Publications by authors named "Ryo Okubo"

55 Publications

Lipid and Energy Metabolism of the Gut Microbiota Is Associated with the Response to Probiotic Strain for Anxiety and Depressive Symptoms in Schizophrenia.

J Pers Med 2021 Sep 30;11(10). Epub 2021 Sep 30.

Division of Health Care Research, Center for Public Health Sciences, National Cancer Center Japan, Tokyo 104-0045, Japan.

A recent meta-analysis found that probiotics have moderate-to-large beneficial effects on depressive symptoms in patients with psychiatric disorders. However, it remains unclear how the baseline gut microbiota before probiotic administration influences the host's response to probiotics. Therefore, we aimed to determine whether the predicted functional profile of the gut microbiota influences the effectiveness of probiotic treatment in patients with schizophrenia. A total of 29 patients with schizophrenia consumed A-1 (synonym MCC1274) for 4 weeks. We considered patients who showed a 25% or more reduction in the Hospital Anxiety and Depression Scale total score at 4 weeks from baseline to be "responders" and those who did not to be "non-responders". We predicted the gut microbial functional genes based on 16S rRNA gene sequences and applied the linear discriminant analysis effect size method to determine the gut microbial functional genes most likely to explain the differences between responders and non-responders at baseline. The results showed that lipid and energy metabolism was elevated at baseline in responders ( = 12) compared to non-responders ( = 17). These findings highlight the importance of assessing the gut microbial functional genes at baseline before probiotic therapy initiation in patients with psychiatric disorders.
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http://dx.doi.org/10.3390/jpm11100987DOI Listing
September 2021

The type rather than the daily dose or number of antipsychotics affects the incidence of hyperglycemic progression.

Prog Neuropsychopharmacol Biol Psychiatry 2021 Oct 9:110453. Epub 2021 Oct 9.

Department of Psychiatry, Hokkaido University Graduate School of Medicine, North 15, West 7, Sapporo 060-8638, Japan. Electronic address:

There have been concerns that antipsychotics increase the incidence of hyperglycemic progression. Many factors have been suggested to contribute to the risk of antipsychotic-induced hyperglycemic progression, including the type, daily dose, and number of antipsychotics; however, few studies have examined these relationships. This study aimed to examine the affect of antipsychotic treatment-associated factors on hyperglycemic progression, after adjustment for the affect of background factors suggested to be associated with hyperglycemic progression. This was a nationwide, multicenter, prospective cohort study examining the incidence of hyperglycemic progression during a 12 mo period following the initiation of newly prescribed antipsychotic medication. Demographic data, medication history, and blood test values were collected from 631 study participants with normal blood glucose levels at baseline for 12 mo. The primary endpoint (incidence of hyperglycemic progression) was defined as progression from normal to prediabetic or probable diabetic status, and was evaluated based on the Japanese monitoring guidance in patients with schizophrenia. To further examine the affect of antipsychotics on glucose metabolism over time, we examined changes in HbA1c levels 3, 6, and 12 mo after the initiation of treatment with each antipsychotic. We found that treatment with zotepine and clozapine was associated with a significantly high incidence of hyperglycemic progression. Furthermore, changes in HbA1c levels 6 mo after the initiation of zotepine treatment were significantly higher than those following blonanserin and haloperidol treatments. In contrast, there was no significant difference in the change in total cholesterol, triglycerides, HDL cholesterol, and BMI during the same period. Moreover, the "daily dose" and "number" of antipsychotics did not show an association with the incidence of hyperglycemic progression. However, in a post hoc analysis in which the antipsychotics were divided into two groups according to the strength of blockade of H, M, M, and 5-HT receptors, the incidence of hyperglycemic progression was higher in the medium- and high-daily dose groups than in the low-daily dose group in the antipsychotic group with strong blockade of these receptors. Our study indicated that the type of antipsychotic had a greater affect on the incidence of hyperglycemic progression than the daily dose of antipsychotics or their number. Among these, zotepine was most likely to increase the incidence of hyperglycemic progression, suggesting the need for caution when these antipsychotics are prescribed.
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http://dx.doi.org/10.1016/j.pnpbp.2021.110453DOI Listing
October 2021

The association of work-related stress according to the demand-control model with aggravation of pre-existing disease during the first state of COVID-19 emergency in Japan.

J Epidemiol 2021 Sep 18. Epub 2021 Sep 18.

Cancer Control Center, Osaka International Cancer Institute.

Background: The job environment has changed a lot during the period of coronavirus disease 2019 (COVID-19) pandemic. This study aimed to investigate the association between work-related stress and aggravation of pre-existing disease in workers during the first state of COVID-19 emergency in Japan.

Methods: Data were obtained from a large internet survey conducted between August 25 and September 30, 2020 in Japan. Participants who reported that they had a job as well as current history of disease(s) (i.e., pre-existing conditions) were included (n=3090). Aggravation of pre-existing disease during the state of emergency was self-reported. Work-related stress from April 2020 (since the state of COVID-19 emergency) was assessed according to job demand-control model. Multivariable logistic regression models were used to analyze the association.

Results: Aggravation of pre-existing diseases was reported by 334 participants (11%). The numbers of participants with high demand and low control were 112 (18%) and 100 (14%), respectively. Compared to medium demand, high demand was significantly associated with aggravation of pre-existing diseases (odds ratio: 1.77, 95% confidence interval: 1.30-2.42). Low control compared to medium control was significantly associated with aggravation of pre-existing diseases (odds ratio: 1.39, 95% confidence interval: 1.02-1.92).

Conclusion: Work-related stress during the first state of COVID-19 emergency was associated with aggravation of pre-existing disease during that period.
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http://dx.doi.org/10.2188/jea.JE20210146DOI Listing
September 2021

Increase in Social Isolation during the COVID-19 Pandemic and Its Association with Mental Health: Findings from the JACSIS 2020 Study.

Int J Environ Res Public Health 2021 08 4;18(16). Epub 2021 Aug 4.

Cancer Control Center, Osaka International Cancer Institute, Osaka 541-8567, Japan.

