Okayama Psychiatric Medical Center

BackgroundThe post-discharge period following psychiatric hospitalization is a high-risk period for suicide attempts. This risk is substantially higher for patients admitted for suicidal behavior. Despite the urgent need for effective countermeasures, evidence-based interventions specifically designed to prevent suicide reattempts in this high-risk population remain limited. Although assertive case management is recognized as an effective intervention, its feasibility, safety, and efficacy for patients in psychiatric hospitals remain uninvestigated. The ACTION-JP study aims to evaluate the feasibility, safety, and efficacy of such an intervention adapted for patients in Japan admitted to psychiatric hospitals following a suicide attempt.MethodsThe ACTION-JP study is a multicenter, single-arm clinical trial. A total of 220 adult patients admitted to participating psychiatric hospitals following a suicide attempt will be enrolled. The intervention comprises two main components: a psychoeducation program conducted during hospitalization and an 18-month structured assertive case management follow-up. The primary outcome is the change from baseline in the Columbia-Suicide Severity Rating Scale total score at the 6-month follow-up. Secondary outcomes include the incidence of suicide reattempts and self-harm, as well as changes in Beck Depression Inventory-II and Global Assessment of Functioning Scale scores.DiscussionThis study protocol describes the essential first step in developing an evidence-based suicide prevention strategy for psychiatric inpatients. This study will provide important data on the intervention’s feasibility, safety, and efficacy. The findings are expected to offer important insights into the potential effectiveness of assertive case management for reducing suicide risk post-discharge. The successful implementation of this study will provide the necessary basis for designing a future large-scale randomized controlled trial that may help to establish a new standard of care in psychiatric hospitals.Trial registrationThis trial was registered on the University Hospital Medical Information Network clinical trials registry: UMIN000057009 (Date of registration: April 1, 2025) and the Japan Registry for Clinical Trials: jRCT1010250041 (Date of registration: October 20, 2025).Supplementary informationThe online version contains supplementary material available at 10.1186/s12888-025-07554-0.

The Japanese language has a unique writing system that consists of kanji (morphograms, derived from Chinese characters) and kana (phonograms, a simplified form of kanji representing syllables). A kanji character has two distinct ways of reading: on-reading (Chinese-style pronunciation) and kun-reading (native Japanese pronunciation). Some kanji words have irregular kun-reading called jukujikun. Furthermore, kana characters have two script forms: hiragana (cursive form) and katakana (square form), each of which is used for different purposes. Because of these features, Japanese individuals with alexia and agraphia show characteristic symptoms. Lesion-to-symptom analyses and functional imaging studies developed beginning in the 1970s have reported the following findings: (1) kanji–kana dissociation in alexia/agraphia: pure alexia for kanji or kana, lexical agraphia for kanji, and phonological agraphia for kana; (2) on-kun dissociation in alexia: predominant kun-reading and jukujikun reading impairment in semantic dementia and selective on-reading impairment in the extensive posterior middle temporal gyrus lesion; and (3) allographic agraphia between hiragana and katakana.

ABSTRACTInternational studies describe considerable multi‐faceted burdens for patients living with psoriasis vulgaris. However, there is few research on the experience in the life of patients with psoriasis vulgaris in Japan, particularly regarding psychosocial impacts when symptoms are visible parts of their body. A qualitative descriptive study using semi‐structured one‐on‐one interviews was conducted with 23 patients. Interviews focused on the impact of psoriasis vulgaris on motivation, daily life, social interactions, life course decisions, and psychological burdens, and the transcripts were distilled into discrete qualitative concepts. Common concepts elicited from patients included changes in clothing preferences and reluctance to engage in public activities like visiting public baths and pools due to their visible skin lesions. Many patients reported encountering misconceptions about their condition, which impacted their social relationships. Notably, effective treatment led to positive life changes. The adoption of a more patient‐centered treatment design may reduce the unique psychological challenges faced by individuals living with visible psoriasis vulgaris symptoms and increase their quality of life.

Patient-derived induced pluripotent stem cells (iPSCs) are a useful pathological model for debilitating diseases caused by mitochondrial DNA (mtDNA) mutations. We established iPSCs derived from mitochondrial disease patients, heteroplasmic for the m.3243A>G mutation. The proportion of a selected mtDNA can be reduced by delivering a programmable nuclease into the mitochondria, and we developed various mtDNA-targeted Platinum TALENs (mpTALENs) to modify m.3243A>G-iPSC heteroplasmy levels in either wild-type or mutant direction. For TALEN optimization, the use of non-conventional repeat-variable di-residues (ncRVD)-LK/WK or NM-enhanced cleavage activity and specificity, and the replacement of conventional with obligate heterodimeric FokI nuclease domains increased target specificity and protected mtDNA from copy number depletion. Invitro, depending on whether wild-type or mutant mtDNA was targeted, we could obtain m.3243A>G-iPSCs with a higher or lower mutation load, while the cells retained their ability to differentiate into three germ layers. These results demonstrate that our mpTALEN optimization created a usefultool for altering heteroplasmy levels in m.3243A>G-iPSCs,improving the potential for studying mutation pathology. The enhanced efficiency also holds promise for using m.3243G(MUT)-mpTALEN as a therapeutic strategy for treating patients suffering from m.3243A>G mitochondrial diseases.

Introduction: Acute kidney injury associated with the consumption of Beni-koji CholesteHelp supplements, which contain red yeast rice (Beni-Koji), has become a significant public health concern in Japan. While renal biopsy findings from several case reports have suggested tubular damage, no definitive causal relationship has been established, and the underlying mechanisms of kidney injury remain poorly understood. The complexity of identifying toxic substances in supplements containing various bioactive compounds makes conventional investigative approaches both time-consuming and challenging. This highlights an urgent need to establish a reliable platform for assessing organ-specific toxicity in such supplements. In this study, we utilized a kidney organoid model derived from adult rat kidney stem cells (KS cells) to assess the potential tubular toxicity of these supplements. Methods: KS cell clusters were cultured in three-dimensional system supplemented with growth factors to promote kidney organoids. The organoids were subsequently exposed to Beni-koji CholesteHelp supplements or cisplatin, followed by histological and molecular analyses to evaluate structural impacts. Results: Established organoids had the kidney-like structures including tubular-like structures and glomerulus-like structures at the tips of multiple tubules. Treatment with Beni-koji CholesteHelp supplements induced significant tubular damage in the organoids, characterized by epithelial cell thinning, structural disruption, and increase in cleaved-caspase 3-positive apoptotic tubular cells, similar to the organoids treated with cisplatin. Conclusion: These findings provide the first evidence suggesting that certain toxicants in specific batches of Beni-koji CholesteHelp supplements cause direct renal tubular injury. This KS cell-based organoid system represents a cost-effective, reproducible, and technically simple platform for nephrotoxicity screening.