Translated and culturally adapted internet-delivered cognitive therapy for social anxiety disorder in Japanese clinical settings: study protocol for a randomised controlled trial

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

Evaluation of Fatigue Properties under Four-point Bending and Fatigue Crack Propagation in Austenitic Stainless Steel with a Bimodal Harmonic Structure

Austenitic stainless steel (JIS-SUS304L) with a bimodal harmonic structure, which is defined as a coarse-grained structure surrounded by a network of fine grains, was fabricated using powder metallurgy to improve both the strength and ductility. Four-point bending fatigue tests and K-decreasing tests were conducted in air at room temperature under a stress ratio R of 0.1 to investigate fatigue crack propagation in SUS304L. The fatigue limit of this harmonic-structured material was higher than that of the material with a homogeneous coarse-grained structure. This is attributable to the formation of fine grains by mechanical milling and to the suppression of pore formation. In contrast, the threshold stress intensity range, DKth, for the harmonic-structured material was lower than that for the homogeneous coarse-grained material, while the crack growth rates, da/dN, were higher at comparable DK. These results can be attributed to a reduction in the effective threshold stress intensity range, DKeff,th, due to the presence of fine grains in the harmonic structure

Evaluation of fatigue properties under four-point bending and fatigue crack propagation in austenitic stainless steel with a bimodal harmonic structure

Austenitic stainless steel (JIS-SUS304L) with a bimodal harmonic structure, which is defined as a coarse-grained structure surrounded by a network of fine grains, was fabricated using powder metallurgy to improve both the strength and ductility. Four-point bending fatigue tests and K-decreasing tests were conducted in air at room temperature under a stress ratio R of 0.1 to investigate fatigue crack propagation in SUS304L. The fatigue limit of this harmonic-structured material is higher than that of the material with a homogeneous coarse-grained structure. This is attributable to the formation of fine grains by mechanical milling and to the suppression of pore formation. In contrast, the threshold stress intensity range, ?Kth, for the harmonic-structured material is lower than that for the homogeneous coarse-grained material, while the crack growth rates, da/dN, are higher at comparable ?K. These results can be attributed to a reduction in the effective threshold stress intensity range, ?Keff,th, due to the presence of fine grains in the harmonic structure

Intrinsic Promoter Activities of Primary DNA Sequences in the Human Genome

In order to understand an overview of promoter activities intrinsic to primary DNA sequences in the human genome within a particular cell type, we carried out systematic quantitative luciferase assays of DNA fragments corresponding to putative promoters for 472 human genes which are expressed in HEK (human embryonic kidney epithelial) 293 cells. We observed the promoter activities of them were distributed in a bimodal manner; putative promoters belonging to the first group (with strong promoter activities) were designated as P1 and the latter (with weak promoter activities) as P2. The frequencies of the TATA-boxes, the CpG islands, and the overall G + C-contents were significantly different between these two populations, indicating there are two separate groups of promoters. Interestingly, similar analysis using 251 randomly isolated genomic DNA fragments showed that P2-type promoter occasionally occurs within the human genome. Furthermore, 35 DNA fragments corresponding to putative promoters of non-protein-coding transcripts (ncRNAs) shared similar features with the P2 in both promoter activities and sequence compositions. At least, a part of ncRNAs, which have been massively identified by full-length cDNA projects with no functional relevance inferred, may have originated from those sporadic promoter activities of primary DNA sequences inherent to the human genome

武庫川女子大学附属幼稚園における研究実践報告―保育実践の質を高め合う園内研究体制の確立を目指して―

　本稿では，令和3 年度の武庫川女子大学附属幼稚園において推進された園内研究の成果と課題について報告する。ここでは，「幼稚園教育要領」の改訂を受けて再編成した期の指導計画及び同大学教育学科教員（「附属幼稚園連絡会」）の出席のもと，令和3 年11 月に実施した研究保育と事後研究会における協議内容を中心に報告する。研究保育（異年齢による協同的な遊び「あきの わくわくどっきりらんど たいむ」）を中心に検討した結果，附属幼稚園における研究と実践の成果として見出されたのは，(1)学級の枠を外した異年齢による遊びの構築と教師の協働，(2)幼児のイメージや思い，考えを出発点とした保育実践の構築，(3)言葉による伝え合いの充実と応答的な人間関係の育成，(4)幼児同士で共有するイメージや考えに基づいて遊びを創り出していこうとする心情・意欲・態度の育成の4 点である。今後の課題は，(1)幼児一人一人の思いや考えに基づいた環境構成・援助を確実化させ得る保育体制の確立と教師の協働性の向上，(2)好きな遊びにおける活動と学級活動との連関を意図した保育内容の構築にある

Use of the index of pulmonary vascular disease for predicting long-term outcome of pulmonary arterial hypertension associated with congenital heart disease

AimsLimited data exist on risk factors for the long-term outcome of pulmonary arterial hypertension (PAH) associated with congenital heart disease (CHD-PAH). We focused on the index of pulmonary vascular disease (IPVD), an assessment system for pulmonary artery pathology specimens. The IPVD classifies pulmonary vascular lesions into four categories based on severity: (1) no intimal thickening, (2) cellular thickening of the intima, (3) fibrous thickening of the intima, and (4) destruction of the tunica media, with the overall grade expressed as an additive mean of these scores. This study aimed to investigate the relationship between IPVD and the long-term outcome of CHD-PAH.MethodsThis retrospective study examined lung pathology images of 764 patients with CHD-PAH aged <20 years whose lung specimens were submitted to the Japanese Research Institute of Pulmonary Vasculature for pulmonary pathological review between 2001 and 2020. Clinical information was collected retrospectively by each attending physician. The primary endpoint was cardiovascular death.ResultsThe 5-year, 10-year, 15-year, and 20-year cardiovascular death-free survival rates for all patients were 92.0%, 90.4%, 87.3%, and 86.1%, respectively. The group with an IPVD of ≥2.0 had significantly poorer survival than the group with an IPVD <2.0 (P = .037). The Cox proportional hazards model adjusted for the presence of congenital anomaly syndromes associated with pulmonary hypertension, and age at lung biopsy showed similar results (hazard ratio 4.46; 95% confidence interval: 1.45–13.73; P = .009).ConclusionsThe IPVD scoring system is useful for predicting the long-term outcome of CHD-PAH. For patients with an IPVD of ≥2.0, treatment strategies, including choosing palliative procedures such as pulmonary artery banding to restrict pulmonary blood flow and postponement of intracardiac repair, should be more carefully considered