The coronavirus disease 2019 (COVID-19) pandemic is assumed to have caused an increase in the number of socially isolated people. However, the prevalence of social isolation during the pandemic has not been well studied, particularly among Asian populations. This study investigated changes in the prevalence of social isolation caused by the COVID-19 pandemic and examined its association with mental health among the general Japanese population. Data were obtained from a large-scale, web-based nationwide survey conducted from August to September 2020 ( = 28,000; aged 15-79 years). Social isolation was defined as less frequent contact with people other than co-residing family members. We assessed the participants' frequency of contact in January (before the pandemic) and August 2020 (during the pandemic). Mental health outcomes included psychological distress, suicidal ideation, loneliness, and fear of COVID-19. We analyzed the data of 25,482 respondents. The weighted prevalence (95% confidence interval) of social isolation was 21.2% (20.7-21.7%) and 27.9% (27.3-28.4%) before and during the pandemic, respectively. The prevalence of social isolation increased by 6.7 (6.3-7.0) percentage points during the pandemic. Older people and men had the greatest increase in the prevalence of social isolation. People who became socially isolated during the pandemic had greater loneliness and fear of COVID-19 than those who were consistently not socially isolated since before the pandemic. This study suggested that social isolation had increased during the COVID-19 pandemic in Japan. Our findings highlight the importance of developing immediate measures against social isolation to maintain good mental health.
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http://dx.doi.org/10.3390/ijerph18168238DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8394951PMC
August 2021

Study Protocol: The Evaluation Study for Social Cognition Measures in Japan (ESCoM).

J Pers Med 2021 Jul 16;11(7). Epub 2021 Jul 16.

Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan.

In schizophrenia, social cognitive impairment is considered one of the greatest obstacles to social participation. Although numerous measures have been developed to assess social cognition, only a limited number of them have become available in Japan. We are therefore planning this evaluation study for social cognition measures in Japan (ESCoM) to confirm their psychometric characteristics and to promote research focused on social cognition. Participants in the cross-sectional observational study will be 140 patients with schizophrenia recruited from three Japanese facilities and 70 healthy individuals. In our primary analysis, we will calculate several psychometric indicators with a focus on whether they can independently predict social functioning. In secondary analyses, we will assess the reliability and validity of the Japanese translations of each measure and conduct an exploratory investigation of patient background, psychiatric symptoms, defeatist performance belief, and gut microbiota as determinants of social cognition. The protocol for this study is registered in UMIN-CTR, unique ID UMIN000043777.
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http://dx.doi.org/10.3390/jpm11070667DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8305726PMC
July 2021

Association between coronary artery calcium score on non-contrast chest computed tomography and all-cause mortality among patients with congestive heart failure.

Heart Vessels 2021 Jul 22. Epub 2021 Jul 22.

Department of Cardiovascular Medicine, Toho University Graduate School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan.

Coronary artery calcium (CAC) score is a robust prognostic tool to predict cardiac events. Although patients with congestive heart failure (CHF) occasionally undergo non-contrast computed tomography (NCCT), the prognostic utility of CAC by NCCT is not widely known. We aimed to determine if CAC measured on NCCT is associated with all-cause mortality (ACM) among patients with CHF. We identified 550 patients admitted due to CHF who underwent NCCT. Patients were categorized into three groups according to CAC scores 0, 1-999, and ≥ 1000. The multivariate Cox proportional hazards model was used to assess if CAC by NCCT was associated with ACM after adjusting for traditional coronary artery disease (CAD) risk factors, brain natriuretic peptide and left ventricular ejection fraction (LVEF). In a subset of 245 patients with invasive coronary angiography (ICA), the associations between CAC scores and ACM were assessed in the multivariate Cox proportional hazards model. Further, we assessed if CAC increased statin use at discharge. During a mean follow-up of 3.3 ± 3.1 years, ACM occurred in 168 patients (30.55%). Compared with patients with CAC 0, those with CAC ≥ 1000 (HR 1.564, 95% CI 0.969-2.524, P = 0.067) were more likely to experience ACM, while those with CAC score 1-999 (HR 0.971, 95% CI 0.673-1.399, P = 0.873) were not. Similarly, a trend toward significance was observed in patients with LVEF < 40% (HR 2.124, 95% CI 0.929-4.856, P = 0.074). In the sub-analysis, patients with CAC ≥ 1000 had increased ACM compared to those with CAC 0, only if ICA ≥ 50% (HR 3.668, 95% CI 1.141-11.797, P = 0.029). Multivariate logistic regression revealed that statin use at discharge was increased with ICA ≥ 50%, but not CAC. The CAC score measured by NCCT tended to be associated with ACM among CHF patients. Statin use was not increased by CAC on NCCT.
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http://dx.doi.org/10.1007/s00380-021-01906-yDOI Listing
July 2021

Perilla Oil and for Alleviating Fear of Cancer Recurrence in Breast Cancer Survivors: Study Protocol for a Three-Arm Phase II Randomized Controlled Study (POB Study).

Methods Protoc 2021 Jul 6;4(3). Epub 2021 Jul 6.

Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan.

The fear of cancer recurrence (FCR) is the most common and most severe unmet need among cancer survivors. Safe treatments for the FCR that are easily disseminated are greatly needed. Our primary aim is a preliminary evaluation of the efficacy and effect size of perilla oil, which is rich in omega-3 fatty acids, and , a probiotic, on FCR in breast cancer survivors after the completion of chemotherapy. This study has been planned as an exploratory clinical study (phase II) and will be conducted as a three-arm, 12-week parallel group, masked-rater randomized controlled trial. Fifteen participants will be randomized with 1:1:1 allocation to receive plus perilla oil, alone, or no intervention (control). Interventions will end within 12 weeks after the random allocation of each participant. The participants will be outpatients with invasive breast cancer aged 20 years or older whose chemotherapy was completed at least 6 months before registration; hormone therapy may be ongoing. The primary outcome will be severity of FCR at 12 weeks assessed by masked raters using the 4-item Concerns about Recurrence Scale concerning overall fear of recurrence. The study protocol for the current study is registered in the Japan Registry of Clinical Trials (jRCTs031200029).
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http://dx.doi.org/10.3390/mps4030046DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8293445PMC
July 2021

Factors associated with serious psychological distress during the COVID-19 pandemic in Japan: a nationwide cross-sectional internet-based study.

BMJ Open 2021 07 5;11(7):e051115. Epub 2021 Jul 5.

Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.

Objective: To investigate the factors associated with serious psychological distress (SPD) during the COVID-19 pandemic in Japan.

Design: Nationwide cross-sectional study using survey data.

Setting: Internet survey using sampling weights for national estimates conducted between 25 August and 30 September 2020 in Japan.

