care is effective for the community integration of patients, there are cost challenges. State policy changes are needed to resolve staffing problems, along with the introduction of appropriate indicators of community integration., Competing Interests: Dr. Kimura has received speaker's honoraria from Janssen Pharmaceutical K.K., Meiji Seika Pharma Co. Ltd., MSD K.K., Otsuka Pharmaceutical Co. Ltd., Sumitomo Pharma Co. Ltd., Takeda Pharmaceutical Co. Ltd., and Teijin Pharma Co. Ltd., and a Grant‐in‐Aid for Young Scientists (B) from the Japan Society for the Promotion of Science (20K16640). Dr Iyo is a consultant of Otsuka Pharmaceutical Co. Ltd. and Sumitomo Pharma Co. Ltd. Dr Iyo has received speaker's honoraria from Janssen Pharmaceutical K.K., Otsuka Pharmaceutical Co. Ltd., and Sumitomo Pharma Co. Ltd. Dr. Masaomi Iyo is an Editorial Board member of Psychiatry and Clinical Neurosciences Reports and a co‐author of this article. To minimize bias, they were excluded from all editorial decision‐making related to the acceptance of this article for publication. The remaining authors declare no conflict of interest., (© 2024 The Authors. Psychiatry and Clinical Neurosciences Reports published by John Wiley & Sons Australia, Ltd on behalf of Japanese Society of Psychiatry and Neurology.)

Aim: The mental healthcare system in Japan is transitioning from institution-based to community-based treatment. To prevent prolonged hospitalization and community integration of psychiatric patients, mental health social workers (MHSWs) are pivotal in coordinating post-discharge arrangements for psychiatric inpatients. This study aimed to propose a care model to improve clinical outcomes in psychiatric emergency wards in Japan., Methods: We conducted a mail-in questionnaire survey targeting medical facilities with psychiatric emergency wards. We collected data of the psychiatric care system, including facility profiles, staffing conditions and caseloads, and the provided psychiatric services and treatment options. Using multiple regression analyses, we explored associations between these data and clinical outcomes, focusing on the average number of days for hospitalization and the integration of patients into a community., Results: Data were collected from 82 facilities (response rate, 45.8%). The average number of days for hospitalization and community integration were 64.7 and 327.9 days, respectively. The caseloads for MHSWs were significantly associated with longer hospitalization ( β  = 0.31, p  = 0.009) and shorter duration of community living ( β  = -0.28, p  = 0.027)., Conclusion: The clinical performance in psychiatric emergency wards surpassed the Japanese government's targets regarding these outcomes. We found that heavy caseloads on MHSWs were associated with worse clinical outcomes for patients in psychiatric emergency wards. These findings suggest that reducing MHSW caseloads (≤20 cases) may be a potential interventional strategy to prevent prolonged hospitalization and promote successful community integration of patients., Competing Interests: Masaomi Iyo is an Editorial Board member of Psychiatry and Clinical Neurosciences Reports and a co‐author of this article. To minimize bias, they were excluded from all editorial decision‐making related to the acceptance of this article for publication. The remaining authors declare no conflict of interest., (© 2024 The Authors. Psychiatry and Clinical Neurosciences Reports published by John Wiley & Sons Australia, Ltd on behalf of Japanese Society of Psychiatry and Neurology.)