The Myoshirt, an active exosuit, provides gravity compensation for the shoulders. This study evaluated the impact of the Myoshirt on range of motion (ROM), endurance, and activities of daily living (ADLs) performance through tests involving nine participants with varying levels of arm impairments and diverse pathologies. Optical motion capture was used to quantify ROM of the shoulder and elbow joints during isolated movements and functional tasks. Endurance was quantified through a timed isometric shoulder flexion task, and a battery of ADL tasks was used to measure the perceived support of the exosuit, along with changes in movement quality. Feedback and usability insights were gathered with surveys. The Myoshirt did not significantly improve ROM during isolated movements (shoulder flexion, shoulder abduction, and elbow flexion/extension), but during the reaching phase of a functional drinking task elbow extension increased significantly by 13.5% (t = 7.52, p = .002). Participants could also keep their arms elevated 78.7% longer (t = 1.942, p = .047). Patients also reported less perceived difficulty with ADLs while using the device, and a therapist reported improved execution quality. Participants who self-reported severe impairment levels tended to derive greater benefits compared to those with milder impairments. These findings highlight the potential of the Myoshirt as an assistive device, particularly for individuals with severe impairments, while emphasizing the need for further refinement.

In his paper “Moral Permissibility and Desert in the Therapy-Enhancement Distinction,” Ozan Gurcan takes a fresh look at the therapy-enhancement distinction and argues that, while the distinction does not establish rigid moral boundaries, it nevertheless serves an important purpose because it differentiates between interventions that are, generally speaking, owed to individuals as a matter of justice (i.e., therapies) and those that are not (i.e., enhancements). Because therapies help to promote justice in society, therapies are always permitted and, in many cases required, whereas enhancements may be, at best, permitted. In this commentary, I argue that we would be concerned about the morality of genetic enhancements even if they did not raise issues of social justice and I propose that other key moral ideas, such as the concept of human nature, may also be important in establishing the boundary between therapy and enhancement.

This paper examines the social meanings embedded in Japanese melodramas produced since the 1990s and their use by the public for comfort and healing in an attempt to deal with declining confidence, both personal and national, in the wake of the burst of the bubble economy. It notes, further, how the Japanese media has used similar tropes in an effort to rebuild morale in the aftermath of the March 11 earthquake.

Ludwig Wittgenstein’s later philosophy has been hugely influential but can be difficult to understand. He has a radical approach to philosophy. Most philosophers think that questions such as ‘How can I know there is an external world?’ or ‘How is my private inner world of thought and experience related to my body?’ raise genuine puzzles requiring solutions. Wittgenstein, on the other hand, takes such questions to result from linguistic confusion and a scientistic approach to philosophy. Such questions require, not answers, but conceptual elucidation. This article introduces Wittgenstein’s later philosophy.

Major depressive disorder (MDD) is considered a psychiatric disorder and have a relationship with stressful events. Although the common therapeutic approaches against MDD are diverse, a large number of patients do not present an adequate response to antidepressant treatments. On the other hand, effective non-pharmacological treatments for MDD and their tolerability are addressed. Several affective treatments for MDD are used but non-pharmacological strategies for decreasing the common depression-related drugs side effects have been focused recently. However, the potential of extracellular vesicles (EVs) derived from mesenchymal stem cells (MSCs), microRNAs (miRNAs) as cell-based therapeutic paradigms, besides other non-pharmacological strategies including mitochondrial transfer, plasma, transcranial direct current stimulation (tDCS), transcranial magnetic stimulation (TMS), and exercise therapy needs to further study. This review explores the therapeutic potential of cell-based therapeutic non-pharmacological paradigms for MDD treatment. In addition, plasma therapy, mitotherapy, and exercise therapy in several in vitro and in vivo conditions in experimental disease models along with tDCS and TMS will be discussed as novel non-pharmacological promising therapeutic approaches.

Cognitive–behavioural therapy (CBT) has been widely used for a broad range of mental health problems for several decades and has been researched extensively. Its techniques are relatively easy to learn and follow in treatment protocols. Many new CBT-based psychotherapies have been developed that go further than traditional CBT, some specifically addressing personality disorders. These so-called third-wave approaches target emotional responses to situations by using strategies such as mindfulness exercises and acceptance of unpleasant thoughts and feelings (observing thoughts as ‘from afar’). In this article, we discuss the historical context of these therapies, dissect common and specific factors in some treatment modalities often used to treat personality disorders, and suggest potential future directions for research and treatment.

In this issue of BJPsych Advances Siddaway explores the challenges of assessing and treating post-traumatic stress disorder (PTSD) and complex PTSD. In this commentary I reflect on those challenges, not least of which is the need for a thorough understanding of different approaches to diagnoses. The very concept of diagnostic classification systems can be problematic, but when used sensitively they can aid communication, assessment and treatment. The relatively new diagnosis of complex PTSD may serve as a more accurate and more useful description of some psychological difficulties, leading to better treatment decisions. Good assessment, leading to accurate diagnosis, useful formulation and effective treatment takes time, and adequate resources should be allocated. Professionals can help patients to make well-informed choices about treatment options and they should offer evidence-based treatments without unnecessary delay.

Glioblastoma IDH wild type (GBM) is a very aggressive brain tumour, characterised by an infiltrative growth pattern and by a prominent neoangiogenesis. Its prognosis is unfortunately dismal, and the median overall survival of GBM patients is short (15 months). Clinical management is based on bulk tumour removal and standard chemoradiation with the alkylating drug temozolomide, but the tumour invariably recurs leading to patient's death. Clinical options for GBM patients remained unaltered for almost two decades until the encouraging results obtained by the phase II REGOMA trial allowed the introduction of the multikinase inhibitor regorafenib as a preferred regimen in relapsed GBM treatment by the National Comprehensive Cancer Network (NCCN) 2020 Guideline. Regorafenib, a sorafenib derivative, targets kinases associated with angiogenesis (VEGFR 1-3), as well as oncogenesis (c-KIT, RET, FGFR) and stromal kinases (FGFR, PDGFR-b). It was already approved for metastatic colorectal cancers and hepatocellular carcinomas. The aim of the present review is to focus on both the molecular and clinical knowledge collected in these first three years of regorafenib use in GBM.