Exposures: Demographics (age, gender), socioeconomic status (income level, employment type, educational attainment, marital status, family composition and caregiving burden); the experience of domestic violence (DV), the state of emergency and fear of and stigma related to COVID-19.

Main Outcome Measures: Prevalence of SPD, defined as Kessler 6 Scale score ≥13.

Results: Among 25 482 respondents, 10.0% met the criteria of SPD. Overall, women (adjusted OR (aOR) 1.59; 95% CI 1.17 to 2.16; p=0.003), ages 15-29 (aOR 2.35 compared with ages 45-59 years; 95% CI 1.64 to 3.38; p<0.001), low-income level (aOR 1.70 compared with intermediate income; 95% CI 1.16 to 2.49; p=0.007), providing caregiving to family members (aOR 5.48; 95% CI 3.51 to 8.56; p<0.001), experiencing DV (aOR 5.72; 95% CI 3.81 to 8.59; p<0.001) and fear of COVID-19 (aOR 1.96; 95% CI 1.55 to 2.48; p<0.001) were associated with SPD. Among women aged 15-29 years, who have a higher risk of suicide during the COVID-19 pandemic in Japan, caregiving, DV, fear of COVID-19 and COVID-19-related stigma were associated with SPD.

Conclusions: Economic situation, caregiving burden, DV and fear of COVID-19 were independently associated with SPD during the COVID-19 pandemic. Among young women, similar factors, except economic situation, were associated with SPD. Targeted interventions based on age and gender may be more effective in mitigating the negative impact of the COVID-19 pandemic on the population's mental health.
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http://dx.doi.org/10.1136/bmjopen-2021-051115DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8260284PMC
July 2021

COVID-19 Vaccine Hesitancy and Its Associated Factors in Japan.

Vaccines (Basel) 2021 Jun 17;9(6). Epub 2021 Jun 17.

Cancer Control Center, Osaka International Cancer Institute, Osaka 541-8567, Japan.

The vaccine confidence index in Japan is one of the lowest worldwide. This study aimed to examine the proportion of COVID-19 vaccine hesitancy in the Japanese population using a larger sample and more robust statistical methods than previously, and to identify factors associated with vaccine hesitancy. We conducted a nationwide, cross-sectional Internet survey on 8-26 February 2021, and calculated the proportion and odds ratios for vaccine hesitancy. Among 23,142 responses analyzed, the proportion of COVID-19 vaccine hesitancy was 11.3% (10.9-11.7%). The proportion was higher among younger respondents and female respondents, and especially among younger female respondents (15.6%) compared with the lowest proportion among older male respondents (4.8%). The most cited reason for not getting vaccinated was concerns about adverse reactions in more than 70% of the respondents. The proportion of COVID-19 vaccine hesitancy in Japan was comparable to that in previous studies overseas, and the proportion among younger respondents was more than double that among older respondents. Factors associated with the hesitancy were female sex, living alone, low socioeconomic status, and presence of severe psychological distress, especially among older respondents. Thus, adequate measures should be taken to ensure that vaccines are delivered to people with these factors.
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http://dx.doi.org/10.3390/vaccines9060662DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8234307PMC
June 2021

Simultaneous aortic and pulmonary valve replacement in a young patient after intracardiac repair for tetralogy of Fallot: mechanical or biological valve? A case report.

J Surg Case Rep 2021 May 17;2021(5):rjab170. Epub 2021 May 17.

Department of Cardiac Surgery, Asahikawa Medical University, Asahikawa, Japan.

Pulmonary valve stenosis and regurgitation can occur in the distant stages after intracardiac repair of tetralogy of Fallot (TOF). Aortic regurgitation (AR) can also occur, although it is rare in postoperative patients. However, there are few reports of simultaneous replacement of the pulmonary and aortic valves in young patients after intracardiac repair of TOF, and there are no clear guidelines for selecting a valve prosthesis in such patients. We report a case of severe pulmonary valve stenosis and regurgitation with severe AR 38 years after the TOF operation, in which urgent double valve replacement and right ventricular outflow tract patching were performed with a mechanical valve in the aortic valve position and a bioprosthetic valve in the pulmonary valve position, with a successful outcome.
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http://dx.doi.org/10.1093/jscr/rjab170DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8130639PMC
May 2021

Evaluation of Social Cognition Measures for Japanese Patients with Schizophrenia Using an Expert Panel and Modified Delphi Method.

J Pers Med 2021 Apr 6;11(4). Epub 2021 Apr 6.

Department of Neuropsychiatry, Toho University Faculty of Medicine, Tokyo 143-8541, Japan.

Social cognition is strongly linked to social functioning outcomes, making it a promising treatment target. Because social cognition measures tend to be sensitive to linguistic and cultural differences, existing measures should be evaluated based on their relevance for Japanese populations. We aimed to establish an expert consensus on the use of social cognition measures in Japanese populations to provide grounds for clinical use and future treatment development. We assembled a panel of experts in the fields of schizophrenia, social psychology, social neuroscience, and developmental disorders. The panel engaged in a modified Delphi process to (1) affirm expert consensus on the definition of social cognition and its constituent domains, (2) determine criteria to evaluate measures, and (3) identify measures appropriate for Japanese patients with a view toward future quantitative research. Through two online voting rounds and two online video conferences, the panel agreed upon a definition and four-domain framework for social cognition consistent with recent literature. Evaluation criteria for measures included feasibility and tolerability, reliability, clinical effectiveness, validity, and international comparability. The panel finally identified nine promising measures, including one task originally developed in Japan. In conclusion, we established an expert consensus on key discussion points in social cognition and arrived at an expert-selected set of measures. We hope that this work facilitates the use of these measures in Japanese clinical scenarios. We plan to further examine these measures in a psychometric evaluation study.
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http://dx.doi.org/10.3390/jpm11040275DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8067370PMC
April 2021

Evaluation of Social Cognition Measures for Japanese Patients with Schizophrenia Using an Expert Panel and Modified Delphi Method.

J Pers Med 2021 Apr 6;11(4). Epub 2021 Apr 6.

Department of Neuropsychiatry, Toho University Faculty of Medicine, Tokyo 143-8541, Japan.

Social cognition is strongly linked to social functioning outcomes, making it a promising treatment target. Because social cognition measures tend to be sensitive to linguistic and cultural differences, existing measures should be evaluated based on their relevance for Japanese populations. We aimed to establish an expert consensus on the use of social cognition measures in Japanese populations to provide grounds for clinical use and future treatment development. We assembled a panel of experts in the fields of schizophrenia, social psychology, social neuroscience, and developmental disorders. The panel engaged in a modified Delphi process to (1) affirm expert consensus on the definition of social cognition and its constituent domains, (2) determine criteria to evaluate measures, and (3) identify measures appropriate for Japanese patients with a view toward future quantitative research. Through two online voting rounds and two online video conferences, the panel agreed upon a definition and four-domain framework for social cognition consistent with recent literature. Evaluation criteria for measures included feasibility and tolerability, reliability, clinical effectiveness, validity, and international comparability. The panel finally identified nine promising measures, including one task originally developed in Japan. In conclusion, we established an expert consensus on key discussion points in social cognition and arrived at an expert-selected set of measures. We hope that this work facilitates the use of these measures in Japanese clinical scenarios. We plan to further examine these measures in a psychometric evaluation study.
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http://dx.doi.org/10.3390/jpm11040275DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8067370PMC
April 2021

Evaluation of Social Cognition Measures for Japanese Patients with Schizophrenia Using an Expert Panel and Modified Delphi Method.

J Pers Med 2021 Apr 6;11(4). Epub 2021 Apr 6.

Department of Neuropsychiatry, Toho University Faculty of Medicine, Tokyo 143-8541, Japan.

Social cognition is strongly linked to social functioning outcomes, making it a promising treatment target. Because social cognition measures tend to be sensitive to linguistic and cultural differences, existing measures should be evaluated based on their relevance for Japanese populations. We aimed to establish an expert consensus on the use of social cognition measures in Japanese populations to provide grounds for clinical use and future treatment development. We assembled a panel of experts in the fields of schizophrenia, social psychology, social neuroscience, and developmental disorders. The panel engaged in a modified Delphi process to (1) affirm expert consensus on the definition of social cognition and its constituent domains, (2) determine criteria to evaluate measures, and (3) identify measures appropriate for Japanese patients with a view toward future quantitative research. Through two online voting rounds and two online video conferences, the panel agreed upon a definition and four-domain framework for social cognition consistent with recent literature. Evaluation criteria for measures included feasibility and tolerability, reliability, clinical effectiveness, validity, and international comparability. The panel finally identified nine promising measures, including one task originally developed in Japan. In conclusion, we established an expert consensus on key discussion points in social cognition and arrived at an expert-selected set of measures. We hope that this work facilitates the use of these measures in Japanese clinical scenarios. We plan to further examine these measures in a psychometric evaluation study.
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http://dx.doi.org/10.3390/jpm11040275DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8067370PMC
April 2021

Impact of peritraumatic distress on posttraumatic stress disorder symptoms at 6 months after acute coronary syndrome: a prospective cohort study.

Eur J Psychotraumatol 2021 Jan 13;12(1):1854511. Epub 2021 Jan 13.

Division of Health Care Research, Center for Public Health Sciences, National Cancer Center Japan, Tokyo, Japan.

: Posttraumatic stress disorder (PTSD) symptoms are known to occur after acute coronary syndrome (ACS). Peritraumatic distress has been indicated as a risk factor for PTSD and can be measured by the Peritraumatic Distress Inventory (PDI). However, no studies have yet measured peritraumatic distress after ACS using the PDI to predict PTSD. : This prospective cohort study examined the impact of peritraumatic distress on PTSD symptoms at 6 months after ACS. : We used the PDI to assess peritraumatic distress in patients treated for ACS at a teaching hospital in Tokyo within 7 days after percutaneous coronary intervention. They were followed up over the next 6 months and were assessed for PTSD symptoms at 6 months using the Impact of Event Scale-Revised. The association between peritraumatic distress and PTSD symptoms was examined by multiple linear regression analysis. : The study enrolled 101 ACS patients, and 97 completed the follow-up assessment. PDI total score was an independent predictor of PTSD symptoms after adjustment for potential covariates (beta = 0.38; < 0.01). : The results were obtained from a single teaching hospital and assessment of PTSD symptoms was questionnaire based. : We provide the first evidence that PDI score can predict the development of PTSD symptoms in ACS patients. Assessing peritraumatic distress after ACS with the PDI may be useful for initiating early intervention against PTSD symptoms.
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http://dx.doi.org/10.1080/20008198.2020.1854511DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7817212PMC
January 2021

Smoking and drinking among patients with mental disorders: Evidence from a nationally representative Japanese survey.

J Affect Disord 2021 01 20;279:443-450. Epub 2020 Oct 20.

Cancer Control Center, Osaka International Cancer Institute, Osaka 541-8567, Japan.

Background: No studies to date have addressed the association of mental disorder with smoking and drinking behaviors independent of anxiety and depressive symptoms. We therefore examined this association, stratified by age and sex, to determine the target population for behavioral modification in Japan.

Methods: We analyzed data from participants aged 20-79 years without hospitalized or institutionalized status who participated in the nationwide Comprehensive Survey of Living Conditions conducted in 2016. Prevalence ratios (PRs) for current smoking, heavy daily smoking (>20 cigarettes per day), at-risk drinking (>100 g alcohol per week), and heavy drinking (>350 g) were calculated with adjustment for potential confounders. After stratification by age (20-39, 40-64, and 65-79 years) and sex, prevalence and PRs were calculated using propensity scores.

Results: From among 340,194 participants, 8275 (2.4%) had mental disorder. Presence of mental disorder was significantly associated with current smoking (PR=1.18, 95%CI=1.12-1.23) and heavy daily smoking (PR=1.35, 95%CI=1.21-1.50) and inversely associated with at-risk drinking (PR=0.70, 95%CI=0.66-0.75). PRs for smoking behavior were higher in women than in men and in younger adults than in the other age groups. They were particularly high in younger women (PR=1.67 for current smokers and PR=2.17 for heavy daily smokers).

Limitations: Our findings were obtained from a cross-sectional study.

Conclusion: This is the first evidence that the association of mental disorder with smoking behavior is independent of anxiety and depressive symptoms. Our results indicate the need for tailored behavioral modification interventions for young people with mental disorders in Japan, particularly young women.
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http://dx.doi.org/10.1016/j.jad.2020.10.037DOI Listing
January 2021

The relationship between coronary artery calcium density and optical coherence tomography-derived plaque characteristics.

Atherosclerosis 2020 10 29;311:30-36. Epub 2020 Aug 29.

Department of Cardiovascular Medicine, Toho University Graduate School of Medicine, Tokyo, Japan.

Background And Aims: Although coronary artery calcium (CAC) density has been associated with plaque stability, pathological evidence is lacking. We investigated the relationship between coronary computed tomography (CCT)-derived CAC density and multiple calcified and high-risk plaque (HRP) characteristics using optical coherence tomography (OCT).

Methods: We analyzed 83 plaques from 33 stable angina patients who underwent both CCT and OCT. CAC density was measured at calcium plaques with ≥90 Hounsfield units (HU) and ≥130 HU using custom CT software. The correlation between median CAC density and OCT-derived calcium size (thickness and area) was assessed. To investigate whether median CAC densities measured at the 90 HU threshold were associated with plaque vulnerability, OCT-derived plaque characteristics and HRP characteristics were compared between the low (90-129 HU), intermediate (130-199 HU) and high (≥200 HU) CAC HU groups.

Results: Median CAC densities at 130 HU were moderately associated with calcium thickness (R = 0.573, p < 0.001) and area (R = 0.560, p < 0.001). Similar results were observed at 90 HU (thickness, R = 0.615, p < 0.001; area, R = 0.612, p < 0.001). Among groups with low, intermediate and high HU levels, calcium thickness (0.42 ± 0.14 mm, 0.60 ± 0.17 mm and 0.77 ± 0.19 mm, respectively; p < 0.001) and area (0.55 ± 0.29 mm, 1.20 ± 0.58 mm and 1.78 ± 0.87 mm, respectively; p < 0.001) were significantly greater in the high HU group. HRP characteristics, however, did not differ among the three groups.

Conclusions: OCT-derived calcium size, but not HRP characteristics, were associated with CAC density, suggesting that CAC density is driven mainly by calcified plaque size but not local plaque vulnerability.
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http://dx.doi.org/10.1016/j.atherosclerosis.2020.08.010DOI Listing
October 2020

Pregnancy in GNE myopathy patients: a nationwide repository survey in Japan.

Orphanet J Rare Dis 2020 09 11;15(1):245. Epub 2020 Sep 11.

Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry (NCNP), 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8502, Japan.

Background: GNE myopathy is an autosomal recessive adult-onset distal myopathy. While a few case reports have described the progression of GNE myopathy during pregnancy, to our knowledge, none have examined disease progression after delivery or obstetric complications.

Objective: This study aimed to reveal maternal complications, newborn complications, and the impact of pregnancy on disease progression in GNE myopathy patients.

Methods: We conducted a questionnaire survey on pregnancy, delivery, and newborns involving female GNE myopathy patients who are currently registered in a national registry in Japan.

Results: The response rate for the questionnaire survey was 60.0% (72/120). Of the 72 respondents, 44 (61.1%) had pregnancy experience (average, 1.8 pregnancies; 53 pregnancies before onset and 28 after onset). The incidence of threatened abortion was 26.9% among post-onset pregnancies, which was higher compared to those of the general Japanese population (p = 0.03). No other maternal or infant complications were commonly observed. Over 80% were unaware of changes in disease progression during pregnancy (mean age, 32.8 ± 3.5 years) or after delivery (32.9 ± 3.8 years), while 19.0% experienced disease exacerbation within a year after delivery (30.0 ± 1.0 years). Six patients developed myopathy within a year after delivery (29.7 ± 4.6 years), while none developed myopathy during pregnancy.

Conclusions: There were no serious maternal or newborn complications, and subjective progression did not differ during or after delivery in the majority of GNE myopathy patients. However, our findings suggest the importance of considering the possibility of threatened abortion and disease progression after delivery.
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http://dx.doi.org/10.1186/s13023-020-01487-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7488253PMC
September 2020

Development and validation of the hypersomnia-specific beliefs scale.

Sleep Med 2020 11 13;75:256-262. Epub 2020 Jun 13.

Institute of Neuropsychiatry, Seiwa Hospital, Tokyo, Japan; Sleep Disorders Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.

Objective/background: Patients with Central hypersomnia, especially Narcolepsy type 1 and Idiopathic Hypersomnia (NT1 and IHS) often have psychological frustration in their daily lives. We aimed to develop the first scale of hypersomnia-specific beliefs (HSB).

Patients/methods: We developed the HSB scale consisting of three factors ("aversion toward doze", "hypersensitivity toward others" reactions about my doze", and "sense of defeat caused by doze") with 12 items through interviews to 11 patients with NT1 and IHS. Validity and reliability of the HSB were evaluated cross-sectionally with 166 patients with NT1 and IHS and 375 controls. Simultaneously, scores of patient health questionnaire -2(PHQ-2), mini-Social Phobia Inventory (mini-SPIN), and Epworth Sleepiness Scale (ESS) were obtained.

Results: This 3-factor model had enough fitness (χ2 = 60.25, df = 51, p = 0.18, TLI = 0.99, CFI = 0.99, RMSEA = 0.03), Cronbach's α coefficient being 0.90. The intraclass correlation coefficient was 0.76. Also, the area under the receiver operating characteristic curve (AUC = 0.88) confirmed good discrimination ability. A cut-off score of 38 resulted in a sensitivity of 90% and a specificity of 75%. Multiple linear regression analyses showed that these scales were independently associated with the HSB score; the PHQ-2 (β = 0.24, p = 0.002), mini-SPIN (β = 0.29, p < 0.001) and ESS (β = 0.15, p = 0.048).

Conclusions: Our data suggest that the HSB scale measured beliefs in NT1 and IHS patients with good validity, reliability, and discrimination ability. The HSB scale assesses the negative beliefs specific to patents with NT1 and IHS. This scale could be applied to the development of novel psychotherapeutic approach to patients with NT1 and IHS.
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http://dx.doi.org/10.1016/j.sleep.2020.06.012DOI Listing
November 2020

Heart Rate After Resuscitation From Out-of-Hospital Cardiac Arrest due to Acute Coronary Syndrome Is an Independent Predictor of Clinical Outcome.

Circ J 2020 03 18;84(4):569-576. Epub 2020 Feb 18.

Department of Cardiovascular Medicine, Toho University Graduate School of Medicine.

Background: Heart rate (HR) is a useful predictor of cardiovascular disease, especially in acute coronary syndrome (ACS). However, it is unclear whether there is an association between HR and clinical outcomes after resuscitation from out-of-hospital cardiac arrest (OHCA) due to ACS. The aim of this study was to investigate the impact of HR on clinical outcome in individuals resuscitated from OHCA due to ACS.Methods and Results:Data from 3,687 OHCA patients between October 2002 and October 2014 were retrospectively analyzed. We divided 154 patients diagnosed with ACS into 2 groups: those with tachycardia (HR >100 beats/min, n=71) and those without tachycardia (HR ≤100 beats/min, n=83) after resuscitation. The primary endpoint was 1-year mortality and the secondary endpoint was neurological injury at discharge according to cerebral performance category score. Overall, mean HR was 95.6 beats/min. There were several significant differences in patient characteristics, indicating poor general condition of patients with tachycardia. Mortality at 1-year was 41.6%, and neurological injury at discharge was observed in 44.1% of individuals. In the multivariate analysis, tachycardia after resuscitation was an independent predictor of both 1-year mortality (hazard ratio, 2.66; 95% CI: 1.20-5.85; P=0.03) and neurological injury at discharge (odds ratio, 2.65; 95% CI: 1.27-5.55; P=0.04).

Conclusions: In patients who recovered from OHCA due to ACS, tachycardia after resuscitation predicted poor clinical outcome.
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http://dx.doi.org/10.1253/circj.CJ-19-0836DOI Listing
March 2020

Study protocol for a nationwide questionnaire survey of physical activity among breast cancer survivors in Japan.

BMJ Open 2020 01 20;10(1):e032871. Epub 2020 Jan 20.

Division of Health Care Research, Center for Public Health Sciences, National Cancer Center Japan, Tokyo, Japan

Introduction: A major concern is that few cancer survivors meet the guidelines for recommended levels of physical activity. No studies have investigated physical activity among breast cancer survivors nationwide in Japan. Therefore, the aims of this study are to identify the levels of physical activity among breast cancer survivors, to examine factors-related physical activity among breast cancer survivors and to identify breast cancer survivors' preferences for and interest in exercise programmes in order to inform the future programme development.

Methods And Analysis: We will administer a cross-sectional survey using a self-report questionnaire to breast cancer survivors. At each of 50 facilities selected to include a variety of institutional backgrounds according to the population distribution of different regions throughout Japan, we will consecutively distribute the questionnaire to 30 outpatients who have completed initial treatments, except for hormone therapy. The target sample size is 1500 survivors. We will calculate descriptive statistics for each measurement item and perform univariate and multivariate analyses using outcome measures (eg, physical activity and quality of life) related to physical, psychological, social and environmental factors.

Discussion: This is the first nationwide survey of physical activity levels among breast cancer survivors in Japan. Identifying the factors associated with physical activity will help us to develop, disseminate and implement programmes that encourage more survivors to adhere to physical activity guidelines.

Ethics And Dissemination: The protocol was approved by the Institutional Review Board (IRB) of the National Cancer Center on 11 January 2019 (ID: 2018-295). In addition, many of the participating facilities required ethical approval from their local IRBs, while others did not. Accordingly, approval from the local IRBs of individual facilities was obtained when required. The findings will be disseminated through peer-reviewed publications and conference presentations.
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http://dx.doi.org/10.1136/bmjopen-2019-032871DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7044853PMC
January 2020

Pilot Validation Study of the Japanese Translation of the Brief Negative Symptoms Scale (BNSS).

Neuropsychiatr Dis Treat 2019 23;15:3511-3518. Epub 2019 Dec 23.

Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan.

Purpose: The brief negative symptoms scale (BNSS) is a concise instrument used to assess negative symptoms of subjects with schizophrenia covering five domains of negative symptoms and is suitable for use in clinical, experimental, and epidemiological settings. The original and translated version of BNSS has thus far been shown to have adequate psychometric properties. This study aimed to examine internal consistency, inter-rater and test-retest reliability, discriminant and convergent validity, and factor structure of the Japanese version of BNSS.

Patients And Methods: The assessment was performed by 11 raters using interview videos of nine subjects. Reliability was calculated with Cronbach's alpha for internal consistency and intra class correlation coefficient (ICC) for inter-rater reliability. Pearson's correlation coefficients were calculated to estimate the test-retest reliability. In addition to BNSS, Scale for assessment of negative symptoms (SANS) and scale for assessment of positive symptoms (SAPS) was obtained to assess the convergent and discriminant validity. Factor structure was assessed using principle factor analysis.

Results: The Japanese BNSS showed excellent internal consistency (Cronbach's alpha=0.95), inter-rater reliability (intra class correlation coefficient=0.97), and test-retest reliability (r=0.94, p<0.001). The convergent validity shown by correlation with SANS total score (r=0.87, p<0.001) and discriminant validity shown by correlation with SAPS total score (r=0.17, p=-0.68) were also good. Principal factor analysis revealed a two-factor structure of BNSS, although the loading of each item differed from that in the literature.

Conclusion: Our pilot study demonstrated that Japanese BNSS had good psychometric properties which were achieved with relatively brief training. Further studies with more subjects and raters with various backgrounds recruited from multiple sites are warranted.
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http://dx.doi.org/10.2147/NDT.S237449DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6934108PMC
December 2019

National database study on the use of long-acting antipsychotic injections and hospital readmission proportions in patients with schizophrenia in Japan.

Psychiatry Clin Neurosci 2020 Mar 3;74(3):211-217. Epub 2020 Feb 3.

Department of Mental Health Policy, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.

Aim: It is important to investigate the current prescription status and clinical outcomes of patients with schizophrenia receiving long-acting antipsychotic injections. We aimed to determine the prescription proportion of long-acting antipsychotic injections and hospital readmission proportions of patients with schizophrenia in Japan.

Methods: An open dataset was created using data from the National Database of Health Insurance Claims and Specific Health Checkups of Japan. Patient records with the term 'schizophrenia' were included. In Analysis 1, antipsychotic prescription proportions were determined for outpatients who had visited psychiatric facilities between 1 February 2015 and 31 March 2017. In Analysis 2, patients who had been discharged from a psychiatric facility and had received a long-acting antipsychotic injection prescription within 90 days after initial discharge were selected; then, their readmission proportion was examined for 365 days after the initial discharge.

Results: The long-acting antipsychotic injection prescription proportion was 3.5% for outpatients with schizophrenia receiving antipsychotics. The readmission proportion was 41.0% in the entire patient population, 36.2% in patients receiving typical long-acting antipsychotic injections alone, and 23.5% in patients receiving atypical long-acting antipsychotic injections alone.

Conclusion: Long-acting antipsychotic injections are not yet widely used in Japan. The readmission proportion was lower in the patients receiving atypical than typical long-acting antipsychotics injections. The results may provide important basic information to develop new future research questions but should be interpreted with caution because generalizability may be limited by the use of aggregated data and the data structure of the database used.
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http://dx.doi.org/10.1111/pcn.12970DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7065150PMC
March 2020

The olfactory basis of orchid pollination by mosquitoes.

Proc Natl Acad Sci U S A 2020 01 23;117(1):708-716. Epub 2019 Dec 23.

Department of Biology, University of Washington, Seattle, WA 98195;

Mosquitoes are important vectors of disease and require sources of carbohydrates for reproduction and survival. Unlike host-related behaviors of mosquitoes, comparatively less is understood about the mechanisms involved in nectar-feeding decisions, or how this sensory information is processed in the mosquito brain. Here we show that spp. mosquitoes, including , are effective pollinators of the orchid, and demonstrate this mutualism is mediated by the orchid's scent and the balance of excitation and inhibition in the mosquito's antennal lobe (AL). The orchid emits an attractive, nonanal-rich scent, whereas related species-not visited by mosquitoes-emit scents dominated by lilac aldehyde. Calcium imaging experiments in the mosquito AL revealed that nonanal and lilac aldehyde each respectively activate the LC2 and AM2 glomerulus, and remarkably, the AM2 glomerulus is also sensitive to N,N-diethyl-meta-toluamide (DEET), a mosquito repellent. Lateral inhibition between these 2 glomeruli reflects the level of attraction to the orchid scents. Whereas the enriched nonanal scent of activates the LC2 and suppresses AM2, the high level of lilac aldehyde in the other orchid scents inverts this pattern of glomerular activity, and behavioral attraction is lost. These results demonstrate the ecological importance of mosquitoes beyond operating as disease vectors and open the door toward understanding the neural basis of mosquito nectar-seeking behaviors.
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http://dx.doi.org/10.1073/pnas.1910589117DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6955360PMC
January 2020

Frailty and coronary plaque characteristics on optical coherence tomography.

Heart Vessels 2020 Jun 21;35(6):750-761. Epub 2019 Dec 21.

Department of Cardiovascular Medicine, Toho University Faculty of Medicine, 6-11-1 Omorinishi, Ota-ku, Tokyo, 143-8541, Japan.

The relationship between frailty and plaque characteristics is unclear and was investigated by optical coherence tomography (OCT) in this study. One hundred and four patients undergoing OCT before percutaneous coronary intervention were evaluated. Frailty was defined as a clinical frailty scale score of ≧6. Frailty was found in 16% of the patients (17/104). Compared with the nonfrail patients, frail patients showed significantly lower body mass index (BMI; 20.8 ± 4.0 kg/m vs. 25.0 ± 3.9 kg/m, P < 0.001), less dyslipidemia [47% (8/17) vs. 75% (65/87), P = 0.023], lower triglycerides levels (95 ± 42 mg/dL vs. 147 ± 81 mg/dL, P < 0.001), less use of statin [29% (5/17) vs. 60% (52/87), P = 0.021], more lipid-rich plaque [82% (14/17) vs. 46% (40/87), P = 0.006] on OCT, more thin-cap fibroatheromas [TCFAs; 71% (12/17) vs. 26% (23/87), P < 0.001], more plaque rupture [53% (9/17) vs. 25% (22/87), P = 0.023], and significantly higher adverse clinical outcomes (death, acute myocardial infarction, acute heart failure, acute coronary syndrome, or target lesion revascularization) [24% (4/17) vs. 6% (5/87), P = 0.007]. The multivariable analysis showed that frailty was one of the independent predictors of TCFAs (odds ratio 8.95, 95% CI 2.40-33.32, P = 0.001). In conclusion, frailty was associated with high plaque vulnerability due to more lipid-rich plaque, TCFAs and plaque rupture on OCT regardless of low BMI, less dyslipidemia and low triglycerides levels, and frail patients had higher adverse clinical outcomes.
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http://dx.doi.org/10.1007/s00380-019-01547-2DOI Listing
June 2020

Developing the structure of Japan's cancer survivorship guidelines using an expert panel and modified Delphi method.

J Cancer Surviv 2020 06 6;14(3):273-283. Epub 2019 Dec 6.

St. Luke's International Hospital, 10-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan.

Purpose: To develop consensus-based components used in the first evidence-based cancer survivorship guidelines in Japan.

Methods: Purposive sampling was used to recruit a panel of experts in oncology clinical practice, nursing, health science, epidemiology, and patient advocacy. The panel engaged in a modified Delphi process to (1) generate consensus related to the definition of survivorship, (2) determine the aim and target users of the guideline, and (3) identify clinical issues for inclusion. A Web-based survey and panel meeting were conducted to obtain the panelists' feedback on the initial draft proposed by the secretariat. Multiple online votes were then completed until all elements of the proposed guidelines reached an approval rate of 80% or higher. Following each round, iterative refinements were made based on all panelists' feedback.

Results: Twenty-two experts were enrolled in the panel and participated in four rounds of online voting and two face-to-face meetings. Ultimately, the panel reached consensus on the definition of survivorship, the aim of the guidelines, and target users. Moreover, 11 of the original 17 clinical issues were retained. Finally, the panel selected two priority areas to implement immediately.

Conclusion: The panel's consensus on the definition of survivorship, aim and target users of the guideline, and 11 clinical issues will serve as a compass for the development of comprehensive cancer survivorship guidelines in Japan.

Implications For Cancer Survivors: A culturally sensitive consensus approach was developed to improve the long term health and well- being of cancer survivors in Japan.
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http://dx.doi.org/10.1007/s11764-019-00840-3DOI Listing
June 2020

Effect of home-based high-intensity interval training and behavioural modification using information and communication technology on cardiorespiratory fitness and exercise habits among sedentary breast cancer survivors: habit-B study protocol for a randomised controlled trial.

BMJ Open 2019 08 22;9(8):e030911. Epub 2019 Aug 22.

Division of Health Care Research, Center for Public Health Sciences, National Cancer Center Japan, Tokyo, Japan

Introduction: Maintaining high levels of physical activity helps to maintain and improve physical health and quality of life, and plays a role in reducing adverse effects due to cancer treatments. Moreover, a greater degree of cardiorespiratory fitness is associated with reduced risk of all-cause mortality. However, there are no home-based programme for improving cardiorespiratory fitness using body weight exercises for breast cancer survivors. This study will assess the efficacy of the newly developed habit-B programme on maximum oxygen uptake compared with treatment as usual with wearable device. The effects of this programme on exercise habits, level of physical activity, physical fitness and subjective indices will also be investigated.

Methods And Analysis: This is a 12-week, parallel-group, single-blind, randomised controlled trial. Allocation will be managed by a central server using a computer-generated random allocation sequence provided by an independent data centre. Participants will be assigned to the habit-B programme (high-intensity interval training, exercise counselling + guidance, home-based exercise support using information and communication technology, and a wearable device) or treatment as usual with a wearable device. Subjects will be sedentary women aged 20-59 years who have received breast surgery in the past 2-13 months after the diagnosis of invasive breast cancer (stages I-IIa) and have never received chemotherapy except for hormone therapy. The primary endpoint is the change in peak oxygen uptake (VO; mL/kg/min) between the groups after 12 weeks of intervention.

Ethics And Dissemination: The study protocol was approved by the Institutional Review Board of the National Cancer Center Japan on 28 February 2019 (ID: 2018-347). The findings will be disseminated through peer-reviewed publications and conference presentations.

Trial Registration Number: UMIN000036400.
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http://dx.doi.org/10.1136/bmjopen-2019-030911DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6707761PMC
August 2019

Serum polyunsaturated fatty acids and risk of psychiatric disorder at 6 months after acute coronary syndrome: A prospective cohort study.

Prostaglandins Leukot Essent Fatty Acids 2019 10 3;149:18-23. Epub 2019 Jul 3.

Division of Health Care Research, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; Lifestyle Medicine, Cooperative Graduate Program, The Jikei University Graduate School of Medicine, Tokyo 105-8461, Japan. Electronic address:

Cardiovascular disease is a known risk factor for the development of psychiatric disorder and about 20% of patients with acute coronary syndrome (ACS) develop depression. Our previous prospective study showed that serum linoleic acid (LA) level at baseline (admission) is a risk factor for the development of psychiatric disorder 3 months later. However, it was unclear whether serum LA could predict psychiatric disorders after 3 months. Thus, we examined the effects of polyunsaturated fatty acid (PUFA) levels at ACS onset on comorbid psychiatric disorders at 6 months. The study involved a follow-up investigation of the previous prospective cohort study of ACS patients. The sample with complete participant data at 6 months post-ACS comprised 100 patients. On admission, serum n-3 and n-6 PUFA levels were measured by gas chromatography and patients were interviewed to obtain medical information. Eight patients (8%) showed psychiatric disorder at 6 months. The association between psychiatric disorder and serum PUFA concentrations at ACS onset was examined by multivariable logistic regression analysis. Psychiatric disorders were predicted by baseline serum LA level (odds ratio = 7.27, 95% confidence interval = 1.11-47.76), indicating that it is a significant risk factor for the development of psychiatric disorder at 6 months. Thus, dietary education to reduce the intake of LA-containing foods might be useful for preventing psychiatric disorder in the population at high risk for ACS. However, the prevalence of psychiatric disorder, particularly depressive disorder, may have been too low to identify significant differences in PUFA analysis.
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http://dx.doi.org/10.1016/j.plefa.2019.07.002DOI Listing
October 2019

Expectations of and recommendations for a cancer survivorship guideline in Japan: a literature review of guidelines for cancer survivorship.

Jpn J Clin Oncol 2019 Sep;49(9):812-822

Behavioral Science and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center Japan, 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan.

Background: Optimal cancer survivorship care needs its comprehensive guidelines. We aimed to identify English and Japanese guidelines that include cancer survivorship in their title, the issues highlighted in such guidelines, and any existing oncology practice guidelines in Japan that address these issues.

Methods: This literature review was performed in three stages. First, guidelines published in English or Japanese that included cancer survivorship in the title were identified. Then, the issues that each cancer survivorship guideline addressed were defined. Lastly, Japanese guidelines that include survivorship issues were sought.

Results: Six guidelines published in English addressed 31 cancer survivorship issues. No specific cancer survivorship guideline was available in Japanese. Thirty-four Japanese guidelines mentioned cancer survivorship issues. These guidelines addressed screening/surveillance for detecting recurrence or secondary cancer but did not address coordination of care, implications for practice, or inclusion of family. At present, Japanese guidelines poorly address the issue of promotion of a healthy lifestyle in cancer survivors. Also, poorly addressed were long-term and late effects such as pain, psychological distress, fatigue, cognitive dysfunction, cardiovascular effects (including anthracycline-induced cardiac toxicity), sleep disorders, and sexual dysfunction in cancer survivors.

Conclusion: There is a need for guidelines on optimal coordination of care between oncologists and other health care providers to support patients along the cancer care continuum and specifically to encourage a healthy lifestyle as part of cancer survivorship. The development of a comprehensive Japanese guideline that addresses these issues would help to improve the clinical outcome for cancer survivors in Japan.
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http://dx.doi.org/10.1093/jjco/hyz070DOI Listing
September 2019

Diet quality and depression risk in a Japanese population: the Japan Public Health Center (JPHC)-based Prospective Study.

Sci Rep 2019 05 9;9(1):7150. Epub 2019 May 9.

Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center Japan, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.

The association of overall diet quality based on the Japanese Food Guide Spinning Top with risk of depression is not known. This prospective cohort study aimed to determine whether higher adherence to the Japanese food guide reduced the risk of depression. Of 12,219 residents enrolled at baseline, we extracted 1,112 participants who completed a 5-year follow-up (1995) and participated in a mental health screening (2014-2015). Diet quality was scored based on adherence to the Japanese food guide and the ratio of white to red meat according to the Alternative Healthy Index and ranged from 0 (worst) to 80 (best). We calculated odds ratios and 95% confidence intervals for current psychiatrist-diagnosed depression per quartile of total score and of eight component scores with the lowest quartile as reference. Mean age of the participants was 73 years and 59% were women. Total diet quality score was not significantly associated with risk of depression 20 years after the baseline assessment. Among the eight components on the diet quality score, there was a significantly reduced risk for the highest quartile of the white to red meat ratio score. In conclusion, our results do not indicate that higher adherence to the Japanese food guide prevents depression.
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http://dx.doi.org/10.1038/s41598-019-43085-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6509323PMC
May 2019
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